Amazon delivered “In Search of Excellence” by Tom Peters last week. He’s long been influential in my thinking about work and organizations. I own several of his more recent books but have never read the original tome that kicked it all off.

The idea of pursuing excellence has been around for so long—it’s been nearly forty years since “In Search of Excellence” was published—it has lost gusto as a management fad in contemporary organizations.

But Seth Godin resurrected the idea for me when he talked about the book on Brian Koppelman’s The Moment podcast recently. Organizational excellence was a nascent idea before “In Search of Excellence" was published.

The thing is, somewhere between 1982 and today, the idea of excellence was conflated with the notion of efficiency in most organizations. It’s resulted in a questionable efficiency-at-all-costs-excellence-strategy throughout the industry.

There’s nothing wrong with efficiency as an organizational ideal. It’s just that a blind pursuit of efficiency in the name of excellence actually comes at the expense of excellence.

Because the problem with efficiency-as-excellence idea, as Seth relays on the podcast, lies in the definition of efficiency: meeting spec. 

And the definition of excellence is not meeting spec. 

Organizational excellence is actually an output of human caring. Human caring in organizations, according to Seth’s interpretation of “In Search of Excellence,” is the answer to this question: “How would you do the work if you actually cared about it?”

This matters because, in my estimation, many of the problems in healthcare delivery organizations today are mislabeled as efficiency problems when they should be considered problems of excellence.

I think healthcare delivery organizations are rather efficient operators.

What they lack, as I hear a muffled “bullshit” under your breath, is employees who ask themselves, “How would I do the work if I actually cared about it?,” when it comes to improving the operations of healthcare delivery. 

Conflating efficiency and excellence has resulted in a workplace cultural satisfaction that merely meeting spec is good enough when it comes to improving healthcare delivery operations.

It’s not.

Because it ignores excellence.

And it is excellence that will emerge again as an organizational pursuit for competitive advantage as efficiency has merely become the expectation.