Ontario healthcare musings

I just came back from an event with Ontario Health Minister Deb Matthews. It was a great event with a Q&A format, that encouraged some discussion. Here are some musings about Ontario’s health care system:

  • There is a great organization called Rise Asset Managment that helps people with mental health issues get mentoring and start new businesses.
  • Minister Matthews plan of the “right care at the right time in the right place” is a simple way of stating a very complex issue. It is the right plan.
  • There are great initiatives being embarked upon by healthcare providers around the issue of engaging patients. Some of the stories and impacts were amazing.
  • Most providers are recognizing the need to bring patients into major decisions, including the construction of new buildings and department layouts.
  • Industry suppliers are being left out of the conversation somewhat. We need to find a way to leverage their experiences in other provinces and organizations, without affording an advantage when trying to win business. Is that even possible or desirable?
  • We have finally passed the tipping point and realized that healthcare needs to adopt some basic business principles. Dealing with patient issues well creates more loyalty and a better experience. Asking the customer (patient) to be engaged in strategic decisions improves performance. Looking at new innovations can save lives. Reviewing internal operations can increase effectiveness. Aligning strategy and tactics and communicating that effectively improves performance. It’s all about operational excellence.
  • We have patient navigators at some hospitals, but who will navigate the patient through their whole spectrum of care, both inside and outside the hospital? If the answer is the patient, then let’s develop tools to help patients do that.
  • Communication can be a big issue for patients who don’t speak English or French. Why doesn’t every hospital have translators on site or available, either through a central service or through volunteers?

Miller’s Monday Morning Message

Andrew MillerMiller’s Monday Morning Message
presented by ACM Consulting Inc.

Andrew Miller on operational excellence, strategy, life balance and everything in between

Toronto – September 30, 2013
This weekend I completed the Tough Mudder challenge. A series of military style obstacles set out over a tough, hilly course. This challenge is both physical and mental, as you spend hours climbing up and down ski hills, hurtling yourself over barriers, jumping into ice baths, crawling through mud, and climbing over walls. It was an amazing and unique experience.
What was most amazing was the sense of community one had with the other challengers taking part. Since this was not a race. Teamwork and camaraderie were the key focus of the event. People were always pumping each other up, cheering each other on, and helping each other get over the various obstacles. Everyone was there to support everyone else and get them through the challenge. That is what a community is supposed to be.
This is unlike a more recent example in my neighbourhood where people are trying to set up an online community to share information. The problem is that some people use it for their own gain, or their own amusement. There is a lot of insulting comments made, some even bordering on inappropriate. People are hesitant to make comments and others avoid the online community altogether.
So why does one community work and the other doesn’t?
Here’s what makes a successful community:
  • The community members have a common goal (business improvement, good education for kids, neighbourhood safety, completion of a challenge, and so on).
  • There are people in the community who help facilitate the development of the community.
  • The members of the community have each others best interests in mind, not their own individual interests.
  • There is a level of trust amongst community members and they share information and ideas openly.
  • The community provides more value collectively than the members of the community would achieve on their own.
  • The community members attract other like-minded people to join the community and add even more value.
I am now a proud member of the Tough Mudder community, and look forward to next year.
If you would like to see pictures from the event, click here.
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© Andrew Miller. All rights reserved. 2013.

Completing the Tough Mudder challenge

On Saturday, I completed the Tough Mudder challenge. This challenge is a military style obstacle course set on a ski mountain. I spent four hours running (and walking) up and down ski hills, crawling through mud, climbing over walls, and jumping into cold water. It was one of the greatest experiences of my life. Here are some pictures from the event.

Screaming like a warrior after completing the event.


Walking through the human car wash to get cleaned up.


Donating muddy shoes after the event.



Performing Preventative Maintenance on Your People

We perform preventative maintenance on machines, so why not on people? I know it sounds strange but there are steps we can take to avoid the people problems that every organization encounters. Here are some thoughts.

  • Have regular informal checkins with employees to take the pulse of the organization.
  • Ask your direct reports if there is anything they would like to work on, but haven’t had the opportunity to.
  • Hold casual get togethers regularly with your team to talk specifically about outcomes and how better results can be achieved.
  • Walk around every day and get a sense of what everyone is working on and what kind of support they need.
  • Work on some initiatives directly with your people and give them leadership opportunities. Only then will you know how well they can perform.

Too many organizations only react to people issues, and by then it’s too late. As a manager, you need to understand who is on your team, what their strengths are, and whether or not they have the skills and tools to achieve results.

Performing preventative maintenance on your people can save you from ugly firings, bad hiring, and poor decisions.

Running your own business during a home renovation

We just completed a renovation on our house and I wanted to share some insights on how to run a successful business while you are in domicile limbo, especially for those of us running our own businesses.

