Calling all efficiency experts!

You know who you are. You LEAN, six sigma, black belt, ninja turtles.

Explain to me (and the world) how any of you and your methodologies would have come up with the idea of putting a piano in the atrium of the Mayo Clinic where this could happen?


  1. Philip Arnfield says:

    Well, I think I can explain that reasonably easily Ed, but before I do, I would like to explain 1 of the 2 reasons why I feel motivated to do so.

    I am a fan of Verasage because I find it stimulating. However, in recent times some of the posts by, well, you in particular Ed, are close to crossing the line from intellectual debate to parochial vitriol.

    So I feel motivated to write to add some balance to the intellectual debate that this site is trying to cultivate.

    For the sake of this comment let me take on the role of, as you would say, efficiency ninja turtle.

    You put out the challenge to ?Explain to me and the world?…..? Firstly, do not presume the word is hanging on your every word Ed, the world is clearly not. In fact from the number of comments on your community blog, the world is far from switched in, and professional knowledge firms that charge time, as the basis of their revenue generation, far out way the number that do not. (I do not think that you presume to reserve the title of knowledge worker firms to those that do not generate revenue by charging time. I hope so anyway.)

    I rely on time sheets to track efficiency in my business. I work with a lot of trade based businesses, and manufacturing businesses and I encourage the managers of those businesses to track efficiency through job cards and time sheets.

    The act of monitoring time charged, does not prevent us from creating extraordinary customer service experiences, from creating new ways to solve customer problems, from developing new products, from creating more effective production processes, from implementing differential pricing strategies, from creating processes to segment customers, from differentiating products and services, from creating the circumstances within our businesses that allow people to excel, from training people, from teaching customers, and learning from customers.

    So, are my methodologies and the methodologies of many of my successful clients, that use time sheets or something similar to track efficiency, capable of coming up with ideas like placing a piano in the foyer of the Mayo Clinic?…..give me a break, of course they are.

    Ed, firms that focus on efficiency as a way to increase profits do not require their employees to be efficient in the sense of charging their time to revenue every hour of the day. They understand that an efficient firm does not do that.

    Steven Covey makes the point that the essence of effectiveness is balance. He wrote a great book, The 7 Habits of Highly Effective People, you should read it, and if you have read it, read it again.

  2. Hi Philip,

    I love a vigorous debate, and I won’t presume to speak for Ed, so carry on. I’m actually sitting in the Melbourne airport about to fly to Sydney for the day, and read your comment with great interest.

    I have read Covey’s books, including the 8th Habit, where he constantly makes the point that knowledge worker’s real wealth is wisdom and effectiveness, not efficiency. Peter Drucker wrote extensively (and I mean extensively) about the vital difference between efficiency and effectiveness. He didn’t write “The Efficient Executive,” but “The Effective Executive.”

    I have no doubt that firms that have timesheets are capable of doing all the things you say. Unfortunately, it has not been my experience. Executive attention is a limited resource, and one cannot be focused on a lagging indicator such as timesheets and also be focused on all the areas you suggest. Customer service, for example, is the antithesis of efficiency, so is innovation.

    KPIs, After Action Reviews, and project management are far more effective tools to gain both efficiency and effectiveness in a knowledge organization. They actually add to intellectual capital. Timesheets are a form of negative intellectual capital, and the empirical evidence for this is overwhelming. Just go into any firm and watch a partner’s meeting, and see what everyone focuses on. Ask people why they leave professions. I have spoken to hundreds of lawyers on this trip alone, and it confirms my view that the timesheet is a cancer. Do you really need another lagging indicator with no predictive value?

    It’s not a matter of balance. It’s a matter of the effectiveness of the whole, interdependent system. Some parts may have to be totally inefficient for the whole to effective. Drucker made this point emphatically, over and over again.

    Do you agree? If not, why not?

  3. Philip Arnfield says:

    Hi Ron,

    No, I do not agree, well, more to the point; you have not yet convinced me.

    I have followed the trash the timesheet debate for a long time now. Along the way I have been able to learn so much that has been incredibly valuable for both me and my clients. For that, I am grateful.However, I am still not convinced that there is no place for timesheets.

