The Power of a Summary

Hospitals generate reams of patient safety-related data.  But that alone doesn’t make them accountable.

There is power in that data– the power to arm patients and purchasers with the information they need to demand better.  But in the unorganized, unsummarized aggregate, the data are not so powerful. Not to patients anyway.  Obviously, individual patients don’t have the time, inclination or expertise to decipher, organize, summarize and promote the hospital data on their own.  Therefore,  the hospitals’ data are effectively invisible to them.

The hospital data only realizes its potential power in the marketplace when boiled down into something that can be understood by patients at-a-glance, because a glance is all that most of us are willing to give the subject.  Only when boiled down will the hospital data be accessible enough to drive purchasing decisions.

And that is what a national patient safety group called Leapfrog did this week when it summarized hospitals’ patient safety data into school-like grades.  Casting judgements about hospitals is perilous business, because hospitals are fiercely defensive institutions that understandably prefer to promote their miracles over their mistakes.  Though Minnesota hospital leaders were very courageous a few years back to begin publicly disclosing their medical errors, hospital advocates in Minnesota pooh-poohed Report Card Day:

“It’s really a repackaging of what’s publicly available,” (Minnesota Hospital Association (MHA) data expert Mark) Sonneborn said.

I really should have tried that one when I was a lad.  “Chill mom, that “D” in Social Studies is actually just a repackaging of information that has been available to you all semester.”

Yes, the data behind the grades is available from the U.S. Department of Health and Human Services.  So, if I understood which measures were most meaningful, and I don’t, it would have been technically possible for me to construct the spreadsheet that the Leapfroggers did, and make some kind of a comparison on my own.

But the practical reality is that I never did, and never would.  Life is just too busy to summarize all the data impacting my life.  And even if I was geeky enough to do my own little patient safety data research project, the effort would only benefit me, and not the rest of the country.

MHA is correct that Leapfrog’s methodology is just “repackaging.” But the grades will drive quality improvements much faster than the status quo way of managing the data.  Because whether a hospital got an “A” or a “F” grade, the minute hospital leaders know that easily understood grades are going to be regularly appearing in the hometown news media and competitors’ marketing materials is the moment they start investing more effort, thought and resources into patient safety improvements.    With the advent of publicized grades, they now know that consumers and purchasers will use their new found knowledge to vote with their feet, and their pocketbooks.

Markets work if consumers are informed, and the beauty of the grades is that they are simple enough to do that.  Lifesaving work is most often done by the miracle workers in hospitals wielding scalpels, microscopes, medications, lasers, gauze, latex, disinfectants and needles.  To be sure, these folks are heros.  But lifesaving work can also be done, indirectly, by data jockeys wielding spreadsheets and press releases.  Leapfrog, I give you an “A.”

– Loveland

Peeling Back Minnesota’s Media Layers

Compared to other Americans, are Minnesotans more intellectual in their media choices? More conservative? Liberal? Business minded? Worldly?

Or  are they sophmoric wise asses?

It appears the latter.  A recent Forbes analysis says that stereotypically stoic, humorless Minnesotans are disproportionately likely to be readers and sharers of, drumroll please:

The Onion.

Yes, The Onion, the self-styled “America’s Finest News Source.”  For those of you who aren’t real Minnesotans who are familiar with The Onion, it is a satirical news publication that currently features such fine journalism as:

Court Orders Amazon.com To Adopt Bankrupt Bookstores’ Cats

Tiger Woods’ Reputation Takes Another Hit After He Is Caught Operating A Coal Mine With Flagrant Disregard For OSHA Regulations

General Mills Gives Honey Nut Cheerios Bee Intense Backstory Of Childhood Foster Home Abuse In Bizarre Rebranding Effort

Forgive me for getting verklempt, but I’m not sure I’ve ever been more proud of my adopted state.

– Loveland

Politics and Substance Both Call For Dayton to Sign Teacher Seniority Reform Bill

I support teacher’s unions, but they are wrong to oppose reforming “last in, first out” (LIFO) teacher termination practices. Even great organizations sometimes are off-base, and Education Minnesota is wrong on this issue. The logic for changing this system is overwhelming, presented nicely here by an education reform organization called Students First.

The politics of the issue are as compelling as the logic. A statewide poll commissioned by Students First found that almost two-thirds (64%) of Minnesotants believe a measure of teacher performance should be the most important factor in deciding who to keep, while only 15% of voters say seniority should be the most important factor, as it currently is.

Looking at those numbers, it is clear that Education Minnesota is compelling DFL legislators to jump off a political cliff. Governor Dayton should save DFL legislators from themselves, and sign this bill. It’s the right thing to do, both substantively and politically.

