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Reframe Before You Blame: Managing Performance In The Networked Economy

Reframe Before You Blame: Managing Performance In The Networked Economy
Forbes
By Brook Manville
Published: September 3, 2015
>> Reframe Before You Blame: Managing Performance In The Networked Economy

Dad needs a coronary bypass operation—and you’re helping him choose between two local hospitals. You discover both have about the same history of patient deaths per 100 procedures performed. You further learn that, at Hospital A, most recent bypass-related deaths were performed by a few apparently sub-par surgeons. You’re comforted they’ve been asked to leave the hospital. 

Hospital B shows a different pattern of surgical outcomes. Patient deaths there were not concentrated among any group of surgeons. Negative incidents were more widely distributed in the general rotation, with no discernible clustering of failure. Hospital B did not systematically dismiss “the few erring cardiologists,” but instead pursued a broader practice improvement program to enhance evidence-based protocols, training, and multi-disciplinary quality committees. 

So Where Do You Send Dad For His Operation? 

First take, you might choose Hospital A: decisive leadership identified the physicians responsible and moved them out. And who knows about Hospital B? Mistakes were more random there–how can you be sure that Dad won’t just be unlucky and be some doctor’s next operation mistake?


Oddly, Hospital B may be the better bet. Thus argues a new research study by Vinit Desai, an associate professor of management at the University of Colorado Denver (available in the current Academy of Management Journal) .

 

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