    I have come to the realisation that the only way I will come to a definitive position on this subject is to take part in the debate rather than be a passive observer.

    Ron, I do believe it is a matter of balance.

    I think the debate has been sidetracked by the mistaken belief that a firm that uses timesheets necessarily is only focused on time. That may be true for some firms; it may even be true for most firms, I cannot say.

    However, it does not mean that a firm that uses timesheets cannot, as well, track key predictive indicators, carry out after action reviews, and engage in effective project management.

    What it means is that those firms that have time as the sole focus, or predominant focus, are very badly managed. I agree that many legal and accounting firms are not managed well, but that is not the fault of time sheets. It is the fault of how the timesheets have been inappropriately used by management.

    It is a matter of balance. You concede that a firm that has timesheets is capable of good management, but that your experience is that they rarely (ever?) do. My point is, to correct that, you do not have to trash timesheets; you have to instill some balance, and most definitely educate the leaders of the firm.

    I certainly do not agree that customer servcie and innovation are the antithesis of efficiency, and my intention is to demonstrate why I believe that in future posts.

    Enjoy your day in Sydney, it is a wonderful city.

  4. Hi Philip,

    Well, I’ve learned over my life that the great folly of our time is to believe we can change others, so I don’t think it’s my job to convince you.

    I follow the evidence. And there are over 1,000 firms out there that don’t do timesheets, and are doing quite well. Some are the most profitable firms in their sector.

    This certainly doesn’t prove it is impossible to run a good firm with timesheets. What it does prove is they are not necessary, and I have found them to be an enormous distraction for the firms that have them–holding them back from pricing on purpose, doing proper project management, implementing KPIs, AARs, and other innovations. This is my experience with working with literally thousands of firms around the world, in each professional sector.

    You are correct that timesheets aren’t the cause of bad leadership/management. But I believe they contribute to it. Most firms don’t lead well because they believe the timesheets tell them everything they need to know about what/how their team is doing. This is the illusion of control.

    Balance is for tires and ballerinas. Only a theory can replace a theory. Timesheets are a theory. I believe KPIs are a superior theory, because if formulated correctly, they are leading not lagging indicators.

    Perhaps this argument is part semantical. Efficiency is always a measurement, more specifically a ratio (usually outputs divided by inputs). Effectiveness is always a judgment. I rather be approximately right with a judgment than precisely wrong with a measurement.

    Philip, you have to know that timesheets are a lagging indicator, with zero predictive ability. I don’t know what type of firm you run (accounting?) but a timesheet tells me nothing about how successful a CPA is, let alone how effective they are. I still have to judge their attitude, passion, getting along with others, customer service attitude, etc. Timesheets do none of this, and in fact are distracting firms from focusing on this. This is fact, not opinion. Maybe you’re firm is different and if so good on ya’ (as you say here). But I believe they are a cancer that must be cut out so firms can focus on the right things.

    Have you watched my 8 hour Webcast, Measure What Matters to Customers? The timesheet was introduced to professional firms, inspired by Frederick Taylor, who it turns out was a fraud (read “The Management Myth” book review on this blog). There is also no such thing as “generic efficiency.” It all depends on your objectives and what you’re willing to pay. It just can’t be assumed that every increase in efficiency is effective, or worth the price.

    I don’t know how you’re going to prove that innovation is not antithetical to efficiency. Google offers 20% time to its knowledge workers. That’s not very efficient as measured by the ratio, but it does lead to many innovations (even though most of them fail miserably). Why would Google tolerate that inefficiency? Because the ones that hit are effective and the price is worth paying.

    I used to believe what you do Philip, but the evidence has led me to a different conclusion. I know it’s not easy to have your world view turned upside down. Each of us must wrestle with the truth in our own way. I did it by writing 5 books that forced me to confront reality, not what I had been taught.

    At least you’ve benefited from the dialogue, and I hope you keep hanging your assumptions in front of you and challenging them. It’s the only way we progress as humans.

  5. Hi all, I have been enjoying the conversation and feel it is time for me to weigh in. My thoughts are:

    1. On vitriol – Heck yes! My intent was to provoke a reaction not dissimilar to acid, which is what I have done. That said, I am very glad Philip that you have joined the dialogue.

