It was raining when I walked out of work today a little after 6 PM. Bad weather means bad traffic, and I knew I had a long drive ahead of me. I put on my TED talks podcast and began to listen. The second talk was by Barry Schwartz, author of The Paradox of Choice. If you know me at all, I’ve told you to read that book. It’s in my Top 5.
Barry’s arguments about practical wisdom weren’t nearly as convincing as his insights into human choice. You can watch the talk below if you want. It’s not necessary.
At the end of the talk Barry takes a firm stance against having too many rules, giving judges a list of mandatory sentences, telling teachers exactly what to teach, etc. He spent the whole time telling us what not to do, but didn’t provide any solutions for what to do.
I’ve often heard that the organization with the fewest rules is the best organization. That sounds nice, but I don’t completely agree with it. Like most things in life, the answer lies somewhere in the middle.
Author Steven Johnson describes the careful balance quite effectively in his book Where Good Ideas Come From.
“The computer scientist Christopher Langton observed several decades ago that innovative systems have a tendency to gravitate toward the “edge of chaos”: the fertile zone between too much order and too much anarchy… Langton sometimes uses the metaphor of different phases of matter – gas, liquid, solid – to describe these network states. Think of the behavior of molecules in each of these three conditions. In a gas, chaos rules; new configuration are possible, but they are constantly being disrupted and torn apart by the volatile nature of the environment. In a solid, the opposite happens: the patterns have stability, but they are incapable of change. But a liquid network creates a more promising environment for the system to explore the adjacent possible. New configurations can emerge through random connections formed between molecules, but the system isn’t so wildly unstable that it instantly destroys its new creations.”
That led me to remember a healthcare article I read in the New York Times which introduces a healthcare provider focused on learning and best practices. Intermountain Healthcare (IHC) is an integrated delivery system located in Utah and Idaho. In simpler terms, they are the insurance provider and also own the hospitals. IHC is widely considered to be one of the best healthcare systems in the nation. President Obama has cited them as an example of what healthcare should become.
Part of IHC’s success comes from their focus on best practices. They pick a medical condition, define a set of steps to be followed with exactness, then slowly introduce variation into the steps. After testing a wide variety of step combinations, they crunch the data and define the specific steps that should be followed with exactness every single time the condition is encountered. The result? Significantly higher survival rates.