  • Create a space that is your own. That may be in a coffee shop or a friend’s basement or renting a small office temporarily, but find a place where you are comfortable and can be productive.
  • Cut yourself some slack, but don’t make excuses. It is more difficult to run a business when you are working from unfamiliar surroundings, but don’t use that as an excuse for not being successful.
  • Figure out what you NEED to run your business successfully and travel with those things. It’s amazing what can be done with a cell phone, a printer/scanner, a laptop and an Internet connection.
  • If you don’t have one already, invest in a good laptop. It makes it easy to work from anywhere.
  • Look at this as an opportunity to reduce infrastructure and overhead.
  • Hire strong people to oversee the other parts of your life and your business (house contractor, web designer, accountant, lawyer) so you can focus on business growth.
  • Take mental breaks. Find a new hobby, take the dog for a walk, exercise….find something you can do regularly to alleviate the stress.
  • Lean on your support system. Being removed from your comfort zone is never easy, so lean on the people around you for support and guidance.
  • Don’t be any different with clients and customers. They don’t care about your living arrangements or personal situation, so don’t look for sympathy. Maintain a positive outlook and continue to help them generate amazing results.
  • Embrace the situation. Life is full of curveballs and getting through this will make you a better and more resilient person. Remember why you decided to do this in the first place.

Going through moves and renovations and house changes is never easy, but there are ways you can mitigate and reduce some of the stress. I hope you have found these helpful.

Are we capable of change?

In Canada, there will be a great deal of change coming our way in the next few years as we begin to introduce privatization into many industries. We have already seen it for some essential municipal services and some basic provincial healthcare services, but soon we will see it on an even larger scale.

One of the biggest hurdles to overcome will be our perception that privatization is a bad thing. We are so used to the government providing us services that we think they are the only providers we should have. Yet at the same time, we complain about the services we are receiving and that our tax dollars are being wasted. Sounds like our expectations and our behaviour is out of whack.

In Ontario, beer sales are already privatized under Brewer’s Retail, which is jointly owned by three private beer companies, yet most people think it is run by the government. There are private healthcare clinics where people can pay for the services that they need. We have public-private partnerships where much of the funding for certain public services is being provided by private companies. Privatization is all around us and should not be a dirty word, when done properly.

With the amount of change we will see in the next few years, the biggest question I ponder is, “Are we capable of making the necessary changes?” For most change initiatives, there are only three groups of people:

  1. The early adopters, who are constantly looking for change and embrace it. These people represent about 20% of any group.
  2. The masses, who will go along with almost any change initiative without much resistance. These people represent about 50% of any group.
  3. The dissenters, who will never embrace any form of change. They represent the remaining 30%.

If you focus on the first two groups, you will be successful. Here are some things we need to work on in order to increase our capability to deal with the coming changes:

  • We need to embrace new ways of operating and let go of the past. Just like a snake sheds its old skin each year, we need to shed our old ways of thinking and doing business. When industries change, the business models within those industries also need to change. Just because something worked in the past doesn’t mean it will continue to work. In fact, most times it won’t.
  • We need to create ambassadors for change and arm them with the tools to help with the transition. Recruit ambassadors from the early adopters group (and you might even get some from the masses) and have them help make the change by supporting their colleagues and developing easier methods for transition. If these ambassadors are chosen appropriately and at all levels, people will follow them.
  • We need to anticipate the risks and take actions to mitigate those risks. There are always going to be risks associated with any change, but we need to identify what the possible risks and roadblocks are and take steps to remove or mitigate them.

Change that is forced from the top-down will never work, but the vision from leadership needs to be clear. There needs to be a clear road map to get from where you are today to where you need to be and set up sign posts along the way for people to follow. If you remove the fear of the unknown, people will be more open to making the necessary change.

The new Global Innovation Index

Cornell University, INSEAD and the World Intellectual Property Organization have recently launched the Global Innovation Index.This new index looks at the university education, patents and publication of scientific research in order to rank different countries and how innovative they are. I think this is a good start in terms of a new index to measure innovation, but there are still some gaps in it.

For starters, the new innovation index only focuses on the top three schools in each country and only focuses on patents in certain countries and specific publications. Everyone seems to have difficulty measuring innovation, but I think we look at innovation the wrong way. We need to remember that innovation can be game changing and disruptive, but it can also be an incremental improvement, and anything in between. This index is really only looking at game changing innovation on a global scale. But what about a country that is great at making incremental improvements and enhancements to things that already exist? Are they any less innovative than another country? According to this index, the answer is yes.

We need to look at innovation as the creation of something productive and useful. Organizations can measure innovation by measuring new ideas and enhancements that have become a commercial success. They can measure the percentage of their revenue represented by those new ideas. Why not look at something similar here? Only looking at the top schools is like an organization measuring innovation purely based on their best ideas and the ones that worked. The index really tells us who has the best ideas from a global perspective, which may or may not equivocate to being the most innovative.

Why not look at how many ideas have been successfully used or put into practice. Or ones that have become commercially viable, or made an improvement somewhere? What’s the point of innovation if it doesn’t make a difference in the way someone does something? Measuring patents is important, but what if those patents never get used? A critical element of innovation is execution. If we only measure the number of ideas, or patents, or citations, then we are only seeing half of the picture. We need to also consider what is being done with those ideas and patents and citations. Are they being turned into something that we can use to improve our lives? Now that’s an index worth reading about.