Dialectical Behavioral Theory – Decisional Balance Sheet – The Integrity Edition

Bobblehead DollAn email in my inbox started me thinking of Johari Windows first thing this morning, and in the process of proving myself wrong, I learned some interesting things and figured I would share my journey of discovery.  I am always fascinated when I prove myself wrong; I like it; mainly because it proves I am still human with a lot to learn!

Johari Windows

A Johari Window is a visual method for looking at data about self-knowledge and delineates information into four areas of interpersonal relationships:

        • The Open Area – represents what we both know about me and openly share.
        • The Hidden Area – is what I hide from you about myself.
        • The Blind Area is what you know about me, observe about me, and are aware of about me, but refuse to share with me.
        • The Unknown Area – is the part of me which neither of us knows about on a conscious level.Johari Window

Dialectical Behavior Theory

The Dialectical Behavior Theory (DBT) simply stated, is an evidenced-based process where a psychotherapist and a patient work to increase a patient’s emotional and cognitive regulation by learning about triggers leading to reaction and assessing and building coping skills to apply to events, thoughts, feelings, behaviors to avoid undesired reactions.  DBT is a precursor of Cognitive Behavior Therapy (CBT), which has shown significant effectiveness for PTSD-related problems and spectrum mood disorders.  A tool used frequently in CBT and DBT is a decisional balance sheet that looks like a table in an MS Word document.

Plusses/Pros Cons/Minuses
Self
Others/Family

A decisional balance sheet crops up a lot in various forms and under multiple names in psychology to represent data visually in a decisional tree, where the optimum location is in the lower right corner.

Low

High

Low

High

Imperative to understanding is that each decisional balance sheet, or decisional tree, can be read top to bottom or right to left.  The optimum location remains constant, regardless of the topic.  This is mentioned solely as a differentiation method between a Johari Window and a Decisional Balance Sheet.  A Johari Window can be any size but cannot be read top to bottom or right to left with an optimum location in any of the boxes.  That is how you tell the difference and my mistake from earlier this morning.

Integrity

Integrity is the practice of being honest and showing a consistent and uncompromising adherence to strong moral and ethical principles and values.  In ethics, integrity is regarded as the honesty and truthfulness or accuracy of one’s actions.  Integrity is the choice to be the best you can be.

Integrity is holding ourselves to the same high standards that we have for others. Expecting little of everyone is apathy. Expecting less of ourselves than others sets us up for hypocrisy. Leniency is expecting less of others than ourselves, and it fails to create accountability. Integrity is the box where we should be at.” – Adam Grant

Integrity is not malleable, changeable, adjustable, wishy-washy, or like a suit coat that can be put on and taken off.  You either possess integrity, or you do not, and if you do not possess integrity, you are not worth my time and energy!Integrity

The current US President has no integrity, and America’s enemies knew this and desired this quality in the American president.  The Vice President, the majority and minority speakers in both houses of the Congress, and many of the governors and mayors in America all lack integrity.  As witnessed in the 2020 elections, a lack of integrity is being experienced in the judges, the county supervisors, the election boards, and many state legislators, and state election officials as well.  America is suffering from a dearth of integrity in public officials, and that is a significant problem!

Plato 2As a kid, I was told to role model John Wayne, Clint Eastwood, Colonel Sherman Potter, and even Father Mulcahy.  I was told to despise those who weaseled on deals, liars, thieves, cheats, lawyers, and politicians.  These people were necessary evils, but I never believed in a necessary evil.  If you were evil, then you were not worth my time or support.  I maintain that position to this day, and it disgusts me to no end when I have been hoodwinked by politicians I thought had integrity who turned out to be wolves in sheep’s clothing.  Senator McCain, I am talking about you specifically, and I do not care that you are dead!

Millstone of Designed IncompetenceI guess it has been a couple of years now, I thought it had only been several weeks, but I had a conversation on the power of religion to improve integrity.  I have found just as many atheists as religionists with integrity and just as many religionists as atheists without integrity; thus, I can only conclude that religion is a tool for improving integrity, but individual choice trumps religious flavor and fervor.  Yet, religion does play a role in providing a moral background for building a solid foundation under a person with integrity.  Seeing as atheism is a religion, I have no problems calling on religionists of the world to unite to provide a moral background to improve integrity where they currently live, work, and reside.

