Marcus Pierson, MD: Transparency

Trust as a Verb and Insecurity as a Good Thing

Sun, 01 Feb 2004 20:13:27 GMT

Building Trust, by Flores and Solomon is a really good book. I rank it with The Wisdom of Insecurity, by Alan Watts as two of the most mind altering books I have read. Watts turned the conventional wisdom of insecurity on it's head, essentially showing that security or fixedness is closer to death and that insecurity or uncertainty is closer to life. When his wisdom sinks in, one comes to appreciate insecurity for what it is--the experience life-giving growth. On can then quit amplifying a certain amount of natural stress, by dropping the judgment that insecurity is bad.

Flores and Solomon turn broken trust and betrayal on their heads, as Watts did with insecurity. They allow one to see that trust and betrayal are sides of the same coin (one meaningless without the possibility of the other) and they also allow one to see that creating and rebuilding trust is the key act in creating a better and shared future. Without such acts of trusting and rebuilding of trust from moments of betrayal, no better future is possible. Trust is not a thing to be shattered. Trusting is a competency for all forward looking people to practice and learn--a verb, not a noun.

Below is a kind of relationship diagram that captures some of the ideas that filled my head as I read the book.

Clear Leadership

Sun, 01 Feb 2004 18:47:45 GMT

A friend of mine, Gervase Bushe, wrote a very useful book: Clear Leadership. The insights and framework are based upon his career as a professor and business consultant

Clear Leadership is full of practical and immediately useful mental models and advice. Organizations are beginning to use it as a framework for leadership training at all levels.

After reading this book, I created a mnemonic and a drawing that help me keep a few of the book's key points in mind and handy for my use. I give them to you with Gervase's permission.

SOFTeNeD stories and maps.

Sensing--what is my body telling me? Am I poised for a fight, to flee, to hear, to learn, to have fun, etc.

Observing--what would others agree happened, what was objective, what data can we agree upon and share?

Feeling--awareness of feelings is very useful early on, as feeling color everything else.

experience, each person has a different one

Need (want)--what do I want to happen, what do I want in the way of agreements.

experience, our stories come from our experience, we can share these and ask others to share their's. Experience is subjective and has numerous aspects (SOFTND)

Do--what will I do and what will I agree to do?

This little graphic represents for me Gervase's four profound senses of self and matching sets of skills:

Appreciative self--the halos, understand what you and the other have done that you would like to see more of. It is a kind of "assets based" approach or "appreciative" approach and comes form the appreciative inquiry framework.

Aware self--the recursive loop, suggests that we spend time first going over the SOFTeNeD algorithm personally, before trying to tell others or ask others.

Descriptive self--the arrow from my mouth to the other's ear, suggests that I must describe my SOFTeNeD stories and maps to the other in an appreciative frame and expressing understanding that it is only my experience, not all facts.

Curious self--the arrow from the other's mouth to my ear, suggests that I must have skill in asking and hearing about their experiences and if possible their SOFTeNeD stories and maps. I try to hear in an appreciative frame.

It has been about a year since I read this book and I have not reviewed it for this post. I hope you will pick the book up and work with the concepts in it. We can all do our parts to reduce the "interpersonal mush" in our organizations and communities as well as at home.

Weblogs in business, candor, openness, abundance

Thu, 26 Jun 2003 03:38:46 GMT

Some interesting thoughts about weblogs in corporations: http://www.mcgeesmusings.net/2003/06/16.html#a3376

Weblogs in Business would change everything.

Thu, 26 Jun 2003 03:33:05 GMT

Here are suggestions from Todd Brehe on weblogs in business. Sooner or later this level of openness and commitment to what we think and do will arrive. I believe that organizations that can take this step, from paternalism toward their employees to partnership will begin to dominate their industries. Yes it is a prediction.

http://www.optinnews.com/read-article.php?id=1718

Convenience vs. Commitment

Sun, 18 May 2003 15:03:04 GMT

Pursuing Perfection in Whatcom County is not an undertaking of convenience. It is a matter of commitments. Commitments have been made.

The prior five or six years of work by CHIC memebers were agreements and collaborations of convenience, we publicly promised nothing, we did things in our own time. Pursuing Perfection is different, we have made difficult promises to patients and we must keep them. As Karl Weick points out, to have true commitment one must state voluntarily, personally, publicly, and in an irrevocable manner what you will do. We have done this.

Streaming Stories Sooner than Later

Thu, 15 May 2003 07:15:33 GMT

We have the streaming audio and video (QuickTime) server installed and will begin the learning curve to enhance the patients' and healthcare workers' stories with multimedia on the web. We have begun a discussion to track our progress: http://www.wwpp.org:8080/wwppDiscuss/discuss/msgReader$50. Follow along if you are interested.

