There are a number of really awful truisms that we cling to in many operations, businesses and such. One of the worst is ignorance about measurement.
Effectively creating a measurement for something in a meaningful way requires forethought and insight. Instead, we select a flood of incidentals which are inaccurately sampled, that create numbers which are of varying worth, and spill them out as a disorganized mess onto the table, claiming that they are all useful for measuring the efficiency of a process. The psychoanalytic types found no benefit in psychoanalyzing psychotic thought disorders, as there is a flood of incongruent, unsorted rubbish that comes out, verbigeration. Our modern approach would be to record and transcribe the words of the schizophrenic patient, and given the magic of IT and Algorithms, sort it all out into meaningful insight. That’s just silly.
There is no awareness that most measurement data that can be generated from any situation, is rubbish. Examples abound throughout the old days when the Commissars ran the factories in the Soviet Union. Bad or crude data, handled simplistically, drives bad planning.
For example, the light-bulb factories in the Soviet Union manufactured light bulbs for domestic use. In a great example of simplistic bad planning, they evaluated each factory by the wattage of the light bulbs produced every month. Factory A produced light bulbs totaling, 1,000,000 watts last month; but Factory B, only 900,000. Which factory is better?
So, of course, the factories produced the bulbs that had the highest wattage per bulb. 500 and 1000 watt monster bulbs were sold in homes, where in American houses, a 200 watt bulb was considered brighter than most households needed at any one location. Due to another clumsy measurement technique, most apartment complexes charged a per-apartment charge for heating, but a proportionate amount for electricity. If you turned the heat up in the apartment, it actually cost you money – but turn on the lights day and night, no difference!
The USSR had the absurdity of people heating their houses with thousands of kilowatts of unneeded light bulbs, giving off heat. Sitting around the house, one wore sunglasses due to the indoor glare – in a country with winters where the sun hardly shone outside. Keep the apartment at 80 degrees – it’s the same price as sixty degrees, comrade! And burn fossil fuel inefficiently to make electricity. Of course, when the electrical plant burned up its weekly ration of coal, it simply shut down. Too many shutdowns, and the grid went off-line, the electricity died, and the eternal sunshine of the Soviet apartment went dark.
That story speaks of inefficiency and waste, and who could deny it? Yet, all of the steps showed careful consideration of the management details. Somehow, the greedy capitalist economies, caring nothing for the comfort of the worker, yet somehow managed to make the workers’ lives better. Go figure!
In the paper, one reporter chases the Golden Apple of organized healthcare – cutting waste. Yes, if we cut waste, we could pay for more services, and everyone’s panting after the imagined 5%-10% improvement on waste. But if there is no measure to determine waste, how do we know what we are doing? Should we harangue Factory B, using the same amount of materials, but producing less watt-months of light-bulbs? We go about these things literally blind as to what is efficient and what is wasteful, and we seize upon ignorant measures to tell us reassuring nonsense. Dr. Y’s average A1C is 8%, and Dr. X’s is 7%? Who’s the better doctor? And no matter how the medical director insists that this is a poor way to compare providers, the next step or two up the ladder, and the call goes out – Dr. Y better hop to it, or she’s fired!
I would say that the “decline” is a starburst of ignorance, a supernova of bad management that has come into the conventional wisdom of America, and is dragging us down. The percentage of some social irrelevance is reported breathlessly, and some politician will run with it. But did you know that 22.43% of all facts in reports are just made up on the spot? Or was it 24.32%? Anyhow, google it.
We are 100% chasing our tail in pursuit of the unachievable, and we will continue it until the lights go out over the whole endeavor.