Category Archives: Economy

How can an Organization ‘Come Alive’ !? Simple Consulting/Learnings from a Cell can help !!

From ‘The Crucibles’ of Justplainandsimple™ Consulting …..

Simplest form of life is a single cell.

It is also works like an organization !? It has a Mission for its Existence and Structure (nucleus, cytoplasm, mitochondria …..) with well defined roles, relationships and boundaries

What makes it alive is the way it organises its ‘life’ processes …..

– Each part works for development, maintenance and regeneration of other parts and of the cell as a whole ….. collaboration

– This is a self perpetuating creative activity of the cell ….. continuity

– It interacts with the environment outside its boundary and ‘adjusts’ internally while maintaining its structure and integrity ….. fluidity and learning

If these are built into the DNA of today’s organizations, it can ‘breathe life’ into so many organisations that can ‘Come Alive’ !!

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‘Breaking News’ brought to you by ‘The Times of Ants’

From The Crucibles of

I go to a park near my house for walks. There is a paved walkway that I use. Very often I notice a colony of ants in some parts of the footpath. They seem busy running around and carrying out their chores/activities. I step aside onto the grass to avoid stepping on the ants, lest they face a man-caused disaster.

A few days back Delhi (and many parts of India) had very heavy rains. Several areas of the city were water logged. Next morning when I went for a walk, the colony of ants was not there. Continue reading →

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Healthcare and Aviation ….. Cross Learnings

From the Crucibles of JPS Customer Value Academy
Just Plain & Simple
….. Helping Create Customer Value
14^th Issue of HEALTH BIZ INDIA magazine, October, 2011

Recently I came across a very interesting article on the net. It was titled ‘Why Patient Safety is harder than aviation safety and five practices to borrow from aviation’. The author argues that there are a lot of learnings that the health care industry could draw from aviation safety and the rigour and discipline that goes into the same. He also mentions that he does not want to oversimplify the comparison and realizes that healthcare is a lot ‘harder’. The basic reason given for this is related to ‘scale’ ….. number of patients vs passengers, number of pilots vs nurses and types of aircraft vs diseases. The practices listed, that play a role in aviation safety and the ones that healthcare could learn from are ….. usability and safety of technology, crew management, simulation, prediction and root cause analysis (and hence open and transparent exchange of data).

While it is true that there is a difference in ‘scale’ and ‘complexity’ in the two cases, the discipline and learnings can and should definitely flow into ‘speciality/superspeciality/critical care’, where the gap of scale reduces and ‘seriousness’ and ‘speed of response’ maybe equally significant ….. It is ironical that aviation is taking lessons from hospitals and hospitality on aspects of care though !!

However, just stepping back to first principles for a moment and correlating the fundamental dimensions where there may be similarities and differences between the two that we can build on, let us look at the following :

Core Deliverables :
- Healthcare : Good clinical/surgical outcomes
- Aviation : On time and comfortable trips

Essentials to build on :
- Healthcare : Patient Care; course/accuracy of treatment; Doctors and staff
- Aviation : Speed/turnaround time; speed of response; Stringent Processes/technology

Performance Metrics :
- Healthcare : Surplus/sq. ft. or Surplus/bed
- Aviation : Surplus/trip

With ‘cost/trip’ more or less ‘fixed’, there is a concerted effort in aviation, to build on passenger numbers and revenue/passenger (Needless to say, there should obviously be no compromise on speed of response and safety).

If healthcare is to come out of this trap (no matter who pays for the treatments) of chasing numbers and revenues to fulfill a ‘fixed cost or unabsorbed capacity’, the answer lies in (Needless to say, with no compromise on clinical/surgical outcomes and patient safety) :

1) Scale to be achieved through creating reach and accessability to broaden the base (and much needed in the Indian context), alongwith

2)‘Disruptive Technologies’ to reduce cost/sq. ft. or cost/bed.

These answers are available in development/deployment of ‘appropriate technology’ (Innovation) and spreading the cost of technology and doctors (per patient or per bed or per sq.ft.) through initiatives like telemedicine (the doctors deserve to be paid competitively, but the cost implication on the ‘metrics’ per unit of patient or sq.ft. or bed gets enormously spread out)

Having said that, the learnings from aviation can and should be very appropriately and immediately applied in all aspects of healthcare where safety and speed of response is critical. There are examples even in healthcare where such rigour and discipline is followed. As the scale, accessability and reach of healthcare increases, learnings, processes and skils from these centres of excellence in health care and for sure even from aviation, should be weaved into the genetic code of patient care at all levels as the wave spreads over time.

Aviation is definitely a good learning ground as the source article I mentioned, says, but even otherwise, a similar discipline is needed in any field, in the evolution from being a novice to eminence ….. and it will be very helpful to the evolving Indian Healthcare industry to adopt the following practices and catch the wave on the high !!