However, in calling for an increase in integrity, I feel duty-bound to call out those without integrity for public display, ridicule, and scorn.  For example, I have found that the Queen of England has a lot of moral fiber and a high level of integrity, whereas her son is a flat-out creep who somehow missed integrity lessons and is choosing the life of depravity.  For all her faults, I felt Princess Diana had a lot of integrity, and her kids had some integrity, but they seem to be choosing the way of the snake, which is difficult to observe.

Plato 3President Biden is utterly bereft of integrity, his children are also utterly bereft of integrity, and Hunter is the worst of the bunch.  I do not wish to see how deplorable the grandchildren will be as they will be a millstone around America’s neck for a long time!  Vice President Kamala Harris and her spouse are two people utterly bereft of anything approaching integrity, moral uprightness, or even common decency.  They are joined by the Obama’s (including the children), the entire Clinton Machine, and the black hole of integrity has many others currently occupying seats in Washington DC for company.

Exclamation MarkSince we have so many examples of poor integrity, there must be examples of people with integrity.  Thankfully the answer is yes, and they are easy to spot.  Below are common ways to spot integrity, and I challenge you to look for and vocally support integrity where you find it.  One of the best ways to show integrity is to appreciate integrity in others.  Catch people doing good and vocally thank them.  Send thank you cards.  Send thank you emails.  Remember them after the incident.

        • Take responsibility for actions and consequences – Choosing to do the right thing is hard; accepting the consequences for failure, especially when it was not your fault is integrity in action. Allowing others to receive praise for accomplishments is integrity in action.
        • Put another person’s needs above your own. – This requires observation. Do the right!
        • Offer to help with action, not words. – As a disabled person, I do not want someone to offer to get a door, grab the bloody door! If I drop something, don’t offer to get it; bend down and grab it.  I will never criticize anyone for taking action.  Offers are good, but I always refuse offers to help, but I never refuse actions to help!
        • I will always give you the benefit of the doubt and start from the position that you are trying your best; please reciprocate.
        • Honesty is the only policy. Delivering honesty with kindness and forthrightness is socially the only way to move society forward.
        • Aretha Franklin was very clear, R-E-S-P-E-C-T. Learn it, live it, love it!  RESPECT is a two-directional street; you have to show it to get it.
        • Admit when you are wrong. It is called humility.  Humility is not weakness, but strength, learning, and growth.
        • People with integrity are reliable, they are on time (every time), and they work until the job is done.
        • Integrity includes kindness, even to a kid crying, dirty, stinky, smelly, and wet — a homeless person, a peer, a police officer, another driver, etc. Kindness is a choice!
        • Integrity is where we start each day anew as a lifestyle choice.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Thought and Character – A Discussion

WhyIn Proverbs, Old Testament, we find an oft-quoted aphorism, “As a man thinketh in his heart so is he.”  If we first accept this aphorism as truth, then the following from James Allen, from “As a Man Thinketh (1903)” can also be presumed truthful.  “A man is literally what he thinks, his character being the complete sum of all his thoughts.  As the plants springs from, and could not be without, the seed, so every act of a man springs from the hidden seeds of thought, and could not have appeared without them.”  Bringing into sharp reflection the connection between how a person thinks and their character.

In high school, the football and wrestling coaches played mind games to help us players think and become winners. Then, we went through drills to practice thinking and planning moves, so our most important muscle, the mind, was prepared to act when challenged physically.  Likewise, as a firefighter, I know the value of mentally walking through situations to prepare my mind and my fire teams’ minds before being challenged physically to respond to a threat or incident.

Ziggy on Political WeatherI once met a professional soccer player; we shared a bus trip from Salt Lake City to Vernal, Utah, as he traveled to catch a plane in Denver, Colorado.  While I do not envy him, his travel scheduler, we had a very interesting conversation on how thinking builds character.  Professional sports players have similar mental walk-throughs as a regular part of their daily exercises.  Here I had always been under the impression this was for non-professional sports players and was pleasantly surprised to hear his experiences.

