• Providence Health Care - What’s New - Providence Legacy Project, St. Paul’s Hospital, Mount Saint Joseph Hospital, St. Vincent’s Hospitals, Arbutus, Brock Fahrni Pavilion, Heather, Langara, Holy Family Hospital, Youville Residence - The project has yielded great results, with an 87 per cent drop in the time from blood collection to the time of arrival in the lab, and a 45 per cent decrease in turnaround time from blood collection to result reporting.
• Primary Care And Health System Performance: Adults’ Experiences In Five Countries — Schoen et al., 10.1377/hlthaff.w4.487 — Health Affairs - Information about access and secure e-mail use, as well as quality measures across several countries.
• How NOT to lead geeks - This is an interesting post, although I think the title is at odds with the content (this is about leading people who develop great things for society). It adds more information to the LEAN idea that people are not the problem, it’s process.
• Toyota passes Ford as No. 2 in U.S. sales - Toyota’s ability to have humility in this situation is something a healthcare organization would be envious of.
• Running a hospital: Looking back after six years at BIDMC - I liked this. Compliment: It represents Hansei in a good way. Constructive Criticism: Thinking about applying LEAN to be more direct in the communication. Overall: More people should do this.
• Your New Title: Chief Inspiration Officer - I think I want to be this. Actually I think I try to be this. And I love it.

This book was tailor made for the experience I am having now. It’s the travelogue of a man who goes undercover as an employee in some of our most iconic organizations: UPS, The Container Store (not quite, he didn’t pass the interview), Enterprise Rent a Car, Gap, Starbucks, and The Apple Store. This is a true trip to the Gemba, in that Mr. Frankel actually goes to work for the companies discussed as an employee. I am doing a similar thing, but I am not undercover, and I am not actually practicing medicine in the organizations I am spending time with (I suppose I could do something similar as a health professional, but at a huge cost to the organizations and patients they serve). I am, however, putting myself at the interface between the customer and the organization, and I, too, am thinking a lot about culture and about how people and organizations work. It’s an awesome experience, as I’m sure Alex’s was.

Throughout my journey, I have resisted using the term “front line” because the war analogy doesn’t make sense to me in health care. However, I liked the way that Alex described the “front line”:

In the military, the front line is the border between two opposing armies; in retail and service companies it is the invisible divide between customers and employees

This definition frames the experience well in terms of how organizations fixated on “brand” see themselves, and the author stimulates thinking on this, in my opinion.

No one is selling what we think they are selling

The thing we think these companies are here to do doesn’t seem to be the thing they are actually doing. An Enterprise employee is really selling insurance in the form of collision damage waivers. A Gap employee is selling lines of credit. An Apple Store employee is selling add ons (warrantees, etc) onto the main products. Starbucks is selling the “third space” that is not our homes or our work.

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I missed the 60 Day mark due to travel, so this is the 79 day DCVersary. Still a green light, and greater appreciation for this environment by the day. In what other community do people respond to intolerance by staging a hug-in?

There’s a few stray links below about a recent report on RHIOs, and new “innovation” in ISPs accessing the code within Web pages for their customers - a new first.

Links for December 11th through December 12th:

• Wash. Leads Metro Areas in Walkability - people who know me well know that this is a make or break for a city. Another reason to love Washington.
• Underuse of colorectal cancer screening in a cohort of (Fee for Service) medicare beneficiaries - The study excluded managed care enrollees, so it’s really a study of fee for service Medicare, an important asterisk.
• DCist: Hug-In at Rite Aid: ‘It Feels Nice to Hug’ - What a great way to battle intolerance.
• The Shopkeeper Whose Sign Was ‘Open’ - washingtonpost.com - 14th Street Neighborhood leader Noi Chudnoff has passed away
• ZIPskinny demographic information for 20009 - WASHINGTON DC - Demographic Information about my neighborhood
• Dupont Circle Business Networking - Historic Dupont Circle Main Streets - 17th Street is getting a makeover. It looks like Plan B is more elaborate
• The State Of Regional Health Information Organizations: Current Activities And Financing — Adler-Milstein et al., 10.1377/hlthaff.27.1.w60 — Health Affairs - I admit, I have at times gotten in trouble for not being supportive of RHIOs.
• Lauren Weinstein’s Blog: Google Hijacked — Major ISP to Intercept and Modify Web Pages - ISP Content filtering now hits individual Web pages
• What Is Management’s Role in Innovation? ? HBS Working Knowledge - Nice discussion in the comments. I think there is a role, and some of the comments talk about what that role is.