John Patick, ex-IBM VP of Internet Technology, on weblogs / blogging

Sun, 02 Mar 2003 18:47:01 GMT

Word Bursts.
Six months ago I said I would write about blogging as a topic -- to try to capture my thoughts about how profound and important blogging is. There has been so much written by so many thoughtful people that it would be hard to offer new ideas about it and frankly, I have been putting off the task. Yesterday I got an email from Irving Wladawsky-Berger, my friend and former boss at IBM, about Word Bursts. Irving's note motivated me to get going and put my thoughts down -- time to blog about blogging.
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I think the biggest economic potential of blogging is inside the firewall. Intranets are now cluttered with millions of pages of “stuff” and most of it is poorly organized and the relevant things are often hard to find. To some extent the intranet has become an information dumpster. Portal software (like WebSphere) is making an impact but there is a long way to go for most organizations. Every company, government, university or non-profit has inside "experts" and people really care about what they think. They would find it much more productive to go to the expert's blog than do a search with the intranet search engine. Knowledge Management is not an “in” term but to me that is what blogging is about – sharing knowledge. (read more), See John's short bio, [John Patrick's weblog]

Cluetrain Manifesto and Pursuing Perfection in Healthcare?

Mon, 24 Feb 2003 03:20:01 GMT

The Cluetrain Manifesto has something to do with Transparency and with Patient-centered and more. I had never seen it until tonight. It is definitely not business as usual.

Problem-Knowledge Couplers

Sat, 15 Feb 2003 21:44:18 GMT

This is something that a community could support and afford that may not be adopted by many small practices. If the usual adoption delay in health care, 10+ years applies, maybe it is on the horizon.

I have been watching and wanting this for about 7 years.

Web Groupware: forming and supporting groups on the world wide web.

Sat, 15 Feb 2003 18:01:56 GMT

John Udel talks about Radio/Userland and web groupware. How to form and support groups on the WWW. That is what we are doing. We have been collecting enough content from Whatcom County, WA pursuing perfection folks that others can see what we are doing and hopefully want to work with us and communicate with us using weblogs (Radio and Manila), e-mail, and hopefully some day the shared outlines and instant messaging. We keep moving toward this vision.

Appreciative Inquiry Video Clip--a positive orientation for change

Thu, 02 Jan 2003 09:56:34 GMT

Here is an interesting streaming video clip on Appreciative Inquiry from Ernst and Young and The Corporation for Positive Change. David Cooperrider and Diana Whitney are featured. You do need to have RealPlayer installed.

Here are my notes from it:

Three sources of strategic advantage: 1) Engagement of the talent and capacity of every person at every level of the organization. 2) Magnifying the speed for innovation 3) Creating a magnetic setting for the attraction of the best talent.

Get to the value faster.

Go beyond the deficit based ideas of management that we have grown up with. Burning platforms, analysis of what is broken, or what is wrong.

The best you have ever been. Your most successful.

What do you want more of?

When we search for and listen to the stories of the true, the good, the better, the possible, one finds that the system begins to move in that direction with a tremendous amount of energy.

You have to find ways to keep the hearts and the minds of people engaged. Any you have got to find ways to keep them thinking about the future.

Looking at what is possible in the organization or the community.

People move in the direction of what they study, what we think about, and what we ask questions about.

Everyone engaged in the success of the company and committed to the success of each other.

Problem solving can yield incremental gains. Appreciative inquiry can yield breakthrough gains.

Focus on the things that work, the days that result are best, and discover what was happening.

A way to really get people engaged.

Tied back to the bottom line, to tangible outcomes.

Increase throughput

Ernst and Young: ePositive Change. They have an alliance with the Organization for Positive Change

Communications/Transparency Workgroup, Boston, May 2--30, by Carol Boston-Fleischhauer

Sat, 06 Jul 2002 15:04:25 GMT

Observations

1. many of us went to this; so my observations are less relevant

Bottomline, what did I commit to:1. Actually, nothing; however, I think I should continue to partner with Terri Rambosek (who Stu is delegating to handle alot of this transparency stufff), as the seven P2 attorneys start to have conversations with each other. I am meeting with Terri Rambosek next week on the transparency issue; more from the standpoint of information/communication/education; Jim Scott and I both believe we need to keep talking with the inhouse attorneys to help keep them abreast of what we are trying to do.........

Thats it for now; again, an exhilirating experience; clearly, these Learning Groups are taking on lives of their own; that in some ways will go beyond the immediate project goals P2; I feel we are in a lifetime journey with P2/IHI colleagues, dont you! In other words, when the first round of grant money goes away, we wont...

CBoston-Fleischhauer@PeaceHealth.org

Transparency is key to success.

Wed, 26 Jun 2002 04:03:42 GMT

This can seem counter intuitive at times.