Author Archives: Edward Dolan

About Edward Dolan

My expertise is in improving project success for bio-medical technology companies. I consult, train and coach decision makers, both executives and employees to: • Recognize the real, underlying problems that stymie further progress. • Change what is undermining their success. • Develop systems that will reinforce, sustain and build upon their achievements.

3 Essentials For Productive Meetings

A worthwhile meeting: What does it take?

A worthwhile meeting: What does it take?

What does it take to make a meeting productive? 

While there are a lot of valuable meeting improvement tips and techniques out there, I think the keys to making meeting time worthwhile for all involved are more basic.

They require advance work – not a lot, but necessary.

They also require some courage.

1. Appropriate Information

Does everyone attending the meeting have in their hands the information they need to reach important decisions?

Meeting Paperwork

Information is crucial.

One implication of this principle is that informational meetings are a tremendous waste of time. Multiply (hourly wages + salaries) X (number of people present) X (the true length of the meeting) — since they often run overtime. Compare that to the cost of the many electronic and paper means we have for disseminating information. It’s a no-brainer.

There may be some information that cannot be entrusted to computers or put on paper. There may be nuances you need to convey. But do the equation above, and there should be very, very few; very, very compelling reasons to hold that informational meeting. Better returns on learning how to write and convey nuance and appropriate confidential information.

If your meetings are to create social bonds within a team or group, fine; but call it that and design it well with that goal in mind.

Information - Data - Shared

Information – Data – Shared

Otherwise, meetings are about decisions – decisions that require group input. And decisions require appropriate information. Depending on the situation and the decisions needed, that may not mean everyone having the same information. But each individual should always have the information she/he needs for that meeting.

If appropriate information is lacking, don’t have the meeting.

One caution: “appropriate information” does not mean “complete information.” We almost never have “complete information.” Understanding and sharing information gaps with other team members can be one truly useful meeting activity.

2. The Right People

Since meetings are about decisions, everyone who needs to be part of these decisions needs to participate. Sometimes a delegate will suffice: someone with full and real decision-making authority – and the above-mentioned appropriate, up to date information.

Meeting Highlighter Blurry People

Everyone there – and clear about their role?

Whose part of the project or activity or outcome will be significantly damaged by not being part of the decision making process?

Whose perspectives are crucial to making this a success?

Who will be carrying the responsibilities for the next step and/or the ongoing work?

Whose authority is required to take the next steps?

If any of those people will not be there or does not show up, you either need to rework the meeting’s agenda to the decisions that those present can carry forward; or cancel the meeting and let people get back to their work.

Who needs to be there?

Who needs to be there?

If this happens too often, your sponsor, champion or boss (or all three) needs to take action so that you can have the meetings you need to have – and only the meetings you truly need to have.

And it is the meeting leader’s responsibility to make sure that all the right people are not just present, but participating.

3. Clear Decisions

If meetings are about decisions; if you (and everyone involved) have done the work to compile the appropriate information; and if the right people are participating: then, what a tragedy if the outcomes are ambiguous and ambivalent!"On the other hand . . ."

There are many ways to make decisions and many ways to record decisions. Use whichever ones work best for you; but have a clearcut process for making and recording decisions.

You Gotta Make a Decision

You Gotta Make a Decision

Without such an explicit process, people will leave the meeting confused – either immediately or a week later.

Without such an explicit process, you will revisit the same decision over and over again, making it and undoing it and remaking it futilely.

Without such an explicit process, your next meeting will not have a clear beginning point or a desired set of outcomes/decisions that are consistent with overall progress.

You can tell that I have wasted far too many precious hours in meetings that accomplished nothing productive. That doesn’t have to happen to you – not anymore.

Do You Hate Meetings?

Do You Hate Meetings?

Conflict Management Always Begins With Myself

Think quick! How many people does it take to create a conflict???

Serious Reflection

Serious Reflection

One.

We are always torn inside, “of two minds” about our own differing values, needs, interests, approaches.