As with most issues, I know that the devil is in the detail. I know that you have to do all you can to build a solid performance evaluation system to make the new system fair to teachers. I know that evaluating teachers is particularly tricky. But no performance evaluation system will ever be flawless, so waiting for a flawless system to be developed makes perfect the enemy of the good. Almost all large employers have performance evaluation systems in place, and there is no reason why school administrators can’t do the same, and continue to refine the system over time.

I’m glad Governor Dayton isn’t caving to Republicans on corporate property tax cuts, paid for by short-term accounting gimmicks. I’m glad Dayton is fighting Republicans to get a better bonding bill to repair the infrastructure, and put unemployed and underemployed Minnesotans to work. But even a stopped clock is right twice a day, and Republicans are right on this issue.

– Loveland

Top 5 Dying Facts That Endanger Obama’s Reelection

A brilliant and widely circulated Chicago Tribune obituary claims that Facts has died. If you haven’t read the whole thing, here is a flavor:

Through the 19th and 20th centuries, Facts reached adulthood as the world underwent a shift toward proving things true through the principles of physics and mathematical modeling. There was respect for scientists as arbiters of the truth, and Facts itself reached the peak of its power.

But those halcyon days would not last. People unable to understand how science works began to question Facts. And at the same time there was a rise in political partisanship and a growth in the number of media outlets that would disseminate information, rarely relying on feedback from Facts.

… Facts is survived by two brothers, Rumor and Innuendo, and a sister, Emphatic Assertion.

Services are alleged to be private. In lieu of flowers, the family requests that mourners make a donation to their favorite super PAC.

I’m a starry eyed optimist, so I choose to think Facts is still on life support hoping for a miracle recovery. But if the President and his team can’t successfully breathe life back into five key Facts that are currently on life support, it’s difficult to see how he can win in November.

Fact #1: Obama opted for a private health insurance reform model developed by Mitt Romney and other conservatives, rather than an insurance plan run by government.

Fact on life support.
• Fact on Life Support: Only 25% of people who took the Kaiser health reform quiz understood that Obama’s health reforms will not “create a new government run insurance plan to be offered along with private plans.”

• Implications of Death: GOP parrot trainer Frank Luntz has commanded his cockatiels to repeat the phrase “government takeover of health care” for a very sound political reason, because market research shows that is a compelling reason for moderate swing voters to oppose health care reform. The more swing voters believe that falsehood, the less they like Obamacare and Obama.

Fact on life support.
Fact #2: Bush policies and the economic downturn under Bush were the most powerful causes of the ballooning national debt, and Romney wants to extend those Bush policies.

• Fact on Life Support: Out of twelve issues, there is only one issue where voters say Romney would do a better job than Obama – handling the deficit. Voters currently believe Bush disciple Romney is the best person to tackle the debt that Bush policies largely created.

• Implications of Death: The size of the debt is especially concerning to moderate swing voters, so getting blamed for causing that problem badly hurts the President’s prospects of wooing that key constituency.

Fact #3: Obama’s stimulus package of tax cuts and investments helped ease the pain and damage done by the Great Recession.

Fact on life support.
• Fact on Life Support: Over half of independents (56%) believe the stimulus didn’t make any difference.

• Implications of Death: The central issue of the campaign is the economy, stupid. If swing voters don’t believe Obama was effective on the issue that concerns them the most, look out.

Fact #4: In terms of private sector job creation, things have gotten significantly better during Obama’s time in office than they were under Bush and the the Bush policies Romney proposes to resurrect.

Fact on life support.
• Fact on Life Support: Three-fourths (75%) of independents believe that the economy has gotten worse or stayed the same, and 77% of independents believe the economy is still in recession.

• Implications of Death: Even if most voters blame Bush for the economic meltdown, as most still do, according to polls, it’s difficult to see how swing voters who believe that things are still headed in the wrong direction will vote to rehire the incumbent President.

Fact #5: In the Obama years, taxes for the middle class were near historic lows.

Fact on life support.
• Fact on Life Support: Eighty-five percent of independent voters incorrectly believe taxes on the middle class either increased or have not changed.

• Implications of Death: Independent swing voters vote their pocketbooks, and oppose paying more in taxes. If they perceive that they were paying high taxes in the middle of a recession, the Democrat in charge will get the lion’s share of the blame, because Democrats are usually presumed to be advocating for higher taxes.

Of course, there are many other falsehoods hurting Obama. Little things like he is a foreigner, Muslim, socialist designing death panels to kill off your loved ones.