James Allen insists that “Man is made or unmade by himself; in the armory of thought he forges the weapons by which he destroys himself; he also fashions the tools with which he builds himself heavenly mansions of joy and strength and peace.”  In the US Army, while serving as a Chaplain’s Assistant, I was wandering through the line company barracks and stumbled across a tank crew having “Sergeant’s Time” in the hallway.  There I met the most interesting character; he held a doctorate from MIT, he was utterly brilliant, and he was a specialist who drove tanks for a living.  When asked why driving tanks and not working in his field of study, he stated, “I do not like my field of study.”  Through education, this soldier had made himself tools for building a career he detested in a field he was bored with, and in seeking adventure, he joined the US Army as an enlisted man and found something he preferred.

ToolsThe tools of education became the chains of bondage and weapons that left him without passion.  His thoughts had turned his desires in his chosen field into a trap, where he thought his only way out was doing something radical and “out of character.”  Except for those who knew him, his character was always bent towards being a soldier, but he had not thought thru this character aspect himself.  His thoughts had already revealed his character, but he had not become cognizant of this aspect of himself.  How many times has this happened to you?

President Thomas S. Monson, a previous leader of The Church of JESUS CHRIST of Latter-Day Saints, was quoted as saying, “Decisions Do Determine Destiny” [emphasis in original]. Likewise, James Allen maintains, “… Man is the master of thought, the molder of character, and the maker and shaper of condition, environment, and destiny.”  Think of how vital thought is to the grand scheme of a person, and you will find the power to be and do anything!  “Man is always the master, even in his weakest and most abandoned state … [as a conscious master] man can only thus become by discovering within himself the laws of thought; which discovery is totally a matter of application, self-analysis, and experience.”  Doesn’t this assertion fill you with the hope that the chains of bondage in your mind are only there until you allow yourself to change how you think?

LaughterHow did I finally kick the cigarette habit, so the mental addiction could no longer tempt me to smoke; I change my thinking.  Instead of allowing myself to find second-hand smoke delightful, I began seeing it as something to avoid.  As I changed my thinking, my body stopped reacting in a manner to claim a need for the cigarettes.  It was not easy, but I had physically quit smoking 10-years before my mental processes, and mental addictions were finally conquered.  The power to correct my body’s behavior towards cigarettes was always mine to claim and apply, but first, I had to change how I think about cigarettes, then my mental needs changed, and then I was free of the mental addiction.  Changing thoughts and time, experience, was required, and slowly my body obeyed.

I have seen the same occur in reverse.  A female friend of mine claims she needs chocolate during her menstrual cycle to maintain mental health.  When she discovered that chocolate was the main factor in her deteriorating health and obesity, she still maintained that chocolate was healthy and blamed everything but chocolate for the problems.  When she went through menopause, she discovered that chocolate had no power over her body and was left without her mental crutch and excuses.  What could have been a life-altering discovery did not change behavior because the thoughts never changed.  I moved and lost contact before her story ended, but the failure to change thinking has always left me wondering what thoughts I need to change to avoid a similar fate.

Bait & SwitchThe New Testament records, “He that seeketh findeth; and to him that knocketh it shall be opened.”  To which James Allen has added, “… for only by patience, practice, and ceaseless importunity can a man enter the Door of the Temple of Knowledge.”  I remember reading about a famous diamond mine in Africa, the largest diamond mine in the world, and how even with technology, the mining process continues to be one of patiently gathering, carefully digging, and unending repetition to haul diamonds from the dirt.  In L. Ron Hubbard’s book, “Battlefield Earth,” one finds the same pattern in digging for gold.  Patience, careful gathering, unending repetition, and still the results are teaspoons of gold for the tons of rock and dirt shifted.

The mind is the same.  Changing thoughts requires time, patience with yourself, and care in selecting new thoughts to plant.  Care in how old thoughts are removed so as not to damage those thoughts being cultivated, and unending repetition to remove the seeds of thoughts that would be the weeds in your mental garden.  But, with the pattern comes the promise; those who put forward the work will reap a garden of benefits.  What are those benefits of changing our thoughts, “As a being of power, intelligence, and love, [being the] lord [and master] of his thoughts, a man holds the key to every situation and contains within himself that transforming and regenerative agency by which he can make himself what he wills.”

