The Decline of Health Services in Alberta

The Triumph of Professional over Real Management The past 20 years have seen a steady decline in the provision of health services to Albertans. Waiting times for surgeries, diagnostic services and emergency room visits is increasing, costs are escalating and quality of care has remained constant at best. A day doesn’t go by without the

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The New Management Thinking

Managers are being flooded by a host of management ideas and models — Six Sigma, process re-engineering, Lean Enterprise, Lean Production, operational excellence, quality management, value chain analysis, business process redesign, process outcomes management and performance measurement. Whatever else these things are intended to produce, confusion is definitely a by-product. To help work through the

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Implementing Lean and Lean Six Sigma

The most frequent question we are asked by clients these days is how to get started with Lean or Lean Six Sigma. The second most frequent question is some variation of: What is Lean Six Sigma anyway? Let’s answer the second question first and then dive in on how to get started.

Master of Cycle Time: Little’s Law

In physics, laws are a fundamental part of understanding how systems operate. E=mc2 would have to classify as the most famous example. From these three simple letters, physicists and others have been able to greatly improve their understanding of how the universe works and make predictions about how things will behave under differing circumstances –

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  • Operational Excellence

  • Was There an Impact?

    Was There an Impact?

    A major challenge in impact assessment, program, and policy evaluation, is determining whether our actions had a meaningful impact. Did our program work? Is the policy effective? Frequently, data analytics use tests of statistical significance (such as F, t, p, R2) to answer this question. Unfortunately, tests of statistical significance can’t answer questions concerning impact.

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  • Full House: Understanding and expanding capacity in health care

    Full House: Understanding and expanding capacity in health care

    Why is the Canadian health care system struggling with long wait times for everything for emergencies, seniors care and surgeries? The answer–mismanagement. Specifically, a fundamental flaw in the way we think about and manage capacity. Read the article that has kicked the health care industry “on its butt” courtesy of Six Sigma Forum, a peer

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  • Systems Thinking in I.T. and Service

    John Seddon is one of our favorite people and a leader in applying systems thinking to Service, Project Management, and especially in I.T. Below are parts of a speech from John on Systems Thinking–as entertaining as it gets. Part 1 Video Part 2 Video Part 3 Video        

  • Statistical Significance--what do statisticians think?

    Statistical Significance–what do statisticians think?

    Many practitioners have trouble getting over the hurdle of statistical significance testing. We’ve used it for so long, it seems like a trusted friend. Do we really want to toss an old friend aside? No, but then again, statistical significance hasn’t been a friend. In the words of Ziliak and McCloskey, it has cost us

    Read More…

  • The Decline of Health Services in Alberta

    The Decline of Health Services in Alberta

    The Triumph of Professional over Real Management The past 20 years have seen a steady decline in the provision of health services to Albertans. Waiting times for surgeries, diagnostic services and emergency room visits is increasing, costs are escalating and quality of care has remained constant at best. A day doesn’t go by without the

    Read More…

  • Inspections and Audits

    Inspections and Audits

    Developing a cost effective approach Some organizations equate quality with the level of inspection. The greater the number of inspections, checks, audits or evaluations, the greater the level of quality that is assumed to be in the final product or service. Unfortunately for these organizations, just the opposite is true. Quality assurance is only required when processes

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  • More from Operational Excellence
  • Voice of the Employee

  • Employee Engagement Surveys as a Statistical Confidence Game

    Employee Engagement Surveys as a Statistical Confidence Game

    So much depends on your employee engagement survey getting it right. But what if it doesn’t? What if virtually everything in your employee survey from the engagement index, the factors driving engagement to the benchmark comparisons are all junk science–statistical snake-oil robbing you of engagement and productivity? Download, The Statistical Confidence Game of Employee Engagement Surveys, to

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  • Why the Best Companies to Work For are Likely the Worst

    Being labelled one of the Best Companies to Work For is great public and employee relations. It is also bad management. It is a sign that the company is more concerned with image than with reality. That’s not a good thing for either employees or the company. Among other things, it means the company will

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  • Voice of the Employee FAQ

    More and more organizations are abandoning traditional survey research in favour of Voice of the Customer (VoC) or Voice of the Employee (VoE) methods. This trend has accelerated with recent attacks by the scientific/statistical community on the widespread misapplication of traditional survey research (including misuse of statistical significance) and flagrant overreaching, especially when making comparisons

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  • Snake Oil and Science in Employee Research

