In this episode, Dr @StevenJSpear and I learn about how human creativity was unleashed to enable vaccinating 8K people/day, up from 2K/day in Jan, through relentless improvement.
And we explore how the lessons learned may inform how we can improve the overall healthcare system!
@StevenJSpear The things I learned from Trent Green, visiting the mass vaccination site here in Portland, or this interview were…
…some of the most hopeful & inspiring I’ve heard in years.
He describes how we can win this race to vaccinate everyone on planet, in shortest possible time.
@StevenJSpear Some pics from my amazing 3 hr visit to Portland Convention Center, run by our 4 regional health systems:
More pics to come, after I learn which I can post w/o violating patient HIPAA rules.
Imagine this vast 116K sq ft area where 1300+ people are vaccinated per hour, every day
@StevenJSpear That’s Trent Green in the middle, COO, SVP, at @OurLegacyHealth. On right is Chris Strear, MD, an emergency doctor, now Chief Medical Officer at Columbia Memorial.
Dr Strear spent decades improving flow in healthcare systems, and wrote this great book:
@StevenJSpear@OurLegacyHealth I describe what our 3 hour visit to the mass vaccination center was like midway thru the interview, and what we learned on how they created such a fast learning ramp.
On behalf of a very grateful populace, thank you to everyone who makes this happen, every day, since late Jan!
Here's a link to the wonderful @WillametteWeek article that described Oregon Convention Center mass vaccination as a "medical Disneyland", "like the best airport in the world," and "like a Swiss watch."
And they observe how everyone is smiling and happy.
...but I'm trying to refresh my memory on his teachings, and view it through the lens of how it informs how we create and exploit optionality, maybe against an adversary, but also on how one creates and operates systems.
(From Boyd to Steve Blank/Eric Ries & Dr. Carliss Baldwin)
But before I re-read the books on Boyd, I wanted to get a high-level survey of his material, and had so much fun watching this video — which included footage of multiplayer dogfight sims!
On Boyd: After Korean War, he became an instructor, he became known as "40 Second Boyd"
We speculate this aspect of Eroom's Law is what causes:
- the before vs. after state in Team of Teams
- waterfall -> DevOps
I think we even saw this happen in the COVID vaccinations (those that get 100% into people's arms vs 30%)
...and so many more domains!
Here are examples of where we think integrated problems solving was done superbly, resulting in amazing outcomes, vs those that were done poorly, resulting in disastrous outcomes.
Many of you have seen the famous Westrum Organizational Typology model, so prominently featured in State of DevOps Research, Accelerate, DevOps Handbook, etc.
This model was created Dr. Ron Westrum, a widely-cited sociologist who studied the impact of culture on safety
Thanks to Dr. @nicolefv, I was able to interview him for an upcoming episode of the Idealcast! 🤯
It was a very heady experience, and while preparing to interview him, I was startled to discover how much work he's done in healthcare, aviation, spaceflight, but also innovation.
I was startled to learn he has also studied in depth what enables innovation. He wrote a wonderful book "Sidewinder: Creative Missile Development at China Lake"
@mik_kersten@gail_murphy It was a startling thing to hear, as I was talking with @girba, and he mentioned the same thing.
What are the best papers that describe the nature of decision making, and how might inform great decision making (frequent, fast feedback, high levels of exploration, safe?)
vs…
@mik_kersten@gail_murphy …vs environments not conducive to great decisions (slow feedback, infrequent, dangerous, tightly coupled and highly interdependent, no one able to make decisions independently)
I feel like I can viscerally describe from experience what both those extremes feel like…
Wow, a super interesting question! Wasn’t as easy to answer quickly as I thought it would be!
TL;DR: My notes almost always go into Trello first, where I triage and organize them. I actually wrote a (Clojure) app to help manage these cards. Then all into @ScrivenerApp.. 1/N
@ScrivenerApp Almost all my notes start as Trello cards first: I use Zapier to put all starred tweets in there, I send myself emails that get turned into cards.
Each book often has one board, with lists for each broach category. I wrote app to enable moving cards w/1 keystroke, like vi.
2/N
@ScrivenerApp Last two books have had 800-1000 Trello cards, which were shuffled into 10-20 lists.
But the hard work happens in @ScrivenerApp, which is the part I think you’re talking about. Good ideas get copied into there, where they get developed or discarded.