    2. On hyperbole – I have no disillusions that the world is hanging on my words. In fact, I sure hope not.

    3. On the point of my post – It is not that firms cannot come up with the piano in the arboretum idea, it is that a focus on a efficiency itself would NEVER yield that idea. As has been argued on this site before – you cannot improve effectiveness by looking at efficiency.

    “The opposite of love is not hate, but efficiency.” – Pittman McGehee

    And now to really take this to the absurd, a story, passed along to me by my friend Tony Chiodo:

    A lesson on how six sigma can make a difference in an organization.

    Last week, we took some friends to a new restaurant, “Steve’s Place,” and noticed that the waiter who took our order carried a spoon in his shirt pocket.

    It seemed a little strange. When the busboy brought our water and utensils, I observed that he also had a spoon in his shirt pocket.

    Then I looked around and saw that all the staff had spoons in their pockets. When the waiter came back to serve our soup I inquired, “Why the spoon?”

    “Well,” he explained, “the restaurant’s owner hired a six sigma black belt to revamp all of our processes. After several months of analysis, they concluded that the spoon was the most frequently dropped utensil. It represents a drop frequency of approximately 3 spoons per table per hour.

    “If our personnel are better prepared, we can reduce the number of trips back to the kitchen and save 15 man-hours per shift.”

    As luck would have it, I dropped my spoon and he replaced it with his spare. “I’ll get another spoon next time I go to the kitchen instead of making an extra trip to get it right now.” I was impressed.

    I also noticed that there was a string hanging out of the waiter’s fly.

    Looking around, I saw that all of the waiters had the same string hanging from their flies. So, before he walked off, I asked the waiter, “Excuse me, but can you tell me why you have that string right there?”

    “Oh, certainly!” Then he lowered his voice. “Not everyone is so observant. That consulting firm I mentioned also learned that we can save time in the restroom.

    “By tying this string to the tip of our you-know-what, we can pull it out without touching it and eliminate the need to wash our hands, shortening the time spent in the restroom by 76.39%.”

    I asked quietly, “After you get it out, how do you put it back?”

    “Well,” he whispered, “I don’t know about the others, but I use the spoon.”

  6. Philip Arnfield says:

    Ed, that is a seriously funny story, well played.

    Ron?s response to my serious comment about balance, is also amusing, Ron believes balance is for ?tires? (you Americans sure do spell funny) and ballerinas.

    However, I strongly believe that balance is a very important factor in the effectiveness v efficiency debate.

    If efficiency is defined as doing things right and effectiveness is defined as doing the right things, then surely, we all should all be trying to do the right things right.

    That is balance. Why can?t we be both effective and efficient?

    My interpretation of this debate, to date, is that the effectiveness lobby (I will refer to them hereafter as joggers*) believe we efficiency ninja turtle are focused on 100% efficiency. If that were the case, and it is for some timesheet focused managers, then I accept that the focus on efficiency should be criticised.

    However, that is not the general case for successful businesses. Successful businesses do not aspire to anything close to 100% efficiency.

    Steven Covey in his book The 7 Habits of Highly Effective People makes this point far more eloquently than I can.

    Covey talks of the P/PC balance. P stands for production of desired results and PC for production capability.

    On page 59 Covey writes: Effectiveness lies in balance. Excessive focus on P results in ruined health, worn-out machines, depleted bank accounts, and broken relationships. Too much focus on PC is like a person who runs three or four hours a day(*), bragging about the extra 10 years of life it creates, unaware he?s spending them running. Or a person endlessly going to school, never producing, living on other peoples golden eggs-the eternal student syndrome.


    Covey goes on to say…To maintain the P/PC balance is often a difficult judgment call. But I suggest it is the very essence of effectiveness.

    So, all you new age academics, authors, bloggers and joggers, how about some balance. Why can?t you accept that we ninja turtles can be creative, innovative, offer our customers fabulous experiences, provide tremendous value for our shareholders, and also focus on a certain level of efficiency so as to allow it all to hang together?