But in a year when the economy is the top issue, and with the health reform bill about to get hot again after the Supreme Court rules, these are the five dying Facts that are hurting Obama the most with swing voters. Team Obama needs to resuscitate good old Fact, or Obama’s political career will perish with him.

– Loveland

“Rosengate” The Latest News Media Overreaction

A few weeks ago, I wrote about how badly the mainstream media and punditry class had miscalculated the public reaction to the Obamacare contraceptives policy. You’ll recall that the national news media originally declared that President Obama was getting slaughtered due to the “controversy” and “firestorm” he had caused by proposing to provide contraception to women.

Then polls showed that the issue had actually helped expand a gender gap in favor of Obama.

A few days ago, a similar cycle started again, although this one didn’t even have anything to do with Obama or an Obama policy. It all started with lefty pundit Hilary Rosen’s comment that Ann Romney had never worked a day in her life, forgetting three important words “outside the home.”

Reporters and pundits immediately became aroused. Forget that Rosen isn’t Obama. Forget that Rosen doesn’t speak for Obama, or work for him. Forget that most people know what Rosen presumably meant – that millionaire stay-at-home moms don’t have much in common with non-millionaire working moms — and that is an absolutely fair and relevant point. Once again, the national news media and pundits declared that Obama had a huge political problem on his hands that was crippling him with lovers of motherhood everywhere.

U.S. News blared the headline “Damage Already Done By Rosen’s Ann Romney Comment,” relying on conservative pundit Frank Luntz, who assured us:

“What she said is an insult to millions of American women,” Luntz told me, adding that even though Rosen apologized, the damage had already been done because many stay-at-home moms were offended.

CBS News went with the headline “Hilary Rosen flap a ‘win in every regard’ for GOP, says Nicole Wallace.” It quotes the giddy conservative pundit explaining:

“Ann Romney was able to connect in an instant to every woman in the country, with every woman in the country” by defending her decision to raise five boys.”

Talking Points Memo (TPM) even broke out The Suffix of Political Death, “-gate.” I kid you not, they went with “Rosengate” in their headline.

Holy Cuban plumbers, a “-gate!?” Because a supportive pundit mangled her soundbite?

Despite all that hyperventilating about Rosen’s comments and the dire consequences they supposedly had for Obama, today we’re starting to see some polling on the issue. From the Examiner:

A new Reuters poll out Tuesday shows Obama with a comfortable 14-point lead on Mitt Romney among women likely to vote in November’s general election, 51-to-37 percent. That split is more or less the same as a similar poll taken back in March that showed Obama with a 54-38 advantage.

A CNN poll out Monday offered similar numbers. The survey gave the president a 52-to-43 percent lead over Mitt Romney among registered voters, and also gave Obama a 16-point lead over Romney among women, 55-to-39 percent, almost as good as last month’s 18 points.

Another interesting development in the survey: “Despite Republicans’ efforts to portray themselves as the party of the family, Obama even had a big edge on family values among women, with 51 percent picking him as better on that issue compared with 36 percent for Romney.”

In fact, the poll found women rating Obama stronger on all issues, including the economy, jobs, health care and foreign policy.

So, after all of that talking head drama, apparently what we actually have is Nobodygivesashitgate.

– Loveland

Online Brainstorms Overcome Many Problems of Traditional Brainstorms

The other day, I highlighted research showing that face-to-face brainstorming meetings are not as effective at generating ideas as quiet contemplation. It’s important to note one partial exception to that rule: online brainstorming.

E-brainstorming.
The research is very supportive of online brainstorming. With face-to-face brainstorming, the larger the group, the worse the performance, both in terms of quantity and quality. With online brainstorming, however, the bigger the group, the better the performance, according to the research.

Why? I’d say it is because online brainstorming fosters what introverts particularly need to excel, time for quiet contemplation and self-vetting. Online brainstorming – a prolonged email-based discussion, for instance – removes many of the problems associated with the ubiquitous face-to-face brainstorming sessions so many organizations adore.

First, online brainstorms remove many of the distractions inherent in face-to-face brainstorm sessions. In face-to-face brainstorming sessions, our minds are racing from irrelevant subject to irrelevant subject: “The facilitator is not as funny as he thinks he is…do people think I’m talking too little, or too much…why Snickers…bad hair day, dude…why does she always work the word “synergy” into every monologue…if I had pointy shoes like that guy, would people conclude that I’m creative…wouldn’t white boards be more environmentally sustainable than giant Post-it notes…is the facilitator on happy pills?”

When you’re back at your keyboard, those environmental distractions are removed, so you can focus on the task at hand. Sure, distractions still exist in your office, but nothing like the wild sideshows happening in Cirque du Brainstormsession.