Taking feedback continuously ….. it is said that ‘feedback is the breakfast of champions’.
Priority Setting ….. allows effective and efficient utilization of scarce resources.
Sharing ‘The Technique/Method’ with trust and openness ….. for any new entrant, learning from scratch and building up a code from first principle is like re-inventing the wheel.
Coaching Ability and Coachability ….. To reach high levels of expertise, inputs from a good coach are extremely helpful
Practice, Practice, Practice ….. there is no substitute to this ingredient
Simulation, ‘Rehearsals’ and Performance ….. this is a practice followed wherever ‘expertise’ is reached ….. sports, dance, science …..
Root Cause Analysis ….. to be able to search for, hit and face the truth boldly and correct it

These are very much woven into the DNA of the aviation industry as well. No wonder we are able to see the beauty of aircraft flying in a formation ….. with a shared vision, speed, trust, constant communication, safety, teamwork, and grace …..

J.P.Singh,

Justplainandsimple Consulting Pvt. Ltd.

Website : www.justplainandsimple.com

Twitter : @jpsingh55

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Through The Productivity Prism

From the Crucibles of JPS Consulting

Just Plain & Simple

….. Helping Realise Potential

TRIM Update ….. A Showcase of Industrial India, December 2010

Every organisation is searching for ways to enhance productivity. With ever increasing competition, costs and complexities, survival of the fittest (slimmest !!) becomes the norm and hence, the demand for higher productivity from all resources – people, material, time, money …..

‘Cost cutting’ ends up becoming favoured buzz words (with the recent recession, probably rightly placed too) in almost all organisations ….. ‘Do more with less’ kind of slogans finding a prominent place in corporate presentations. While there is absolutely nothing wrong with these as guiding principles for operations, neither of them yield the best outcomes without an understanding of the organisational context. Hence, for example, while ‘frivolous’ expenses are definitely not desirable, cost cutting can add to productivity only to the extent that it cuts flab. Beyond a limit, you ‘ cannot cost cut your way to glory in productivity ’.

Economics is the science/art which studies human behaviour as a relationship between ends and scarce means which have alternative uses – Lord Robbins.

This is probably the most useful and practical principle that can help in productivity increase, if understood well. The subtle meaning captured in this definition throws open the spectrum of possible ways in which organizational resources can create an impact. Alongwith the following statement by Archimedes, it provides a robust model for productivity increase.

Give me a lever long enough and a fulcrum on which to place it, and I shall move the world – Archimedes.

Productivity, in its very simple mathematical/scientific form, is a ratio of output over input. Or in business context, Return on Investment. This can be depicted as a product of (A) Profit/Sales & (B) Sales/Investment. These ratios dance in a colourful spectrum when viewed through the prism of organisational context !! Robbins and Archimedes together provide the canvas and brushes respectively, with which to paint organisational success.

A statement like ‘Do more with less’, breaks up into multiple hues, when passed through The Productivity Prism of organisational context. These are :

1) Do less with much less

2) Do same with less

3) Do more with same

4) Do much more with more

On the spectrum from 1) to 4), are choices available to organisations operating in different situations ….. a shrinking/contracting scenario, holding ground, marginal growth or a high growth environment needing investments !! In situation 1) above, if input is reduced in a manner that output is not reduced to the same extent, the resulting ratio of productivity still ends up being better. The same ‘mathematical’ logic applies to the other three cases as well.

However, in the absence of human intervention, these are ‘passive’ mathematical ratios. In business, there is the option of ‘managerial’ discretion and ‘free will’, which can influence the way these ratios behave, rather than being handed over in a ‘fatalistic’ take it or leave it manner. Understanding and picking the Right ‘shade’ can make all the difference. The palette thus exposed by The Productivity Prism can be used suitably to come out with flying colours !!

Robbins helps when you understand the ‘Core Customer Deliverable’ and ‘What in the Value Chain adds most Value to The Customer’ ….. in the allocation of scarce means (with alternative uses; and mind you, organisations always have finite resources) for an optimal outcome. Archimedes helps by pointing out that unless the ‘leverage ratio’ is calibrated and fixed well, movement at the other end of the organisational ‘lever’ will be sub-optimal.

As a child, I used to play with fractions and found some really funnily (and enlightening) different ways in which ratios behaved depending on whether their values were >1 or <1. As a simple illustration, just try adding and subtracting the same number, to/from the numerator and denominator of two ratios, one >1 and the other <1 ….. The direction and quantum of swings in their values are really interesting !!