No wonder so much that is written about conflict on project teams feels so mechanistic. The helpful suggestions and techniques seem cast inside a framework that implies the project manager is the wise overseer who must reconcile these “kids” who can’t sort out their differences; when, in fact, the manager – and everyone of us – lives with the continuing awareness that often we are not really sure of the best way forward.

Engage

Engage

So, the best ways to prepare for and deal with conflict start with myself.

  1. Invest early and often in building trust, respect and connection. Conflict will come. Don’t skimp on the basics.

  2. Cultivate a healthy doubt about your own certainty. Openly question, analyze and evaluate your own assumptions.

  3. Whether or not you are the project manager, pay close attention to ongoing team work to identify – early – and resolve conflicts before they become serious.

  4. Encourage and support the exploration of alternatives.

  5. Focus on actionable solutions. Don’t belabor what can’t be changed.

  6. Make clear decisions with the rest of the team about what path and priorities are being chosen.

Security / Insecurity

Security / Insecurity

Since about a quarter of managers’ time is spent resolving conflicts, seize this opportunity to do and to model constructive, productive work. The six points listed above are a great recipe for just-plain gluten-free management.

So, why don’t we do this more often?

  1. We have a natural aversion to tension, disagreements, pain and polarization.

  2. This “people stuff,” the risk of getting entangled in others’ emotions, seems like tumbling into a bottomless pit without a bungee cord.

  3. Managers and consultants are often counseled never to show uncertainty or doubt.

  4. Today’s conflict may ultimately be rooted in a history of disappointments, betrayals and losses – which can seem overwhelming and way beyond our reach.

  5. Discussion in a conflict will often shoot off unpredictably into unforeseen, unknowable directions.

  6. Aggression and hostility are infectious, heightening feelings of aggression and hostility even among bystanders.

We have to acknowledge, but question, all these assumptions, too.

Habits - Feelings - Beliefs

Habits Feelings Beliefs

Basic psychological needs are at the root of almost all conflict. It takes courage to manage people respectfully. And what does “courage” mean here? The determination to step into the fire, to get singed – but not consumed – to feel a sense of accomplishment and to step back in the next time.

For more depth on this topic, I recommend several excellent articles:

ADHD and Project Management

“If you’re in [project] management and find yourself frustrated by a talented employee who is undermined by seemingly inexplicable but persistent behavioral issues, it’s possible there’s a specific reason for it. He or she may have ADD/ADHD.” (Victor Lipman, Forbes Online, 10/02/2012 and 9/3/2014)

Request/Questions

How do you deal with ADHD in project management situations? I would like to hear back from people with this experience, as I better formulate my approach to helping people in bio-medical technology companies improve their project successes.

Have you had a project team member with ADHD? As either a project manager or team member, what helped you to help them focus better? Are you a project manager with ADHD? How has your ADHD been an asset, a strength you can build on? What techniques have most successfully enabled you to overcome obstacles that ADHD might otherwise drop in your path?

Context

An explosion of color

An explosion of color

Ten years ago it was estimated that about 4% of the adult population has ADHD; that they are 18 times more likely to be disciplined and 2 – 4 times more likely to be terminated. A 2012 study estimated that 83% of the costs of ADHD were incurred by adults.

Our society, our economic world is clearly diagnosable as having ADHD. No sooner is one task thrown at someone, than a new one slides down the chute. (Changed, but hopefully consistent, metaphors.) “Multi-tasking” is expected, but entails constant distraction and usually comes with a continually changing, uncertain and inconsistent set of priorities.

Noise and clutter are everywhere.

Project Management

Successful project management requires a healthy tension between following structure and having the flexibility to respond to uncertainty; between, on the one hand, being a “good team member” and following directions and, on the other hand, being creative at solving new problems.

We know that the foundation for good project management is a thoughtful preparation to fall back on when the inevitable problems of time, design, resources and compatibility crop up.