Second, the problem of “evaluation apprehension” – the fear of looking moronic in front of colleaugues — is mitigated online. After all, with online brainstorms, you have ample time to self-scrutinize and research your argument before expressing it, which builds confidence in the value of the contribution. When allowed sufficient time to develop the idea, you are much more likely to share it, and it is likely to be a better developed idea. Not so with the spontaneous blurting required in face-to-face brainstorming.

Third, the problem of “production blocking” – where thoughts are lost as you’re waiting for others to express their ideas — is nearly eliminated during online brainstorms. With online brainstorms, thoughts can be written down, and fully developed, as you have them.

In short, online brainstorms allow for uninterrupted contemplation, while still taking advantages of the “wisdom of crowds” phenomena.

In the book Wisdom of Crowds, author James Surowiecki sings the praises of the decisions crowds jointly make. But Surowiecki also stresses that crowds are capable of making very bad decisions. He says that a primary factor that leads to poor crowd decision making is when members of the crowd are so conscious of the opinions of others that they start to emulate each other and conform, rather than thinking as individuals.

Face-to-face meetings are much more apt to generate this kind of blind following of vocal group leaders than large groups of people sitting at their keyboards thinking independently.

Granted, online brainstorms are far from perfect. For instance, the problem of social loafing – sitting back and letting others do the work – arguably could be aggravated with large online groups. And tragically, there is no junk food supplied at e-brainstorms. But online brainstorms do avoid many of the problems associated with face-to-face brainstorms, and research indicates that they produce better results.

– Loveland

Brainstorm or Braindrain?

All wet?
Those of you in the PR, advertising and marketing business are probably very familiar with the brainstorm model of idea generation, but I know it is also used in many other industries.

For those of you who have been left out of the brain rain, here is a crash course: During brainstorms, a group of colleagues closes themselves into a room and spontaneously blurts out ideas on the given topic. The ideas are excitedly written on giant Post-it notes adhered to the walls by a perky brain storm facilitator.

“There is no such thing as a bad idea,” the facilitator, pacing around the room frenetically, continually reminds us, usually after someone offers a particularly bad idea. “The wilder the idea, the better!”

The group is urged to generate a large quantity of ideas, and rapidly build off ideas with supplements or variations. Toys and treats are often offered, to foster creativity. A few people usually sit quietly looking at their watches, and looking idealess, while a relative few dominate the airwaves. The session ends with the chirpy facilitator congratulating the participants, pointing to all of the giant Post-it Notes on the walls as evidence of the world changing ideas that the brainstorm precipitated.

Brainstorming, which was particularly promoted by legendary BBDO ad man Alex Osborn, is the operational and cultural building block of many creatively oriented businesses. The brainstorm session is to PR and agencies as the assembly line is to a manufacturer. It’s the place where the company’s talent synergistically comes together to create MAGIC.

Or does it?

In the book “Quiet: The Power of Intoverts in a World That Can’t Stop Talking,” author Susan Cain examines the heavy workplace emphasis on consensus and teamwork generally, and the brainstorming work model specifically. Cain cites research done by University of Minnesota psychology professor Marvin Dunnette in 1963. Dunnette asked ad executives and 3M executives to do a set of tasks. Some worked alone, and some in groups. Cain writes:

The results were unambiguous. The men in 23 of the 24 groups produced more ideas when they worked on their own than when they worked as a group. They also produced ideas of equal or higher quality when working individually. And the advertising executives were no better at group work than the presumably introverted research scientists.

Since then, some forty years of research has reached the same startling conclusions. Studies have shown that performance gets worse as group size increases…

‘The “evidence from science suggests that businesspeople must be insane to use brainstorming groups,’ writes the organizational psychologist Adrian Furnham. ‘If you have talented and motivated people, they should be encouraged to work alone when creativity or efficiency is the highest priority.’

…Psychologists usually offer three explanations for the failure of group brainstorming. The first is social loafing: in a group some individuals tend to sit back and let others do the work. The second is production blocking: only person can talk or produce an idea at once while the other group members are forced to sit passively. And the third is evaluation apprehehsion: meaning the fear of looking studid in front of one’s peers.”

So, why is brainstorming still such a big part of business operations?

Because we’re all afraid to protest, for fear we will look like killjoys who can’t appreciate all the giddy merriment and free Snickers bars?

Because all of those Post-it notes on the wall feel more like tangible evidence of productivity than the evidence offered by peer reviewed scientific research?

Because the extraverted leaders that tend to lead organizations personally are attracted to the energy such sessions gives them?

Quick, someone get some giant Post-it Notes, colored markers, beanbag chairs and Cheetos. We’ll get to the bottom of this in no time!

– Loveland