I did two things last week which at first seemed unrelated. First, I finished reading the book The Checklist Manifesto by Atul Gawande. Second, I attended a roundtable discussion on the topic of utilization management, with a focus on the history and use of pre-authorization. In The Checklist Manifesto, Gawande describes his quest to increase … Continue reading How do we manifest the checklist?
A police officer arrests the same person dozens of times in order to make an arrest quota. A bank employee opens accounts for customers without their permission because of a cross selling incentive. A teacher helps students cheat in order to improve tests scores so that the school will receive more funding. What's happening in … Continue reading Metrics as judgments
Even well intentioned leaders can sometimes use questions that break down a team rather than build it up. One of these question types I call the trap, and the other is the treasure hunt. The trap works like this. You ask someone a question, expecting that they will get it wrong, so that you can say … Continue reading The trap and the treasure hunt
In the movie The Terminator, Reese, the bodyguard from the future, talks about how the machines took over: "Defense network computers. New... powerful... hooked into everything, trusted to run it all. They say it got smart, a new order of intelligence. Then it saw all people as a threat, not just the ones on the … Continue reading The Problem with Terminators