  7. Hi Philip,

    Nice try, really. I’m glad you agree that we shouldn’t be going for 100% efficiency, that’s at least a start. Who ever said we can’t have both efficiency and effectiveness? It’s just that at some point on the curve, they do become mutually exclusive. They don’t stay “in balance,” they conflict, with different objectives. Despite the cute names, I would really enjoy it if the efficiency folks dealt specifically–and not in generalities–with my points:

    1) There’s no such thing as generic efficiency–read Thomas Sowell (or my posts on this).
    2) I’ve provided many, many examples of where a decrease in efficiency has led to an increase in effectiveness; can you provide ONE example of the causation running in the other direction (be careful with this, it’s not as easy as you think).
    3) It’s nearly impossible to measure the efficiency of a knowledge worker, because it’s not just about outputs and inputs, but quality. Quality is a judgment. I can write a shitty book really efficiently, so what? Was Einstein efficient? How about Jonas Salk developing the polio vaccine. Was he efficient? Do you care?
    3) Competitive advantage is built on effectiveness not efficiency.

    Covey is not the expert on this topic, Peter Drucker is, especially as it relates to knowledge workers and firms. Here’s just one, of many many examples of his writings where he drives home the difference between efficiency and effectiveness:

    “Efficiency means focus on costs. But the optimizing approach should focus on effectiveness. Effectiveness focuses on opportunities to produce revenue, to create markets, and to change the economic characteristics of existing products and markets. It asks not, How do we do this or that better? It asks, Which of the products really produce extraordinary economic results or are capable of producing them?…It then asks, To what results should, therefore, the resources and efforts of the business be allocated so as to produce extraordinary results rather than the ?ordinary? ones which is all efficiency can possibly produce?

    “This does not deprecate efficiency. Even the healthiest business, the business with the greatest effectiveness, can well die of poor efficiency. But even the most efficient business cannot survive, let alone succeed, if it efficient in doing the wrong things, that is, if it lacks effectiveness. No amount of efficiency would have enabled the manufacturer of buggy whips to survive.

    “Effectiveness is the foundation of success?efficiency is a minimum condition for survival after success has been achieved.

    “Efficiency concerns itself with the input of effort into all areas of activity. Effectiveness, however, starts out with the realization that in business, as in any other social organism, 10 or 15 percent of the phenomena?such as products, orders, customers, markets, or people?produce 80 to 90 percent of the results. The other 85 to 90 percent of the phenomena, no matter how efficiently taken care of, produce nothing but costs (which are always proportionate to transactions, that is, to busy-ness). (Drucker, People and Performance, 2007: 34-35).

    Oh, and Philip, what is “a certain level of efficiency?” Since it’s always a measure, you must have a number in mind? How do you know what that number should be?

    No one here is suggesting that you should be inefficient for it’s own sake. We aren’t suggesting going back to typewriters, or forsaking technology (though if you bill by the hour this isn’t a bad idea). But your competitors can match your efficiency gains just as easily, and most of the gains are simply a matter of climbing down the learning curve, especially for knowledge workers. I’m going to be able to complete my 1,000th tax return “more efficiently” than my first. That’s just human nature.

    Would you rather have an efficient or effective heart surgeon? Please don’t answer both. But if you do, then please answer, specifically not generally, how you measure the efficiency of the heart surgeon? Or his bedside manner?

    Ok, I’m off to taste some of your delicious Australian wines. It won’t be an efficient weekend, but it will be quite effective.

  8. Hi Ed,

    Getting back to the original question: How would we come up with ideas like putting a piano in the atrium of the Mayo clinic?

    This is a question of systems improvement, not process improvement. There are plenty of (more or less) structured tools for systems improvement available.

    Quality Control/Quality Improvement folks might use Quality Function Deployment to try to figure out something like this. QFD is not my area of expertise, so I won’t comment on how well it would work.

    Here is what I do:

    Get people together and brainstorm using the Crawford Slip method:

    Structure the results using The Logical Thinking Process (TLTP): (The videocast shows only how to develop an Intermediate Objective Map. There is more to the process.)

    Regardless of which method is used to improve a system, identifying the system goal and the conditions necessary for achieving the goal are extremely important.

    In this case, the Mayo clinic has a stated mission that would serve as the Goal of an IO Map: “Empower people to manage their health”. “Maintain high morale among patients” would inevitably crop up as a Critical Success Factor or Necessary Condition.

