2. Evolving Management Fads
• Just as computers & terminology evolved over the
past 4 decades of HIS-tory, so too have the
management principals used to govern them. These
intellectual fads and the prophets who create them
come and go just like hardware platforms do.
• The “Big Four” trends followed by both hospital and
IT executives in each of the past four decades are:
– 1970 = “MBO” or Management By Objectives
– 1980s = Productivity - # of widgets per hour/day/month
– 1990s = TQM/CQI – Total Quality
Management/Continuous Quality Improvement
– 2000s = Six Sigma - This one is for real…
3. 1970’s “MBO”
• First made famous by Peter Drucker’s book “The Practice
of Management,” published in the mid-1950’s.
• I learned MBO first hand at SMS in the early 70s after CEO
Jim Macaleer attended a Drucker seminar, then came back
and instituted monthly “Status Reports,” whereby each
manger had to write a report and meet with their boss on:
– What we did this past month, followed by
– Our goals for next month.
• Seemed simple, until next month, when your boss pulled
out last month’s report and asked, “What about these
other goals you listed?” or “Is that all you did all month?”
• Surprisingly effective to keep everyone’s eye on the ball,
and start to document more realistic goals!
4. 1980’s = “Productivity”
• In 1980, I bolted SMS and moved to McAuto, the other
giant shared system, and there met the productivity guru
there: Bill Corum, VP of Operations (the data center)
there.
• Bill piloted the Health Services Division’s (HSD)
productivity program, which applied statistical analysis,
measuring output from a production process, per unit of
input. His data center ran so efficiently, Chuck Barlow had
Bill expand it to much of HSD. The airplane company was a
natural home for such a scientific approach to
management.
• Bill was easily one of smartest and nicest ( a rare
combination in IT!) executives I ever worked with, and he
eventually took over McAuto during Chuck’s later illness.
5. 1990’s = TQM/CQI
• I wonder if Edwards Deming would recognize
how his management philosophy swept the US
in the late 90s, after his pioneering efforts in post WWII Japan.
• The acronyms stand for:
– TQM = Total Quality Management
– CQI = Continuous Quality Improvement
• This approach to management centered on quality, that is, error reduction
through improve design, service, and manufacturing, through rigorous
testing and applied statistical methods.
• Ironically, HIS vendors attended TQM seminars en masse in the 90s too, and
learned Deming’s concept of “partnering” with suppliers, for example, to
enable the “JIT” (Just In Time) inventory approach.
• Of course, sales executives latched on to this word and warped it into
today’s pathetic mantra: “we’re not a vendor, we’re your partner!”
• Poor Edwards would roll over in his grave (he died in 1993)…
6. 2000’s = Six Sigma
• Also known as “Sick Sigma,” this latest and greatest management fad had its
origins in Motorola in the 80s. Like TQM, it Six Sigma seeks to improve the
quality of process outputs by identifying and removing the causes of defects
(errors) and minimizing variability in business processes. It creates a special
infrastructure of people within an organization ("Black Belts", "Green Belts",
etc.) who are experts in reducing errors to less than 3.4 per million.
• So what’s new about Six Sigma versus TQM Productivity or MBO? This cartoon
says it far better in pictures than than I can in words!
7. Evolving Management Fads
• So there you have it: the four great “breakthroughs” in
management over the past four decades of the HIS industry:
– 1970 = “MBO”
• Management By Objectives
– 1980s = Productivity
• # of widgets per hour/day/month/year
– 1990s = TQM/CQI
• Deming from post WWII Japan
– 2000s = Six Sigma
• This one is for real!
• Which one has your organization embraced? To quote your
CEO, this new one he or she has found, one that really works…
