Hospitals and a Barcalounger?? What happened to my hospital?

As an ex-CIO of a small healthcare insurance company. I remember attending some of the earliest conferences on the future of healthcare informatics beginning in 1984. The big discussion was the EMR or electronic medical record and privacy being implemented by HIPPA. Today you hardly go in any sizable clinic or community hospital without having some information collected about your health status which is stored in a form of and EMR. Even my small-town MD uses an Ipad to take notes for her records about my health and to look up information while we talk about a health issue. No she isn't one of those 'just out of school' MD's but in her 60's and ready to retire. So EMR's are in use and here to stay as they take on many different guises. UPDATE: Google announces diabetes monitoring with contacts


Is 57% waste real in delivery of projects in the Built Environment?

What is the highest portion of waste in construction projects?
It appears that rework tops the list. The data show that rework often has more than one cause. A recent CII study called "A Guide to Construction Rework Reduction" reveals that the biggest contributor to rework, at 25.4%, is scheduling, followed by issues related to materials and equipment (19%), design and engineering (14.6%) and instruction/monitoring (14.5%). Cutting costs too much can also drive rework. To save money, for example, some architects and engineers use old designs or templates for new projects, and those designs may have problems that were fixed on a previous job but remain in the original design and are passed along to a new one.

At the beginning of this year a conversation began between myself and collaboration principles of NoSilos.com. The reports from the Building SMART Alliance and the Construction Institute and others have been purporting A huge percentage of waste in our industry. While I cringe at the huge numbers, the reality is a lot of that number is infrastructure costs which are inflated due to the litigious nature of our business. Examples such as insurance, performance bonding and financing directly increase the cost due to the risky nature of the current methods we use to deliver Built Environment  projects. So eliminating these excessive costs will be difficult until lenders, insurers and risk assessment folks change their policies to favor less risky arrangements.

That said, the Cll study cited in the ENR article gives us a glimpse behind the numbers from yet another perspective. The study points out that rework, aka failure that manifests itself at the tail end of a project, is spawned by many different failure mechanisms. Bad schedules, materials, equipment, design, execution, supervision etc. etc. account for rework BUT most rework arises from more than one failure mechanism. Further, rework is merely the visible tip of the iceberg. The real failure points lie submerged and ignored.

If necessity is the mother of invention then crisis is the father of failure. And we see the father of failure sowing wild oats all over! And let us count the ways:
  •  RFI's
  • Energy
  • Re-work
  • Waste removal
  • Poor site logistics
  • Over priced construction materials
  • Over priced construction equipment
  • Poor delivery coordination
  • and more, more, more.....
At NoSilos.com we have a metric we use called ROF or Return on Failure. Sort of like the Return on Investment metric known in the financial world, but in reverse. The value of failure compounded over time creates its own wave of increased cascade of failure. 

So how much can be reduced. Past experience shows a possible reduction on privately funded projects of at least 10% and more likely around 15% when we used a modestly integrated design and delivery process not even close to true IPD process. The key to these numbers was a combination of great communication, clear goals and some judicious use of technology to help make the process a bit easier. 

The bottom line, from our perspective, is that waste and inefficiency are known realities by key stakeholders in every sector of the economy regardless of their willingness to admit to the presence of the waste. We bring solutions to identify the differences between uncontrollable and controllable waste. What our clients do to reduce those costs is up to them. There is a vast opportunity for every company to reduce their ROF and increase their ROI to levels not seen before. 


The five words that can swing a meeting in your favour

This post is taken from an article found on www.Techrepublic.com. While an IT-centric publication, there are often gems to mine and harvest and this is one such post. It's been in my holding folder for a while and it seemed time to use it.

Who wouldn't want to find a set of magic words that could swing momentum to your point of view in a meeting? When I saw the title, like you, I wanted to find out more. But instead of a treatise of discovery all I saw was a brief review of some academic research gleaned from listening to hours of recorded meetings. Actually they had used machines to help them wade through the morass of spoken word to glean the short, but important results.

Sure it was important to see the results of their initial work, but more importantly the results were augmented by technology being an enabler. Finding that the five words were  “yeah, give, start, meeting” and “discuss” was astounding to me. "Yeah" is a power word, what you say? It's such a common word, but apparently it does have more power in bringing people together.

So, what's the "take away" for those of us in the Built Environment business? For me it was we need to always be on the lookout for new and unexpected tools to help us discover the hard questions which seem so far beyond our abilities. Much like the linguistics, we are on the cusp of continuing to discover how more complex and pervasive data sources can make our lives more approachable and even better than before. Some call this the advent of "Big Data" but I think it's more fundamental and part of who we are as humans. Ever questioning the everyday to know why something works which seems unexplainable.

So keep your senses tuned and you are likely to find a serendipitous even happen right before your eyes.  And don't forget, "Collaboration is the glue of success."

By Nick Heath
June 25, 2013, 6:27 AM PDT

Takeaway: Frustrated your ideas go unheard in meetings? Academics have identified the five words successful managers use to win backing for their proposals.
Everybody’s sat in a meeting where they felt like they were talking but nobody was listening.
But what if there were a sure fire way to get your colleagues to take notice? Researchers at Massachusetts Institute of Technology’s Sloan School of Management examined what language is most likely to win over peers when used in meetings.
These were “yeah, give, start, meeting” and “discuss”.
The word may ‘yeah’ seems surprising as a persuasive word, but, said professor Cynthia Rudin, “when we looked at the way people were using it, we found they were using it to show agreement with something that someone else previously said. Perhaps if you frame a suggestion as if it were in agreement with others, it’s more likely to be accepted.”
While ‘yeah’ was most frequently used to garner approval, ‘meeting’ was most often successfully used to shut down discussion of a topic, she said.
“For instance, someone might say, ‘Maybe this is something for the next meeting,’ as a way of gently moving the topic onward without causing offence. That suggestion was almost always accepted,” she said.
“We’re just at the beginning of finding ways to use machine learning to produce tools for more efficient meetings. Since everyone wants their ideas accepted, it’s worth considering word choice in proposals. You don’t want to undermine your idea by not using the right language,” said Rudin.

 This is another installment of collection of thoughts and reflections about how the Built Environment affects our lives.