Value hidden in plain view
Everyone is supposed to be creating value now. Those who aren’t in bullshit jobs (David Graeber) that seem to be there to keep them appearing to be employed. These blogs have been exploring what realities those sorts of statement can live in. I want first to consider Conway’s Law. Here is the Wikipedia entry:
“organizations which design systems … are constrained to produce designs which are copies of the communication structures of these organizations.”
— M. Conway
Not only do organisations tend to hire people who are like the people who already work there, but they can only reproduce in their work any dysfunction in communication patterns that already exists. This seems to constrain the ability to learn to things that are not significant cybernetically speaking. Double loop learning where it might concern how to get at new sources of value is off the menu. Is that your experience: that in terms of how things work we repeatedly fail to learn or innovate?
I am setting out when writing, not to accentuate the positive and all that ra-ra that makes my flesh creep, but to say clearly where we do not have to stay stuck wasting the talents and goodwill of ourselves and our colleagues. When we use patterns of communication that didn’t work well last time or the time before, what are we saying? So: what would it be like to be in an organisation (or just think of it as a group of motivated colleagues) that did not get stuck with communication structures that did not work? Or to go up a level: how might people of good heart and good spirit access sorts of value that are hidden in plain view?
Just to be ever so plonky and concrete for a moment, probably the central construct where we would like not to be bound by Conway’s Law is the contract. A contract tries to package up and define all the things that I want you to do for me, and in return what I need to do for you including often paying you. The standard thinking about a contract, and it is thinking where Conway’s Law grips the road, is that we know beforehand what is needed, where value for me is going to come from, so that learning on the way is not needed or even wanted.
There are contracts under the branding of JCT (Joint Contracts Tribunal — you can see where this goes!) that can be used to do a bit better in the domain of construction. A wonderful mate of mine, Vassos Chysostomou, explained to me about the building of the athletes’ village in Stratford for the Olympics. The athletes must not be allowed to source their own food, so the kitchens in all the flats were built and then walled up for the games, before being revealed again for purchasers. You can see that someone understood a dimension of cost and value in this, and everything was built on time. You could also have a look at a recent case study in Old Street here (https://corporate.jctltd.co.uk/white-collar-factory/) where a whole prototype building was constructed for £1M before the real building was attempted, to get a grip on some important learning about the behaviour of the finished factory.
What I am looking for in these examples is a sense that if you want something more or different to what you are going to get anyway, you have to work into the planning a sense of where extra value might be found, and how it might be discovered and then how it can be acted upon amongst the set of people and institutions involved. I hope it is obvious from this last sentence why it doesn’t happen much. Equally you can get it wrong. If you remember the initial baggage handling chaos at Heathrow Terminal 5, another mate of mine, Martin Thomas, had tried to express to the client from day one that baggage handling was on their critical path. He knew five years ahead that it was going to be chaos. The relevant learning was never scheduled in. We don’t so much fail to create value as positively throw away the opportunities.
More than one dimension
These blogs have a default context of health but not healthcare as we know it. Health is naturally integrative. People do not have a list of dysfunctions to be ticked off like servicing a car. I think the basic dimensions in “integrative health care” are thought to be
· Primary and acute healthcare
· Healthcare and social care
· Physical and mental health
That is to say that for the patient these are all of a piece: they are only divided up for management reasons and the division can create more problems than it solves. These are the sites of management throwing away value.
When we think again about value hidden in plain view it is the way we fragment the world that stops us seeing the rather obvious things that need to happen. The most obvious of these obvious things is that an informed, educated patient able to make real choices about their own long term conditions and treatment generates huge value for the patient and all those collaborating in their treatment. Despite many brilliant and compelling examples this is still rare.
The structure of healthcare institutions is still overwhelmingly patriarchal, despite plenty of female senior managers. The way communication happens, as Conway wants to know, is a patriarchal pattern of deference. Conway is telling us that while this is the case, there will be no discovery of value that implies a more networked sense of communication. While the Department of Health issues edicts, work practices that subvert those edicts will not flourish. Worse than that, it is known that the narrowness and lack of imagination of the edicts will increase the more they are challenged, the opposite of the intention of a JCT construction contract.
Informed patients gives us one dimension. The short list of necessary integrations above gives us three more even before we decompose those axes into actual institutions who may, if the structure is right provide elements of value that seriously enhance the whole. And we need to notice that different types of player will typically have different sorts of value that are important to them. For instance, patients may be healed by the aesthetic of the care situation, and professional practitioners may want to track the evidence base for an intervention.
In any health intervention we need to be concerned about wholeness in many dimensions because wholeness IS health. Or to use the inversion we are insisting on in this blog, there are many types of value for many people and institutions that can enhance the intervention is we make space for that to happen. And those extra bits of value are what will stabilise the specific situation if things do not unfold the way we (arbitrarily) think they will.