    Most organizations regularly survey their employees to better assess the state of the employer/employee relationship. The intent is to bring some science to bear on the problem of identifying areas of strength and weakness. By identifying what is important and what isn’t, management actions can be based on the best available evidence. This provides a foundation

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  • Effective Use of Employee Survey Research

    Most organizations regularly survey employees to better assess and understand the state of the employee/employer relationship. Usually this is done with the specific aim of identifying strengths and weaknesses in the relationship in an effort to improve levels of employee engagement and loyalty. Conducting employee survey research isn’t inexpensive. Given the costs involved from consulting fees to

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  • The Cult of Statistical Significance

    If you see statistical significance or significance testing in your Employee , Customer or Operations Research  then in all likelihood you are doing it wrong. Equally important, conclusions drawn and decisions made on the basis of significance tests may very well be doing you more harm than good. This is the basic message of  The Cult of Statistical Significance: How

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  • More from Voice of the Employee
  • Voice of the Customer

  • Are You Satisfied?

    How your voice is corrupted in citizen satisfaction surveys CALGARY, AB, Jun 18, 2012/ Troy Media/ Some years ago, the City of Calgary conducted a multi-million dollar effort to engage citizen’s in the development of a new transportation strategy. The Go Plan used consultations, focus groups, workshops and polls to engage citizens and gather feedback.

    Read More…

  • Snake Oil and Science in Employee Research

    Most organizations regularly survey their employees to better assess the state of the employer/employee relationship. The intent is to bring some science to bear on the problem of identifying areas of strength and weakness. By identifying what is important and what isn’t, management actions can be based on the best available evidence. This provides a foundation

    Read More…

  • The Cult of Statistical Significance

    If you see statistical significance or significance testing in your Employee , Customer or Operations Research  then in all likelihood you are doing it wrong. Equally important, conclusions drawn and decisions made on the basis of significance tests may very well be doing you more harm than good. This is the basic message of  The Cult of Statistical Significance: How

    Read More…

  • Understanding Value using Dr. Kano's Model

    Understanding Value using Dr. Kano’s Model

    How do you define quality? That’s an important question for those engaged in quality improvement. Defining things can be difficult, doubly so when the definitions concern something as vague as quality. Yet define we must, especially if we want to measure current quality levels, or improvement to quality. After all, if you can’t define something,

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  • More from Voice of the Customer
  • Other Areas of Interest

  • Systems Thinking in I.T. and Service

    John Seddon is one of our favorite people and a leader in applying systems thinking to Service, Project Management, and especially in I.T. Below are parts of a speech from John on Systems Thinking–as entertaining as it gets. Part 1 Video Part 2 Video Part 3 Video        

  • Statistical Significance--what do statisticians think?

    Statistical Significance–what do statisticians think?

    Many practitioners have trouble getting over the hurdle of statistical significance testing. We’ve used it for so long, it seems like a trusted friend. Do we really want to toss an old friend aside? No, but then again, statistical significance hasn’t been a friend. In the words of Ziliak and McCloskey, it has cost us

    Read More…

  • Why products get better and service gets worse

    Service standards are really a means of avoiding accountability CALGARY, AB, Jul 17, 2012/Troy Media/ – Remember when getting a 100,000 miles of your car was considered a miracle of sorts? Those invited to bear witness performed the ritual of peering into the driver side window to confirm all those zeros on the odometer. The

    Read More…

  • Are You Satisfied?

    How your voice is corrupted in citizen satisfaction surveys CALGARY, AB, Jun 18, 2012/ Troy Media/ Some years ago, the City of Calgary conducted a multi-million dollar effort to engage citizen’s in the development of a new transportation strategy. The Go Plan used consultations, focus groups, workshops and polls to engage citizens and gather feedback.

    Read More…

  • science matters

    There is a difference between BS and a BSc. People are beginning to say so. CALGARY, AB, May 18, 2012/ Troy Media/ “All life is an experiment. The more experiments you make the better.” wrote Ralph Waldo Emerson. That’s because learning only happens through experiment, through trial and error and the testing of ideas and

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  • More from Other Areas of Interest

    Why products get better and service gets worse

    Posted on: 2012-07-25


    Service standards are really a means of avoiding accountability CALGARY, AB, Jul 17, 2012/Troy Media/ – Remember when getting a 100,000 miles of your car was considered a miracle of sorts? Those invited to bear witness performed the ritual of peering into the driver side window to confirm all those zeros on the odometer. The

    Read More…


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