National Alliance for Physician Competence Discovery Workshop

Pre-Workshop Resources

Related Information

The following materials are being provided as additional resources for participants of the August 27-29, 2007 Discovery Workshop in Chicago. These materials can be explored to provide background information. They can also be thought provoking. Currently there are materials relating to:

Innovation and Creativity

The Structure of Good Ideas
Keith Sawyer • June 22, 2007
I’ve just been reading a fascinating new doctoral dissertation by a recent Ph.D. from Washington University’s Olin School of Business: Chihmao Hsieh, now a professor at the University 0f Missouri. He asks a fascinating question about innovation: what is the structure of successful new ideas? If that sounds abstract, I’ll try to explain by drawing on some of the research from my book GROUP GENIUS.

Genetic Algorithms
Genetic algorithms are one of the best ways to solve a problem for which little is known. They are a very general algorithm and so will work well in any search space. All you need to know is what you need the solution to be able to do well, and a genetic algorithm will be able to create a high quality solution. Genetic algorithms use the principles of selection and evolution to produce several solutions to a given problem.

Genetic Algorithms (2)
by John H. Holland
Computer programs that "evolve" in ways that resemble natural selection can solve complex problems even their creators do not fully understand
Living organisms are consummate problem solvers. They exhibit a versatility that puts the best computer programs to shame. This observation is especially galling for computer scientists, who may spend months or years of intellectual effort on an algorithm, whereas organisms come by their abilities through the apparently undirected mechanism of evolution and natural selection.

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The See-Through CEO
Fire the publicist. Go off message. Let all your employees blab and blog. In the new world of radical transparency, the path to business success is clear.
By Clive Thompson • Wired Magazine Issue 15.04 - March 2007
Pretend for a second that you're a CEO. Would you reveal your deepest, darkest secrets online? Would you confess that you're an indecisive weakling, that your colleagues are inept, that you're not really sure if you can meet payroll? Sounds crazy, right? After all, Coke doesn't tell Pepsi what's in the formula. Nobody sane strips down naked in front of their peers. But that's exactly what Glenn Kelman did. And he thinks it saved his business.

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Complexity and Healthcare

Education and debate • Complexity science
Coping with complexity: educating for capability
This is the last in a series of four articles
Sarah W Fraser, visiting professor, Middlesex University; Trisha Greenhalgh, professor of primary health care
Recent high profile scandals in the United Kingdom have highlighted the changing values by which the National Health Service is judged.1 The public expects, and the government has promised to deliver, a health service that is ever safer, constantly up to date, and focused on patients' changing needs. Successful health services in the 21st century must aim not merely for change, improvement, and response, but for changeability, improvability, and responsiveness.

Electronic Health Record Use and the Quality of Ambulatory Care in the United States
by Jeffrey A. Linder, MD, MPH; Jun Ma, MD, RD, PhD; David W. Bates, MD, MSc; Blackford Middleton, MD, MPH, MSc; Randall S. Stafford, MD, PhD • ARCH INTERN MED/ VOL 167 (NO. 13), JULY 9, 2007
Electronic health records (EHRs) have been proposed as a sustainable solution for improving the quality of medical care. We assessed the association between EHR use, as implemented, and the quality of ambulatory care in a nationally representative survey.

The Practice of Medicine is in the Interactions: A Day with Robert A. Lindberg, M.D.
by Arvind Singhal • Plexus Institute
On the second floor of a plain-looking office building on 1500 Post Road in Darien, Connecticut, an unremarkable door announces the medical practice of Robert A. Lindberg, M.D. In the small reception area, a courteous employee sitting behind the counter extends a greeting as she signs a patient in. Soon, a patient -- a Mr. Rodriguez, or a Mrs. Crawford – is ushered from the reception area, through a door, into a long corridor lined with several examining rooms.

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The Wisdom of Crowds

What Is Crowdsourcing?
by Jennifer Alsever • BNET
Despite the jargony name, crowdsourcing is a very real and important business idea. Definitions and terms vary, but the basic idea is to tap into the collective intelligence of the public at large to complete business-related tasks that a company would normally either perform itself or outsource to a third-party provider. Yet free labor is only a narrow part of crowdsourcing's appeal. More importantly, it enables managers to expand the size of their talent pool while also gaining deeper insight into what customers really want.

Innocentive: Crowdsourcing Diversity
What starts with the crowd ends in research and development
Randy Burge interviews Alpheus Bingham, co-founder of Innocentive, via telephone on May18th
Alpheus Bingham knew something big had to shift in the way invention and innovation happened at pharmaceutical giant, Eli Lilly. A top R&D executive at Lilly in the mid 1990s, Bingham, along with others, struggled to devise new ways to leverage knowledge to reduce the ridiculously high costs of developing new medicines.

Explaining the Wisdom of Crowds: Applying the Logic of Diversity
by Michael J. Mauboussin, Legg Mason Capital Management
Understanding diversity and leveraging its potential requires deeper understanding than we currently possess. We won’t get far with compelling anecdotes and metaphors . . . We need a logic of diversity.