Structure; Flow

Structure; Flow

Goals must be kept specific and realistic. Project managers and team members need systems, discipline and focus to manage the workload.

Project managers have to decide when the result is “good enough” – often (usually?) not perfect by theoretical standards, but meeting something like 80% of the original expectations, with a clear understanding of the costs and benefits of the tradeoffs that have been made.

ADHD

Someone with ADHD lives with the often uncomfortable marriage of a strong individual task focus + distractability; has to learn to systematically chunk larger goals into smaller goals and declutter their agenda; to steadily problem solve their way through uncertain, unclear situations.

Someone with ADHD may find it difficult to juggle the management of diverse (and always ambiguous) personalities with managing the team’s task list, all while upper management and stakeholders may be trying to change both project scope and overall priorities. Project management may challenge someone with ADHD to be very politic in what they share, when and with whom. They may need to find ways to develop charisma and good, attentive listening skills to win over team members and stakeholders; to develop partnerships; and to create enough space for the team to succeed.

It seems to me that the things an adult with ADHD has to get good at are precisely the things that make for successful project management.

What are my strengths?

What are my strengths?

But I don’t know. I would like to hear from you about your experience.

A few additional references:

www.marlacummins.com, “Over 60 Tools For Focused Action”

www.additudemag.com, “10 Ways To Boost Productivity At Work”

www.ADHDAwarenessMonth.org, “7 Facts You Need To Know About ADHD”

Harvard Medical School, Harvard Health Publications, “Mental health problems in the workplace,” 2/1/2010

Attention Deficit Disorder Association, “Workplace Committee,” 2015

www.help4adhd.org, “Succeeding in the Workplace”

www.marciahoeck.com, “5 Power Shifts You Can’t Succeed In Business Without,” 2015

www.marlacummins.com, “Six Common Planning Mistakes Adults with ADHD Make: (and how to fix them),” 2010

The Value of Unstructured Data

Paul Hake, a predictive and advanced analytics specialist with IBM’s Healthcare Analytics team, discusses the emergence of cognitive computing and how it can be applied to healthcare. Paul specializes in data mining and machine learning and has 14 year’s experience designing and implementing analytics solutions in the Healthcare and Life Sciences Industries.

As part of the Medical Development Insights series on URBN, I interviewed Paul about the intersection between “big data” and healthcare. Currently, “structured data” (easily quantifiable, often seen as checkboxes on forms) dominates the healthcare data field. However, “unstructured data” (narrative information) may contain some of the most important information for understanding, diagnosing and treating patients.

Click here to listen to the interview.

Several key quotes from this interview:

  • A lot of the useful, powerful data . . . is not captured in the structured data.”
  • 70% of the determinants of your health is behavioral.”

UDIs and Patient Safety

Under FDA regulations, most medical devices will now include a Unique Device Identifier (UDI) in human- and machine-readable form, creating a system to track and monitor the quality, safety and durability of every medical device. The public will be able to search and download information on specific medical devices.

In this Medical Development Insights interview, I discuss with Jonathan Bretz and Dick O’Brien some of the critical issues that companies now face in coming into legal compliance and the importance of “safety surveillance” through UDIs. Without reliable and consistent identification of medical devices, it is extremely difficult to identify counterfeit products and to help staff distinguish between devices that are similar in appearance but serve different functions.

These issues have recently taken on greater importance as it has been revealed that the federal Centers for Medicare & Medicaid Services has pushed back against plans to include UDIs on Medicare and Medicaid claim forms.

Improving Global Health

I interviewed Beverly Brown for Medical Development Insights on the UR Business Network. Beverly is Director of Development for the Center for Global Health & Development (CGHD) at Boston University. She joined the Center for Global Health & Development at Boston University in 2010 to lead the effort to diversify the funding for programs, people, and projects. She is primarily focused on diversifying funding for global health initiatives, life science research and development.

Click here to listen to the interview.

Once again, it became clear in the interview how important bedrock project management principles can be: listening to the local community to hear their needs and how they describe their needs; planning; scheduling; budgeting; preparing a business model for sustained success.