Knowledge Check!What benefit could be grander, to will something into existence through the power of thought!  How amazing a world we could make when all people realize this power and claim this power by changing how we think.  There is a benefit to cause and effect; that benefit is realization, wisdom, and eventually power to will into being that which is powered by our thoughts. So choose to consider changing how you think and watch how the world shifts around you.  You can change yourself by changing your thinking!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: School Thy Feelings

Calvin & Hobbes - Irony HurtsI know what you’re thinking, not another article on controlling emotions and feelings – well, yes.  However, I wanted to approach this subject from a different tack.  I discuss this topic so often because of the dearth witnessed in choosing proper emotional responses or not choosing an emotional response to the improvement of the environmental conditions in a situation.  Across the globe, we find daily, even hourly, instances where emotional diatribes are ruling common sense, destroying logic, and creating hordes of emotionally charged people hell-bent on destroying.  If I can help just one person understand this cycle of emotional abuse and then choose to correct their behavior, even if that person is only me, I consider these articles successful

Emtional Investment CycleToday’s title comes from Charles W. Penrose (n.d.), who penned the following poem, which has been set to music; the poem is based upon Proverbs 16:32, “One who is slow to anger is better than the mighty, and one whose temper is controlled than one who captures a city.”

School Thy Feelings

School thy feelings, O my brother,
Train thy warm, impulsive soul,
Do not its emotions smother,
But let wisdom’s voice control.
School thy feelings, there is power
In the cool, collected mind;
Passion shatters reason’s tower,
Makes the clearest vision blind.

School thy feelings; condemnation_
Never pass on friend or foe,
Tho’ the tide of accusation
Like a flood of truth may flow
Hear defense before deciding,
And a ray of light may gleam,
Showing thee what filth is hiding
Underneath the shallow stream.

Should affliction’s acrid vial
Burst o’er thy unsheltered head,
School thy feelings to the trial,
Half its bitterness hath fled
Art thou falsely, basely slandered?
Does the world begin to frown?
Gauge thy wrath by wisdom’s standard;
Keep thy rising anger down.

Rest thyself on this assurance:
Time’s a friend to innocense,
And the patient, calm endurance
Wins respect and aids defense.
Noblest minds have finest feelings,
Quiv’ring strings a breath can move,
And the Gospel’s sweet revealings,
Tune them with the key of love.

Hearts so sensitively molded,
Strongly fortified should be,
Train’d to firmness and enfolded
In a calm tranquility.
Wound not willfully another;
Conquer haste with reason’s might;
School thy feelings, sister, brother,
Train them in the path of right.

Knowledge Check!Consider with me these words for a moment.  Controlling emotion is hard, I understand completely.  However, how often do we try to control emotion?  I have been driving, stuck in restricted traffic, and becoming a raving lunatic through choice because of how someone else drove.  My feelings caused them no harm but embarrassed me.  I witnessed road rage, where a 30-car pileup at 45 mph was narrowly avoided.  These two gentlemen would speed up, get around the other, then brake check, hindering and hampering the smooth flow of traffic due to selfish emotional choices.

Besides traffic, where else do we frequently witness unchecked emotional interactions?  Politics, the news, sports arenas, the supermarket, but worst of all is social media, and especially in the emotional controls social media companies exert upon those wishing to use the service.  Consider LinkedIn, they have policies in place to police thought, and curb conversation between professionals, solely because another person complained.  Facebook banned President Trump, using false pretenses and sophistry when the reality is that the media giant always wanted to exert control and thwart free and open communication.Foghorn Leghorn - Medication

Speaking of President Trump, what about the behaviors excused under the banner, “Trump Derangement Syndrome?”  The behaviors of these adults, acting worse than a spoiled toddler, was beyond deplorable, detestable, and needed public shaming.  Instead, their behavior got excused, tolerated, and America is worse for having emotional behavior justified in this manner.