Diverse Perspectives - How we See Things
Chapter 1 of The Difference by Scott Page
We all differ in how we see and interpret things. Whether considering a politician’s proposal for changes in welfare policy, a new front-loading washing machine, or an antique ceramic bowl, each of us uses a different representation. Each of us sees the thing, whatever it is, in our own way. We commonly refer to the ways we encode things as perspectives. But if asked what a perspective is, most of us would have only a crude idea. In this chapter I provide a formal definition, but before I get to that I’ll present an example of a famous perspective: the periodic table.

Research on Collective Decision Making
Los Alamos National Laboratory
What do riots, stampedes, Kool-Aid cults and black market Tuesday have in common? They are all collective decisions. These failed flashes of human potential can now be made successful through a variety of ignorant aggregation systems. Collective decision making systems utilize non-confrontational computer interfaces to facilitate the appropriate combination of the diverse bits of information and insight contained within us all. Here’s to white market Fridays!

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John Holland on Emergence
John Holland answered viewer questions about the concept of emergence on July 16, 2007. One of the world's leading experts on emergence, John Holland is a professor of Psychology as well as of Computer Science and Engineering at the University of Michigan. He is also an external professor and member of the Board of Trustees at the Santa Fe Institute, a MacArthur Fellow, and a Fellow of the World Economic Forum. His two most recent books are Emergence: From Chaos to Order (Oxford University Press, 2000) and Hidden Order: How Adaptation Builds Complexity (Helix Books, 1996). Forty-nine students have received Ph.D.'s under his guidance.

PlexusCalls: Change in Complex Systems
Jun, 2003 - Allen, Peter
Peter will share with us his insights on the notion of change in relation to complex systems. For almost 20 years, Peter has been working on the modelling of change through mathematics and innovation in social, economic, financial and ecological systems. In addition, he has been working on the development of integrated systems models linking the physical, ecological and socio-economic aspects of complex systems as a basis for improved decision support systems.

What is complexity science, really?
Steven E. Phelan • University of Texas at Dallas
The need for a special issue of Emergence on the question “What is complexity science?” is disturbing on several levels. At one level, one could be forgiven for thinking that the voluminous literature generated in recent years on chaos and complexity theory must contain a clear exposition on the definition, mission, and scope of complexity science. That this exposition has not been forthcoming, or is the subject of controversy, is disconcerting. On another level, the inability to clearly differentiate science from pseudoscience in complexity studies is also problematic. Allowing pseudo-science to penetrate a field of study lowers the credibility of that field with mainstream scientists and hinders the flow of resources for future development.

Complexity Theory and Al-Qaeda: Examining Complex Leadership
Russ Marion & Mary Uhl-Bien • EMERGENCE, 5(1), 54–76 2003
[Osama bin Laden is] a product of a new social structure. A new social feeling in the Muslim world. Where you have strong hostility not only against America, but also against many Arab and Muslim regimes who are allying to America ... And that’s why if bin Laden was not there, you would have another bin Laden. You would have another name, with the same character, with the same role, of bin Laden now. That’s why we call it a phenomena not a person.

Complexity, Pattern, and Evolutionary Trade-Offs in Animal Aggregation
by Julia K. Parrish and Leah Edelstein-Keshet • SCIENCE VOL 284 2 APRIL 1999
One of the most striking patterns in biology is the formation of animal aggregations. Classically, aggregation has been viewed as an evolutionarily advantageous state, in which members derive the benefits of protection, mate choice, and centralized information, balanced by the costs of limiting resources. Consisting of individual members, aggregations nevertheless function as an integrated whole, displaying a complex set of behaviors not possible at the level of the individual organism. Complexity theory indicates that large populations of units can self-organize into aggregations that generate pattern, store information, and engage in collective decision-making. This begs the question, are all emergent properties of animal aggregations functional or are some simply pattern? Solutions to this dilemma will necessitate a closer marriage of theoretical and modeling studies linked to empirical work addressing the choices, and trajectories, of individuals constrained by membership in the group.

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Large System Change

Leverage Points: Places to Intervene in a System
by Donella Meadows • Sustainability Institute 1999
Folks who do systems analysis have a great belief in 'leverage points.' These are places within a complex system (a corporation, an economy, a living body, a city, an ecosystem) where a small shift in one thing can big changes in everything.

Lessons of the Last Bubble
by Tim Laseter, David Kirsch, and Brent Goldfarb • 03/26/07 Strategy+Business
Quiz time: What percentage of dot-com start-ups have failed?

Deming's System of Profound Knowledge: Elements and Applications
by Robert Lamb • Process Management International (Australia)
Deming's "System of Profound Knowledge" suggests four key elements that underpin successful continuous improvement. This brief paper elaborates and explores on the nature of these elements and their implications for practice.

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Organizational Models

Better Strategy Through Organizational Design
by Lowell Bryan and Claudia Joyce • McKinsey Quarterly
Redesigning an organization to take advantage of today's sources of wealth creation isn't easy, but there can be no better use of a CEO's time.