An architectural view
This blog is in danger of becoming a checklist of my colleagues, but I want to give a hat tip as well to Alex Hough who is concerned with placemaking. A place, a town or village for instance, cannot thrive as a single function. It has to have a range of shops that are attractive in their own right but also complement each other in some informal way. Not just shops of course: the arts, services of all sorts, and the overall ambience and aesthetic.
Prince Charles’ mate Christopher Alexander, a wonderfully inspiring and broad ranging architect, talks about how a new building in a street should enhance the street, perhaps especially in the quality of the street as public space. The things that enhance a street have to be different from each other and eclectic. This of course is the placemaking view. And of course the types of value that are introduced in the mix are as wide-ranging as possible in order to enhance the place and the number of different sorts of people and the number of different social roles that it can cater to. If you try to maximise some notion of value from a particular perspective (perhaps especially the responsible client perspective) none of this works. Here is Russ Ackoff:
“The more managers try to get rid of what they don’t want, the less likely they are to get what they do want.”
We can now ask a better question about contracts: how do I run this contract to increase the chances that complementary things happen which will make my contract more successful? The key step is to notice that we are starting to pay attention to things that are not in our scope or our gift but still can make all the difference. Complementary things are going to involve stakeholders for this contract also being stakeholders for other work. Suppose the cohort of patients our contract is an intervention for also start some sort of peer-support group that strengthens their understanding and their voice?
We have reached, via this series of scenarios and illustrations, the edge of Conway’s Law. We can only do what we understand in the way of communication patterns but we can research the ecosystem we are part of to understand the many different patterns it encompasses. The ways in which coyotes and rattlesnakes are different are myriad, and they each have their place in a shared ecosystem and each depend on the services in that ecosystem to be diverse and robust. We can become aware of all the ways we can be more successful and add many more different sorts of value if we are ourselves enhancing the way the ecosystem works and not simply doing local maximisation.
The site of our work has to be seen to a place where many different people want to contribute and a place that we are actively trying to enhance. If we have management systems (and we do) that are trying to limit the degree to which people can benefit from the work that is going on if they are not part of the scope and the plan then value will stay hidden in plain view. We have to be prepared to exchange focus for abundance and not worry too much about what is fair.
The g-word
How do you get organised to take up the chances life throws? When we stop thinking about how to deliver exactly what the contract states, knowing it will be out of date by the time we do, and start thinking about working with divers stakeholders who we cannot command, to do exciting things that define the future? What does governance mean when it is not about compliance?
In ecosystem terms, a particular species needs to do two potentially contradictory things: it needs to remain itself, reliably occupying its niche in the ecosystem, and it needs to change or evolve to meet changes in that niche. It can fail to be viable in two ways: by changing when it shouldn’t have or by not changing when it must. Contrary to much of the evolution literature this is a multi-dimensional problem of the sort we have been discussing. At the very least, every organism changes (or stabilises) its environment at the same time as changing itself. However, the number of connections to other organisms and processes that have a significant effect on the outcomes is potentially huge. No species is an island: all have symbionts and depend on DNA that is not their own. We do our biology wrong because we do our economics wrong.
In this frame the governance problem can be seen as pursuing a changing meaning of success in a changing landscape. Somehow an initiative needs to both discover how the world is changing and to change the world in ways that are going to stabilise and make the problem tractable. The means there is some core identity things that need to remain constant while there is potentially very rapid learning that keeps that core identity relevant. Nothing can be completely depended on in this picture and everything is vital.
There are cybernetic models that address this problem and they take their cues from bio-mimicry: this is the governance structure that allows living organisms like ourselves to remain viable over a very wide range of conditions. At its most visceral, governance is about making sure the model that keeps us alive keeps on working. Even giant corporations like Kodak can fail very quickly when this is no longer true, but we are focused on the other side of the coin: where are all these changing sources of value that are the very stuff of successful survival?
When these issues are discussed, and that is already rare, the word autonomy crops up. I need to be autonomous to do what needs to be done in the moment and in the particular circumstances. The meaning of the situation I am in is a product of that local context, not what some budget holder or contract manager says it is. Part of what I bring to that situation is a sense of the needs of the organisation I work for and through: it is precisely the creativity in that conjunction that we are discussing in this blog.
There are well understood ways of mapping out how the world we are delivering into is changing, of debating the changes that the environment implies for the sorts of value we are now trying to create, and getting re-organised to create that value in the new situation. Remember the magical talk that Muhammad Yunus, the founder of microfinance gave:
“Its easy. Just look at everything the banks do around lending and do the exact opposite”
Just take everything a cost-accountant and a project manager would do and understand why you should be doing the reverse.