The Deinstitutionalization of Acute Care Patients ?

An era of restricted revenue”

“The business case for lowering inpatient length of stay”

“As hospitals and healthcare systems pinch pennies”

“The number of avoidable days relative to a benchmark”

“Diagnosing efficiency benchmarks”

PiggyBank+StethoscopeimagesMuch of the healthcare sector is now focussed on reducing length of stay in hospitals. A key element of healthcare reform is both denying payment to and penalizing hospitals for “inappropriate readmissions.”

NursePatientInWheelchairimages-1This can be good for individual patients as well as for the economy. Hospitals can be very dangerous places to be. Robert Pearl, MD, highlights 4 key reasons for that.* It is the 4th that should raise a cautionary note about this trend: “Hospital stays sometimes result in problems after discharge.”

We’ve seen this potentially combustible mix before. It was then called “deinstitutionalization.”

StraitJacket-images-7By 1965, newspaper and movie horror stories had gained enough traction to push politicians to close state facilities and move psychiatric patients into nursing homes and community care. These moves were predicated on the development and provision of adequate community care.

Deinstitutionalization did improve the lot of millions living with “intellectual and developmental disabilities.” It allowed them to escape intolerable conditions in these hospitals and to live with proper support and without stigma. But it was a very different story for Americans suffering from severe mental illness.

mental-illnessCalifornia had taken the lead in aggressive deinstitutionalization.**

  • And California became “the first state to witness not only an increase in homelessness . . . but also an increase in incarceration and episodes of violence.”

  • In 1972, a “California prison psychiatrist . . . claimed to be ‘literally drowning in patients . . . who have serious mental problems.’”

  • A study of . . . patients discharged . . . between 1972 and 1975 found that 41% of them had been arrested [and] the majority . . . had received no aftercare following their hospital discharge.”

Nationally, by “the mid-1980s, 23% of nursing home residents . . . had a mental disorder.” There was no comparable increase in training or resources. It is estimated that 1/3 of the homeless and 16% of the total jail and prison population have schizophrenia or bipolar disorder.PrisonMentalIllnessimgres-1

In 1984, the New York Times reported, “The policy that led to the release of most of the nation’s mentally ill patients from the hospital to the community is now widely regarded as a major failure.”

Today’s healthcare reform is similarly predicated on the provision of appropriate aftercare. Hundreds, perhaps thousands, of apps, techniques and approaches are under development to improve home care and prevent the now-costly readmissions.

Again it is assumed that the market, our states and our communities will provide what hospitals up to now have not. As of Aug 28, 2014, 23 states – only 2 short of ½ – had not elected the Medicaid expansion under the ACA – a bad omen.

Not only was there a failure of will to provide adequate aftercare support for the seriously mentally ill. There was also what an author referred to as “one awkward reality”:

  • [T]he economic case for deinstitutionalization – highly appealing to both fiscal conservatives and civil libertarians – turned out to be almost entirely wrong. . . . Effective community-based supports are generally superior to institutional care. They aren’t necessarily cheaper; often the opposite is true.”***

So whither 21st century American healthcare reform?

* Robert Pearl, MD, “4 reasons why hospitals can be very dangerous places to be”

http://www.kevinmd.com/blog/2014/02/4-reasons-hospitals-dangerous-places.html

** E. Fuller Torrey, MD, “Ronald Reagan’s shameful legacy: Violence, the homeless, mental illness”

http://www.salon.com/2013/09/29/ronald_reagans_shameful_legacy_violence_the_homeless_mental_illness/

*** Harold Pollack, “What happened to U.S. mental health care after deinstitutionalization?”

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/06/12/what-happened-to-u-s-mental-health-care-after-deinstitutionalization/

The Key Aspects of Trademark Protection for Med Tech Companies

Trademarks are business assets. Safeguarding their value in medical device and life sciences product and service businesses and product lines is too often not considered until late in the development and marketing process. But as assets, trademarks are best protected if established as early in the process as possible.