Semper GumbyAs a kid, if my parents did not like another child’s behavior, I was refused the opportunity to play with that child for fear the child’s emotional behaviors would rub off on me, and I would begin to act like a nincompoop!  Yet, as an adult, I can witness rampant emotionally charged conduct, and I have to tolerate nonsense due to helicopter parents, political choices, and the media; I think not!  I firmly support Robert Solomon’s claim that emotions are a choice, a judgment, and a social construct.  In supporting this line of reasoning, I affirm I am not perfect in choosing better emotions, choosing the proper emotion, or even judging social situations properly to emote at all.  However, now that I have been made aware, I am actively striving to emote less and know the why behind my emotions to empower better decision-making down the road.

There is a piece of golden advice given to commanders in the military, choose when to become angry as a method of commanding performance improvement.  I had a commander who understood this principle well and many an officer who had no clue.  I met non-commissioned officers who understood this principle well and others who had been promoted above their level of incompetence, who chose not to understand the value of controlling emotional outbursts.  I have worked with managers across America in a myriad of positions who could learn this lesson, and I have met some amazing people who know this lesson all too well and apply it perfectly.Plato 2

Consider well the words from Charles Penrose, and believe you can choose to emote or not to emote, when to emote, where, and how to emote, as tools for improving communication, performance in yourself and others, and in making better decisions.  Runaway emotions hinder, not help, performance.  Emotional hyperbole thwarts and hurts everyone, everything, and everywhere it is found.  How embarrassing to you is it when you witness emotional meltdowns?  Be it a toddler, teenager, or adult; the sight is truly embarrassing when emotions run away.

Image - Eagle & FlagThus, on this Memorial Weekend, let us firmly recommit to living life with more controlled emotions where we are choosing our emotional states more precisely.  Selecting our emotions more carefully and allowing the emotions of others to have less hold upon our minds and bodies.  As I continue to make strides in not allowing myself to be hooked into other people’s emotions, I do not lose anything, and the control gained improves how I feel mentally and physically.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Intention and Discernment – Tools Worth Knowing

Foghorn Leghorn - MedicationParents, how many times have you witnessed a toddler going about their day, an idea crosses their face, and you can tell they are about to do something that gets that toddler in trouble?  I heard a comedian talk about witnessing this as the toddler saw the cat sleeping in the sun, the toddler crossed the room and kicked the cat.  When asked why the toddler claims “it was accident.”

What is intention?

Intention is all about deliberate action, using a plan, and involving ideas in action.  According to Webster, intention is also the healing process of a wound, but this definition is not part of our discussion.  From Latin, we find intentio as “stretching purpose” and originates with intendere meaning “towards, stretch, and tend.”

Calvin & Hobbes - Irony HurtsConsider these definitions for a moment and the story about the toddler kicking the cat.  We have a plan, a purpose, and a deliberate action.  How does the parent discern the act was deliberate; the use of observation as to what the toddler had done to the cat previously, what the toddler was doing immediately before they kicked the cat, and the attempt to use an excuse to get out of trouble.

Discerning Intention.

Never Give Up!When defining discernment, I am not entering holy waters to discuss the pieces of discernment that belong to discerning for religions.  Discernment is the ability to obtain sharp perceptions, observations that empower decision-making.  Discernment can be psychological, moral, or aesthetic.  Discernment is also defined through the contexts; scientific, normative, and formal. The process of discernment involves going past the mere perception of something and making nuanced understandings about its properties or qualities.

Note, there is also a legal definition, or standard, for discernment, “the cognitive condition of someone who understands; savvy, understanding, apprehension knowing about their actions before, after, and during the act;” which is where things get sticky when discernment and intention cross paths.  Hannity and Carlson disagree on the actions of the jury in the Derek Chauvin case.  Not being a lawyer and not knowing all the legal jargon, the best I can do is form an opinion.  I base my opinion on other high-profile cases where the media has condemned an individual as guilty before the judge and jury are formed.  Meaning, I feel the jury was intentionally and unfairly biased against Derek Chauvin due to the influence of the media and the mob outside the courtroom’s doors.Thin Blue Line

There was a shooting of a teenage girl in Columbus, Ohio, by a police officer.  The girl had a knife in hand, did not listen to the police officer responding, and lunged at another person before being shot.  Again, we come to discerning intention and split-second decision-making.  Only, in this instance, the officer has no history of the person holding a knife, only reports of a stabbing and an apparent altercation involving a knife when they arrive on the scene.  I offer no judgment in this case as this case continues to unfold, details are still being investigated, and family interviewed.  Yet, the media is already off and running their biased opinions, and mobs have formed for mobocratic justice, which is never just nor proper.