    From there, it would be easy to involve _both_ patients and staff in generating ideas using Crawford Slip. (Assuming management support and involvement. Without it, it would be doable but very difficult.)

    An alternative to Crawford Slip/TLTP would be Edward DeBono’s Six Thinking Hats (for small groups), or Brainwriting.

    For engineering problems there is a method called TRIZ. I do not use TRIZ myself, put it has a good reputation as a method of generating creative solutions. (Not really applicable in this particular case.)

    What I particularly like about the TLTP approach, is that it will take you all the way from systemic goal (vision/mission statement) to executable project plan (Buy piano. Put it in the atrium).

    Plenty of good methods. Not enough people using them.

  9. Henrik, thanks for your comments.

    Innovation is rarely a part of a formalized process. You cannot decide to innovate on any given day, nor can you demand that a knowledge worker innovate on cue.

    I think promoting a culture that encourages innovation (Google’s 20 percent time) is more likely to work than a quarterly “ideating” meeting.

    As for the Mayo clinic, I bet it went something like this.

    “I think we should put a piano in the atrium.”

    “Excellent idea, do it.”

  10. Hi Ed,

    Here are my comments to your comments:

    “Innovation is rarely a part of a formalized process.”

    Correct. And most companies are terrible at innovation. Even companies that are good at one type of innovation, for example technological innovation, usually suck at other types of innovation, like innovations in culture, organization and strategy.

    Structured processes can help all kinds of innovation, just like a structured design process can help design innovation.

    “Structured process” can easily be misinterpreted as “stifling process”. There are many horribly bad processes out there, but that is not what I am talking about. An example of a widely spread, horrible, non-functioning process is the ISO 9001 version of the PDCA cycle. (The original PDCA model works when used for the purpose it was intended for.)

    “You cannot decide to innovate on any given day, nor can you demand that a knowledge worker innovate on cue.”

    Correct, but you can collect ideas on given days. Some processes have that built in, for example the retrospectives in Scrum.

    People innovate more if they are immersed in a problem _and_ are primed to think about solutions. I have found the priming process used in Crawford Slip to be very valuable. Even without a priming process, having regular meetings where you enumerate problems and propose solutions are valuable.

    “I think promoting a culture that encourages innovation (Google?s 20 percent time) is more likely to work than a quarterly ?ideating? meeting.”

    A culture of innovation is vitally important. What is often overlooked is that in order to build and maintain that culture, an organization must be _structured_ for innovation. Companies like Gore & Associates, Ltd and Semco have such structures. They had it long before Google appeared on the scene.

    Google has a simple, workable innovation process, and the slack time (see Tom DeMarco’s Slack) necessary to make use of it. Whether they have an organizational structure that enables them to maintain their innovative capability over time is a different matter. I do not know enough about Google’s organizational structure to be certain.

    Quarterly “ideating” meetings seem pretty unworkable to me too. There are various speed innovation techniques that can be used to give an organization a quick, temporary boost. Without a _paradigm_ that encourages innovation, the boost won’t last long. It is the paradigm that gives rise to strategy, culture and organizational structure.

    “As for the Mayo clinic, I bet it went something like this.

    ?I think we should put a piano in the atrium.?

    ?Excellent idea, do it.?”

    Very likely. Also very likely that for every great idea developed and implemented this way, many, many more just as great or even better ideas are lost.

    It is my experience that people often have great ideas, but do not talk about them. They are afraid to be ridiculed, or even punished, for bringing up something new. Sadly, these fears are often founded in experience. A formal innovation process, especially one which preserves anonymity, like Crawford Slip, can be used to encourage people to tell their “dangerous” or “ridiculous” ideas. Sometimes you find real gems there.

    Of course, using one method does not preclude using another. Fr example, I use Crawford Slip and TLTP. I also have a notebook for jotting down ideas, and I use mind mapping and the Fieldstone method for generating ideas about books, blog posts, and videocasts.

    I find value in all of these methods, which range from informal and simple to very structured and moderately complex. I strive to use methods appropriate to the type of problem I am trying to solve, and the context in which I am trying to solve it.

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