Robert Adelson, a corporate and tax attorney for over 30 years, discusses key aspects of trademark protection:

  • Value of choosing “suggestive” brand names for businesses, products and services, and value of trademarks as a commercial asset
  • Registration process to protecting of brand names in Use, and those desired on an ITU – Intent To Use basis
  • Pitfalls to registration, and how to avoid loss of trademark protectio

Click here to listen to this Medical Development Insights interview on the UR Business Network.

 

Ingenuity of the Bionic Ear : Cochlear Implants

Sam Silberman has had a hearing problem since he was a young child. His parents got him a hearing aid early on, and as he grew he replaced his hearing aids with ever newer hearing aids. But in 1999 he did something transformational for himself: he had a cochlear implant. From somewhat indistinct sound and speech, he immediately leapt to clear sound and increasingly clear speech. Today you wouldn’t know he has a hearing problem unless he told you.

With my co-host, Kevin Franck, I interviewed Sam and we explored his journey from deaf child to Senior Area Manager for Cochlear Americas, the global leader in bionic hearing devices.

Click hear to listen to the interview.

Counterfeit Medical Device Parts

In another “Medical Development Insights” interview, I spoke with Rich Nadeau and Al Cruz about counterfeit medical device parts. They had prepared some interesting thoughts for the FDA-MDG conference on October 30, 2014. Rich is the Founder and president of eComp-Electronic Components Inc, a 14 year old company focused on specialty distribution and counterfeit product detection. Al is a Senior Product Quality Engineer III, at Hologic, where he develops, modifies, applies and maintains quality plans and protocols for processing materials and products. They met when Al went to Rich with a concern about failure rates in one of the products he was testing.

Counterfeit medical products cause risks to consumers’ health and well-being, adversely affecting companies by loss of sale and loss of reputation when counterfeit parts fail. With the ease of access that the Internet provides to procurement offices, the medical dangers of counterfeit parts have grown.

Patent Protection: Interview with Kirk Teska

I have recently begun an Internet radio interview show, titled “Medical Development Insights,” on the UR BusinessNetwork: http://urbusinessnetwork.com/medical-development-insights/

In this conversation,

http://urbusinessnetwork.com/intellectual-property-patent-law/

along with Jeff Karg, I interviewed Kirk Teska, an attorney with over 20 years of intellectual property law experience, managing partner of the intellectual property law firm Iandiorio & Teska based in Waltham, MA, and professor at Suffolk University Law School in Boston. Jeff is Director, Program Development, for TechEn, where he oversees project engagements by aligning client needs with TechEn’s suite of services and capabilities. He is the primary inventor on 22 patents in areas ranging from inhalers and drug delivery devices to water filtering faucets and blood collection disposables.

In the interview, Kirk examines intellectual property patent protection for medical devices, something he presented at the October 1, 2014 MDG monthly forum on “Intellectual Property Approaches To Safeguard Value.” He covered several key points:

  • Myths the general public – and many entrepreneurs – have about patents
  • What the potential inventor needs to know
  • How to work with patent attorneys

Kirk Teska’s book, “Patent Savvy,” was published in the fall of 2007 by Nolo Press. His second book, “Patent Management,” was published by ASME in 2010.

Air France Flight 447: Mystery Solved

The mystery of Air France Flight 447 – which disappeared, crashing into the Atlantic Ocean in good weather off the coast of Brazil in May 2009 – is no longer a mystery.imgres-1

The causes: a breakdown in communication; unclarified assumptions about team roles; deskilling of the workforce; and arrogance about previous success.

images
Sound familiar? Whether it is a highly complex, state of the art airplane or a medical technology designed, honed and manufactured under highly regulated conditions: we can become our own worst enemies.

William Langewiesche analyzed the tragedy of Flight 447.* Early in his article, he states his thesis clearly:

Over the years, “automation has made it more and more unlikely that ordinary airplane pilots will ever have to face a raw crisis in flight – but also more and more unlikely that they will be able to cope with such a crisis if one arises.”

