A blind pursuit of targets

Two pertinent articles in today’s Sunday Times relating to a lack of understanding of complex systems.

The first “Labour hid ugly truth about NHS” includes the news that reports on the state of the NHS conclude that:

a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.

The second “Too many GCSEs make children ill” gives the opinion of the new children’s commisioner that:

many children were under such stress to achieve good exam results that they lacked a “work-life balance” and were at risk of falling ill from stress.

Last week at the Henley KM Forum and goodness knows how many times previously Dave Snowden and others have repeatedly pointed out that applying outcome management to a complex system does more harm than good. I have very recent personal experience of  a crazed new wave of managers introducing outcome measures, traffic light systems and a constant barrage of progress reporting meetings which achieve little but the disatisfaction of staff and a decrease in trust.

Is anyone in Govt health, education or the environment listening? or more optimistically put, perhaps this is the tipping point where they all self realise the error of their ways and measure impact not outcome.

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15 Comments

  1. Thanks Ron … I agree with you on the targets stuff … but in my experience … few people will listen to people who are telling them are wrong.

    So I would like to add something … in that most government organisations are now so target driven … that people only care about the short term. They have to meet their targets … and that is what drives them.

    So I think ironically … the leaders reliance of targets … has reduced their leadership role.

    So the only way they can change the organisation is to

    1. Get rid of targets,
    2. Change the targets, or
    3. Keep the targets but trust people to engage with each other to better meet the targets … without blaming each other, stressing each other, and making the work place an unpleasant place to be.

    I am not sure what option is best … but discussing the options feels to me … a better than standing on a box telling people they are wrong

    Does that all make sense?

    Cheers Jon

  2. Thanks ever so much for the comments.

    Jon I couldn’t agree more, but admit to leaving a Government Organisation after 22 happy years because the target measuring enslaught was too much to suffer never mind trying to discuss options with them. Its become so acceptible and ‘normal’ to impose targets and measures that ‘they’ really dont accept any criticism IMHO.

    Paul, I will take a look at John Seddons writing as he sounds a good soulmate.

    Bonzer, The simplest way would be to get ‘customers’ to record their anecdotal experiences of the services they receive and self signify them to add context. Decision makers (not consultants or outcome managers) could monitor this material constantly for patterns, access individual stories and act directly on the anecdotal evidence. It could save the NHS a fortune.

    Cheers, Ron

  3. “What you measure is what you will get”. It has always interested me the health fixation of an evidence based approach and measuring against such short term targets. Flawed because we rarely measure the evidence that is not available and then fraught because we target the known knowns to ensure that we get more of the same.

  4. Thanks Peter, an additional twist was quoted by Victor Newman last week at the Henley KM Forum that organisations are begginning to “only manage what they measure” which is a terrifying thought regarding the Health Service targets.

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  6. Nick, Thanks for your comments and I agree with your Blog post that setting your own targets is an improvement. The deeper issue is that a target (whoever sets it) attracts all the effort and thereby skews the system. I remember when English Nature was merged that I was asked to define my own targets and ‘increased knowledge sharing’, ‘greater sense of belonging’, ‘more effective teams’ were all deemed too wishy washy and difficult to measure so I ended up with ‘number of workshops’,’number of attendees’ and ‘satisfaction of attendees’ which can all be so easily gamed without achieving the original goals.

    The reason I like Dave Snowdens ‘narrative fragments’ approach so much is that ‘a good customer experience’ can be achieved in so many different ways and be perceived so differently by the customer that only the anecdotal story with its signification can approach the complexity of meaning of the experience. The built in ambiguity makes the questions less direct. The resultant patterns represent cross sections through the landscape (of all customer experience) which are extremely difficult to ‘game’.

  7. I appreciate both the work of Dave Snowden and John Seddon, and am glad to see referrals to both of them in this interesting post and the ensuing comments.

    As to John Seddon: here is a link to a lecture he held last year for the Human Givens Institute: http://vimeo.com/4670102.

    The text at the vimeo site where the video had been published, runs as follows: “John Seddon explains why targets make organisations worse and controlling costs makes costs higher. (…) Target Obsession Disorder laid bare.”

    Recommended!

  8. Targets, objectives, plans and measures have become absolute orthodoxy. What I find nowadays is that any group of people who are given the opportunity to develop a way of working for themselves will automatically self-impose rules and targets that they really didn’t need to and weren’t asked to!
    Actually I’m in favour of all these things but in a softer (and I think more sensible) way …
    So I’m fed up in a way of being hauled over the coals for project variances to plan – – of course there will be variances to plan in a project of any difficulty at all! The point isn’t to run completely to plan – but to be able to use the plan and adapt it as you learn during the project.
    So my approach is softer. It’s good to have some view as to where your headed and targets (and so on) help frame that. But at the same time we should be able to adapt and learn and not lose sight of common sense and other things that are emergent as we progress.
    The problem comes when some higher authority is going to judge performance strictly according to the initial target (etc) regardless of these other factors. It’s law without justice.
    So, Ron, I feel that even the implied outcome for the NHS of ‘customer satisfaction’ is a kind of target, but one that can take many forms and that has to be balanced with other needs (taxpayer approval, staff happiness – so on). I think it’s OK and necessary to use models of what these outcomes mean in order to manage – – but ultimately not to have you feet held to the flame if the final settlement between competing demands isn’t the same as the original guess.

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