While the canvass and brush are provided by Robbins and Archimedes and the palette is made available through The Productivity Prism, (I dabble in oil painting sometimes, with the output, as per my children, of the type from the dyslexic child in Taare Zameen Par !!) the only thing that one now needs is a thinner to dilute the paint to the right consistency, so as to be able to get the ‘Right Flow and Application’. Expertise in tools for proper prioritisation of issues at hand, understanding cause-effect relationships between various parameters and risk analysis can provide the right ‘consistency’ to enable ‘A Smooth & Graceful Flow’ in decision making with Optimal Innovative Solutions in the pot of gold at the end of the rainbow ….. leading from complexity to simplicity ….. The Justplainandsimple Way !!

J.P.Singh

Justplainandsimple Consulting Pvt. Ltd.

JPS Consulting

Just Plain & Simple

….. Helping Realise Potential

JPS Customer Value Academy

Just Plain & Simple

….. Helping Create Customer Value

Website : www.justplainandsimple.com

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The Indian Health Care Growth Story ….. A Perspective

From the Crucibles of JPS Customer Value Academy

Just Plain & Simple

….. Helping Create Customer Value

The Indian Optician, September-October, 2010 Issue

Health care in India is clearly poised to grow. The last decade has seen the growth curve take a definite upward swing.

With the growth opportunity in an industry, needless to say, also comes entry of new players. So also has been the case in India. The industry has seen an increase in players in the direct domains of health care service delivery, as also related stakeholders in insurance, funding agencies, manufacturers, consultants, manpower outsourcing etc..

Each stakeholder brings a background and knowhow and definitely adds valuable contribution to the growth story. Each also has its own perspective and its own strategy on how to ‘create value’.

One is reminded of the story of five blind men (or men in a dark night situation) and the elephant, from school days. This needs to be taken in the right context of the meaning and the lesson it offers please.

There were five blind men who came upon an elephant.

“What is this?” asked the first one, who had touched its side. “It’s an Elephant.” said the elephant’s owner. The man ran his hands up and down the elephant’s side and said “It is like a huge wall”.

The second man, touching the elephant’s leg, said, “This is like a pillar”.

“An elephant is just like a snake. It’s wrapping around my arm” said the third man, stroking the elephant’s trunk.

Said the fourth man pulling the elephant’s tail, “This is not a snake, it’s more like a rope.”

The fifth man had touched the elephant’s ear and declared, “This is like a husking basket”

And they moved on along the road, arguing as they went ahead.

One way this story is used is to illustrate the principle of living in harmony with people who have different belief systems and that truth can be stated in different ways. This is the theory of Manifold Predictions.

Rumi, the Sufi poet, uses this story as an example of the limits of individual perception.

Each stakeholder has his/her view and rightly so. Each will try to use his/her own strategies and decisions to maximise his/her value creation.

With multiplicity of players in health care, there will be increased competition and that should be, for sure, good for the customer. Hence, Customer Value Offering will necessarily become extremely critical.

Survival of the fittest will therefore be linked to whoever is able to master ‘what the customer really wants’ & ‘what adds most value to the customer’.

Latest technology will be a key element, but may not be the only factor in winning this game. India needs ‘appropriate’ technology as well, to cater to the huge mass of population. And for that matter, there is money to be made at all levels of the income hierarchy and geographic spread. But how does this get unlocked ?

Strategically, a key differentiator that will emerge is operational efficiency. This is also a key element in customer satisfaction, be it for service providers, health insurance companies (portability/cashless debates included), suppliers, medical tourism or outsourcing agencies. Operational Efficiency includes cost, process efficiency, service cycle times, continuous improvement etc..

However, one point which is probably not getting enough attention in this whole excitement over growth, is the importance of Right People and Right People Processes. It is people, across all stakeholders and across all domains, functions and levels, who fundamentally drive all the strategies, decisions and operations. Ability to select, develop, retain and grow The Right People will probably emerge as the single most important Success Factor.

Any of the players in this industry, definitely spends a large percentage of its revenue in people cost (and it will be comparatively higher in pure service led businesses). This is the biggest expense after cost of goods ….. and just consider how much attention goes behind purchase (and annual maintenance contracts) of inanimate goods compared to selection, development, retention and growth of The Right People !!

Development of skills and talent, specific to health care itself, maybe an investment worth making in the business. There are organisations doing it, but very often it is seen as a social sector activity. However, this one activity could be the biggest value and profit enhancer, from the top end paying customer to a no frills primary centre in rural areas, where also, as they say, there is a lot of fortune lying !!

It is people at all levels who will become critical to success.

Leadership Challenge is to build bridges into the future.

For those who think operational efficiency may not be as important, it may be appropriate to share here that “Fielding historically has been seen as a Service Function in cricket for too long, till Jonty Rhodes changed the game and showed that a Fielder can win matches !!”

J.P.Singh

Justplainandsimple Consulting Pvt. Ltd.

JPS Consulting

Just Plain & Simple

….. Helping Realise Potential

JPS Customer Value Academy

Just Plain & Simple

….. Helping Create Customer Value

Website : www.justplainandsimple.com

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