Today “the very design of the . . . cockpit is based upon the expectation of clear communicationimages-5 and good teamwork.”

3 hours and 41 minutes into the flight from Rio to Paris, ice crystals clogged 3 air-pressure tubes. That knocked out the cockpit’s 3 airspeed indicators. This did not materially affect the performance of the aircraft. But it startled the pilots. “The episode should have been a non-event, and one that would not last long.” But it set off a chain of reactions by the pilots in the cockpit. It became unclear who was in charge. Assigned roles were ignored. There was confusion about who had done what and why. As a result, the plane went into a stall – clearly announced by the computer, but virtually ignored at first in the actions they took. In less than 5 minutes, the plane hit the surface of the ocean at a descent rate of 11,000 feet per minute.

images-2

As in the case of the West Africa Ebola epidemic, we see catastrophic consequences of admirable and generally successful efforts. Langewiesche is clear about this in the article: “the new airplanes deliver smoother, more accurate, and more efficient rides – and safer ones, too. . . . Since the 1980s . . . the safety record has improved fivefold.”

But the resultant “deskilling” of airplane pilots means that for today’s pilots “most of their experience had consisted of sitting in a cockpit seat and watching the machine work.”

The hard-won wisdom of project management can help us better use – and protect ourselves from – advanced technologies.

  • Risk assessment: “What can go wrong?”

  • Think about the big picture. “How will this piece of technology fit into the human experience of x?”

  • Surface the assumptions that underlie this project – and proceed to “perfect” the technology cautiously.

  • View people – veteran, resistant pilots; newer, less experienced pilots; regulators; clients; naysayers – as allies to learn from, not as adversaries to beat down.

*Vanity Fair, October 2014, “The Human Factor: Anatomy Of an Airliner Crash

Management Mistakes In the Ebola Hot Zone

Every project starts with a worthy goal. Unfortunately we often then assume that all reasonable people will accept the initiative. The Ebola epidemic in West Africa poignantly illustrates how that can go wrong – badly and fatally – even in something as important as health care.

Ebola-virus-structure

Once it was recognized that the epidemic was Ebola (in March 2014), the international community’s response was “rapid and comprehensive – exactly what you would hope.” But therein lay the seeds of an even worse explosion of cases a few months later – making the West Africa Ebola epidemic the worst ever. “The foreigners had come so fast that they had actually out-run their own messaging: there were trucks full of foreigners in yellow space suits motoring into villages to take people into isolation before people understood why isolation was necessary. . . . [I]solation centers [were] a one-way maze [where] relatives and friends went in and then you lost them.”

images-4Rumors then started about organ harvesting at the hands of rich foreigners. As fear itself became “a contagion,” people ran from, hid from and attacked health workers. They stopped cooperating – and as they fled their ancestral homes in fear, the disease spread unseen into other, farther outlying villages.

What does this horrific story have to do with project management in our everyday workplaces?

Well, it sets out in stark relief the unforeseen collapse of some of our best intended interventions.

images-1
If we were to replay the West Africa Ebola response, what might we do differently?

  • Realize that no matter how noble and important the effort, no problem solving will be effective without engagement of and clear communication with the affected parties.

  • Engage local champions – “drivers,” people with real credibility – to understand and explain the effort.

  • Surface and candidly address rumors. You just can’t afford to disdain and ignore viewpoints you consider irrational.

  • Have the humility to listen to the people’s experience, their concerns and fears, and cast your proposed solution in those terms – and modify it accordingly.

The source of all quotes is “Hell In the Ebola Hot Zone,” by Jeffrey E. Stern, Vanity Fair, October 2014, one of 2 excellent articles in this issue with clear implications for how we handle important problems – and ourselves – in this brave new world. I will be commenting on the other – “Anatomy of an Airliner Crash,” by William Langewiesche – in my next post.