Calvin & Hobbes - Ontological QuandryUnfortunately, this pattern repeats too often, and thus the need to understand discernment and correctly discerning intention.  My intent is not to make you as adept at this practice as a police officer. In a Republic, and even in many democratic societies, the citizens need to discern and discern intention, two separate processes.  The media will sell a lurid and emotionally charged story with all the bias of a bull in a China Shop and never care about the consequences.  But, the citizen does not have the same luxury or legal protections as the media.  Hence, we must discern what the media relates and discern the media’s intention before we ever read or listen to their story/reporting of events.  Thus my intent in this article and bringing up this topic, we, the citizens, are held to a higher law than the media and cannot afford to form mobs, trust the media’s reporting, or even rely upon the press reported “facts” to discern and discern intent.

How do you make a decision requiring action?

GearsThe process for critical thinking, leading to intentional decision-making, with purposeful action, generally follows the following pattern:

      1. Gather data
        • Requires knowing the validity of the source data and trusting the sources.
      2. Organize the data
      3. Make preliminary decisions and determine an action to take.
      4. Beta test the decision through application to a minimal audience to refine the solution and ensure the integrity of the data.
      5. Roll out the entire decision, including the solution and the reasoning, take timely action.
      6. Monitor and make course corrections as needed.

Detective 4These steps are useless unless we understand our own intention before launching a decision-making process.  Consider, do you intentionally believe that others are doing their best or giving their best efforts?  Do you intentionally shut down your own opinion to consider the perceptions of others in making decisions?  Where in those steps do you stop and take a moment to ponder the short and long-term consequences of the solution devised?  When making decisions, do you ever consider the axiom, “If a solution is not Win/Win, everyone loses?”  Do we fear failing to make a correct decision if the future teaches us something new about the data changing the pattern of decision-making?  How do you learn?

Let us briefly examine that axiom, “If a solution is not Win/Win, everyone loses,” does not mean making everyone happy.  A good compromise leaves everyone upset and feeling cheated and settled on the issue under consideration.  Yet, the media and many politicians firmly believe that unless they win everything they desire in a solution, they have been robbed and feel justified in stirring up public angst and creating a worse problem.  The adults in society must understand both the good and the ill in creating Win/Win solutions, or all is lost, and the patients run the asylum.

Anton Ego 4In going back to the analogy of the toddler kicking the cat.  Does the solution in the short-term mean corrective behavior modification for a long-term lesson learned?  Does the better solution involve instruction as well as behavior modification?  Have we, the parents, discerned correctly the intention of the toddler sufficient to justify our decision?  Will the cat be safe around the toddler in the future because of the action we take at that moment?

How do you learn?

In answering this question, we must return to the topic of failure.  Do we consider failure a learning moment?   Do we appreciate the power of failing as integral to achieving success?  A close relative of mine in high school went out for the track team as a pole vaulter.  I looked into pole vaulting to learn more and was surprised at the ways, means, and multiple times the pole vaulter will fail.  The technical skills to pole vault are incredible, almost as unbelievable as being an operations manager in a manufacturing environment and being a parent.  Hence, the need for discernment and intention.

2012-08-13 07.37.28I close with a challenge, use discernment more intentionally in learning your way through failure to success.  Liberty and freedom allow us the power to fail our way to success, but only if we consciously choose to learn and discern better our steps in decision-making.  Know your intent, take a moment every day to consider your intent, and purposefully make decisions to live your intentions.  Trust yourself to discern.  Your confidence in discerning is key to understanding and using your intention to power decision-making as a process.  Please remember, what I am discussing requires time, you will fail, but you will also win and win BIG!  Enjoy the journey of discovery!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Tiger Teams – A Potential Solution to VA Issues: An Open Letter to Secretary Wilkie

I-CareTo the Honorable Secretary Robert Wilkie
Department of Veterans Affairs
Washington D.C.

