Through The Work

a creativity development studio for people working in healthcare

The Now of Work

A follow-on guide to the "Healthcare is changing. How we work hasn't. And it's holding us back." introductory series. Here are ten ideas for getting started with the now of work.

Written By
Drew Weilage
February 27, 2020
"Many of us go through life only half awake."
Bill James

There's not a secret to improving how you and your team work. It just requires promoting things that organizations haven't been very good at doing in a desire for complete efficiency, namely better thinking and learning by everyone.

It can be disconcerting to learn the way we work isn't working.

It's not an easy task, but not impossible. That's the biggest hurdle. For you, for anyone, for me. In fact, when I first started finding evidence of a different worldview, I felt like I was never going to get it. New concepts, new ideas, new theories. It was overwhelming. (And exciting.)

So I created this list as a guide for where to go next, designed as a follow-on to the introductory email series you can sign-up for here if you haven't already.

These are ten foundational ideas I've collected along the way that have helped me understand why work is the way it is and—most importantly—helped me to take action in finding the ways to work more effectively.

As you'll learn, the only way to change work is through the work by doing the work.

Two Questions Worth Asking

Why is work the way it is?

What can we do about it?

Get Started With This Idea

(1) Niels Pflaeging has been a major influence in my learning on this subject. You'll see his ideas sprinkled throughout much of my writing (and biases). My introduction to Niels started with his book Organize for Complexity: How to Get Life Back Into Work to Build the High-Performance Organization. Buy it. Read it. Read it again. (And again.)

Then This Idea

(2) A lot of improve-the-work initiatives are undertaken for the wrong reasons, namely to improve employee engagement or improve the organization's culture. Dave Snowden's Cynefin framework, especially the illustration of different business contexts and the introduction of complexity, provides us a different reason to work in a more natural way: so the business can be successful!

Here's a quote: "Most situations and decisions in organizations are complex because some major change—a bad quarter, a shift in management, a merger or acquisition—introduces unpredictability and flux."

Doesn't that sound like the situations and decisions in your job? Read this: "A Leader's Framework for Decision Making‚" in the Harvard Business Review.

Then These Ideas

(3) Command and control management relies on an incorrect assumption about human behavior, that humans dislike work and must be told what to do. What Douglas McGregor asserts in his seminal The Human Side of Enterprise (published in 1960! and still very relevant today) is if an employee is disengaging from the work it is as a result of how the organization is managed and not because of their human nature.

McGregor's Theory Y postulates that under the right conditions employees seek responsibility and exercise self-direction and self-control in the pursuit of organizational objectives. In other words people can be trusted to do the work if conditions of trust are present. The book is (most assuredly) worth reading.

Here's a summary of Theory X and Theory Y to familiarize yourself.

(4) Harold Jarche's "Work is learning and learning is the work" insight was a revolutionary finding for me. What it means is work and learning are the same. We're learning about the problems we're solving as we're solving them, because ... complexity.

Here's what Jarche writes: "There is no time to pause, go into the back room, and then develop something to address our learning needs. The problem will have changed by then. We need to learn as we work."

(5) It's human nature to desire proof that working differently, well ... works.

It's also dangerous because there is a natural bias to copy and paste what works for one organization into your own. This behavior is a big reason for why work is the way work is. When we copy and paste, we eliminate context, and we subcontract our thinking to methods, models, and consultants.

That said, Stanley McChrystal's Team of Teams: New Rules of Engagement for a Complex World can scratch that natural itch in a way that studying private corporations can't.

It's the story (and much more) of when McChrystal took command of the Joint Special Operations Task Force in Iraq. What he found was the world's best military and its conventional military tactics failing against an inferior enemy. This book is the story of the transformation required to work differently (not only to be successful, but largely to stop failing).

If the military can do it—command and control at its absolute height—so can your department.

And Then These Ideas

(6) Systems. I know about systems. I still don't have a handle on systems. I'm not sure it's possible to have a handle on systems. But seeing systems provides an explanation for why so many things are the way they are. That's important.

A good start with systems is Donella Meadows's Thinking in Systems: A Primer. Her twelve leverage points are worthwhile reading even if, taken together, it's an advanced concept.

My ... ahem ... thing with systems is I've found the concept can be a little debilitating. As I've embraced the idea of systems, I've also become more reticent—at times—to take action. Which is perhaps the point. Nonetheless, it can be confusing.

Anyway, our world is systems. Important to know.

(Also: John Gall's Systemantics is a practical critique-like text about systems that's been helpful to my understanding. Check to see if it's available in a library near you.)

(7) Who in your organization can meet the needs of a single patient without working with other people? Yet most organizations are still highly focused on the performance of the individual employee, often at the expense of the team performance and value creation.

Individual performance is a myth. Performance reviews can be toxic. And while we're on the topic: "Telling people what we think of their performance doesn't help them thrive and excel, and telling people how we think they should improve actually hinders learning."

Some out-of-context but bang-on quotations from management legends henceforth:

John Seddon: "The problem of people not working together won't be solved by interventions such as teamworking, participation, empowerment programmes and the like, for one simple reason: it is the system that governs behaviour."
W. Edwards Deming, part one: "The fact is that the system that people work in and the interaction with people may account for 90 or 95 percent of performance."
W. Edwards Deming, part two: "Put a good person in a bad system and the bad system wins, no contest."
W. Edwards Deming, part three: "The role of management is to change the system rather than badgering individuals to do better."

(8) Making change happen is literally the job we're all paid to do. Unfortunately, the models of change that many of us have learned are incomplete or a misinterpretation of good theory. It's had an unfortunate impact on our change outcomes.

So start with this delicious Niels Pflaeging blog post: Change is more like adding milk to coffee. It's another mythbuster. Then read this one: Now to New: How to flip your company to perpetual beta.

Then make another visit to Amazon for two essential books. John Kotter's Leading Change will help you reacclimate to the situational aspects of managing change. And William Bridges's Managing Transitions will be your guide to the psychological transition that accompanies every change, a concept we've essentially been ignoring to the detriment of the people we work with and the outcomes of our efforts.

(9) I want to bring some of these interconnected topics together. Actually, I am going to have Niels Pflaeging bring them together in this video where you can hear why he believes drinking more coffee and starting a smoking habit are good for your career:

(10) It's time for reflection, for thinking, and applying these ideas to your work world. And the question Aaron Dignan asks in his book Brave New Work: Are You Ready to Reinvent Your Organization? is perfect for the exercise. It is this:

"What's stopping you from doing the best work of your life?"
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Through The Work is a creativity development studio for healthcare people embracing The Transforming—the always-happening, always-unfolding state of change in your job ... and using it to make more of the change you know should be happening, happen.

The Transforming is the most important professional opportunity of our careers—one that will lead to new job opportunities, real change, and a transformed industry for all of us and everyone else.

My name is Drew Weilage and I work in healthcare, too. At Through The Work, I help people like you make develop a creative practice to do your best work.

Oh, and pep talks! Get a pep talk when you need one: big day, bad day, or any day at all. Text me at 646-450-2465 or send me a note.

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