Chapter 1 from Mobilizing Minds
Creating Wealth from Talent in the 21st Century Organization
by Lowell Bryan and Claudia Joyce • McKinsey

The Deming Systems Model
from the Institute for Healthcare Improvement's web site.

The Viable System Model
by Trevor Hilder Cavendish Software Ltd. (Presentation v1.03 12-Jun-1995)
This presentation provides a brief introduction to Stafford Beer’s Viable System Model (VSM).

The Semco Management Model
The only way to communicate this is to walk through the companies web site and have your own experience. Please click on the link to the SEMCO Management Model and click through the presentation (flash needed). In addition, it might be valuable to explore this page:

Lessons from Semco on Structure, Growth and Change
Semco is one of the most interesting companies on the planet. There are no job titles and no personal assistants. People set their own salaries. Everybody shares in the profits.

CCA Global Partners
With 15 affiliated companies, over 3,600 stores producing $8.7 billion in aggregate annual sales, and 78 consecutive quarters of profitability, CCA Global Partners knows how to set progress in motion.

Visa International
Visa is not a traditional multinational corporation. Visa has an organizational structure whereby 20,000 member financial institutions are brought together through the Visa Association. These partnerships with financial institutions around the world allow Visa to meet the needs of local markets and to benefit from economies of scale. This model also allows Visa to adapt products and services to local culture and customs, which in turn allows Visa to meet the needs of buyers and sellers in each market. Internally, staff is governed by a Code of Conduct.

United Western Grocers
Unified Western Grocers, Inc. is a retailer-owned wholesale grocery cooperative that supplies independent retailers throughout the Western United States. Unified and its subsidiaries, which generated approximately $3 billion in sales during the 2000 fiscal year, offer independent retailers all the resources they need to compete in today's supermarket industry.

Housing Partnership Network
The Housing Partnership Network operates as a peer network and business alliance of high-capacity, entrepreneurial development nonprofits. By collaborating through the Network, our members share and spread the innovations that emerge from their local practice. They obtain more flexible and better priced capital that rewards their demonstrated performance and capabilities. And they create strategies and cooperative ventures that respond to the rapidly changing regulatory, policy, and economic environment.

CoopMetrics facilitates improvements in a member company's operation by working in partnership with cooperatives and associations to build virtual chains of similar enterprises. Members access comparisons of financial and operating data within a framework of peer collaboration, allowing them to take advantage of the knowledge and experience of their industry peers and make improvements in their organization.

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Positive Deviance and Appreciative Inquiry

by Arvind Singhal and Karen Greiner
Heidi Walker stood by a gurney loaded with standard infection control supplies—gloves, gowns, nasal swabs, hand sanitizer—and an incongruous pile of 21 packages of uncooked macaroni. As a curious audience of patients, doctors, nurses, and other members of staff looked on, Ms Walker cracked open a bag, scooped out a
handful, and let the pieces fall slowly and resoundingly into a plastic bowl.

The Power of Positive Deviance
by David R Marsh, Dirk G Schroeder, Kirk A Dearden, Jerry Sternin and Monique Sternin • BMJ VOLUME 329 13 NOVEMBER 2004
Identifying individuals with better outcome than their peers (positive deviance) and enabling communities to adopt the behaviours that explain the improved outcome are powerful methods of producing change

The Power of Positive Deviance
by Prucia Buscell, page 8 of Aug 04 Emerging from the Plexus Institute
Positive Deviance. Haven’t heard the term? You will. It is a powerfully simple process that has enabled results in the world’s poorest communities. And it may be coming to a board room near you.

The Positive Deviance Initiative
In every community there are certain individuals (the "Positive Deviants") whose special practices/ strategies/ behaviors enable them to find better solutions to prevalent community problems than their neighbors who have access to the same resources. Positive deviance is a culturally appropriate development approach that is tailored to the specific community in which it is used.

Appreciative Inquiry in Organizational Life
by David L. Cooperrider and Suresh Srivastva
This chapter presents a conceptual refiguration of action-research based on a "sociorationalist" view of science. The position that is developed can be summarized as follows: For action-research to reach its potential as a vehicle for social innovation it needs to begin advancing theoretical knowledge of consequence; that good theory may be one of the best means human beings have for affecting change in a postindustrial world; that the discipline's steadfast commitment to a problem-solving view of the world acts as a primary constraint on its imagination and contribution to knowledge; that appreciative inquiry represents a viable complement to conventional forms of action-research; and finally, that through our assumptions and choice of method we largely create the world we later discover.

The Appreciative Inquiry Commons
Welcome to the "AI Commons"--a worldwide portal devoted to the fullest sharing of academic resources and practical tools on Appreciative Inquiry and the rapidly growing discipline of positive change. This site is a resource for you and many of us--leaders of change, scholars, students, and business managers--and it is proudly hosted by Case Western Reserve University's Weatherhead School of Management.

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