Dear Sir,

For almost a decade, I have read and studied the Department of Veterans Affairs (VA) from the position of patient, employee, concerned citizen, and now as an organizational psychologist.  During this time, I have read many Department of Veterans Affairs – Office of Inspector General (VA-OIG) investigation reports, and yearned to be of fundamental assistance in improving the VA.  I have an idea with potential for your consideration, “Tiger Teams.”

In the US Navy, we used “Tiger Teams” as “flying squads” of people, dedicated to a specific task, and able to complete work quickly.  The teams included parts people, technicians, specialists, and carried the authority of competence and dedication to quickly fixing whatever had gone wrong during an evolution, an inspection, or even in regular operation.  It is my belief that if your office employed a “Tiger Team” approach for speedy response, your job in fixing core problems the VA is experiencing would be easier.  Please allow me to explain.

Tiger TeamThe VA-OIG recently released a report regarding deficiencies in nursing care and management in the Community Living Center (CLC) at the Coatesville VA Medical Center, Pennsylvania.  The inspection team validated some complaints and were unable to validate all complaints because of poor complainant documentation.  Having a Tiger Team able to dispatch from your office, carrying your authority, would provide expert guidance in rectifying the situation, monitoring the CLC, and updating you with knowledge needed to answer the legislator’s questions regarding what is happening.  The VA-OIG found other issues in their investigation that were not covered under the scope of the investigation, leaving the VA-OIG in a difficult position.  Hence, another reason for a Tiger Team being created, to back stop and support the VA-OIG in correcting issues found outside their investigatory scope.

Fishbone DiagramFor a decade now, I have been reading how the VA-OIG makes recommendations, but where is the follow-up from the VA-OIG to determine if those recommendations are being followed and applied?  Too often there is no return and report feature built into the VA-OIG investigation, as these investigators just do not have the time.  Again, this is what a Tiger Team can be doing.  Taking action, training leaders, building a better VA, monitoring and reporting, building holistic solutions, and being an extension of your office on the front lines.  Essentially using the tools from your office to improve the operations locally, which builds trust between the patients and the care providers, building trust between the families and the VA, and delivering upon the Congressional mandate and VA Mission.

Another recent VA-OIG report also supports the need for a fast response Tiger Team.  Coordination of care and employee satisfaction concerns at the Community Living Center (CLC), Loch Raven VA Medical Center, in Baltimore, Maryland.  In geographic terms, this incident is in your backyard.  While the VA-OIG inspection was rather inconclusive, and recommendations were made, it appears some things are working in this CLC and other things are not working as well as they should.  By using a Tiger Team as a flying squad, intermittent and unannounced inspections by the Tiger Team can aid in discovering more than the VA-OIG could investigate, monitoring the situation, and reporting on progress made in improving performance.

As an employee, too often the director of HAS would claim, “That problem is too hard to fix because it requires too many people to come together and agree on the solution.”  Or, “The solution is feasible, but not worth the effort to implement because it would require coordination.”  Getting the doctors and nurses talking to and working with administration is a leadership role, providing support to leaders is one of the best tools a Tiger Team possesses one authority is delegated.  The Tiger Team presents the data, presents different potential solutions, and the aids the leadership locally in implementation.  As an employee I never found a problem in the VA that could not be resolved with a little attention, getting people to work together, and opening lines of communication.  Thus, I know the VA can be fixed.

Root Cause AnalysisThe Tiger Teams need to be led by an organizational psychologist possessing a Ph.D. and a personal stake in seeing the VA improve.  The organizational psychologist can build a team of like-minded people to be on the flying squad, and these team members should be subject matter experts in VA policies, procedures, and methods of operation, and should change from time to time.  I have met many people from the VA who not only possess the passion, but are endowed with the knowledge of how to help the VA, and I would see the VA succeed.  Yet, I am concerned that the VA is not changing, not growing, and not developing the processes and procedures needed to survive, and this is damaging the VA, which leads to wasted money and dead veterans.

Why not have a flying squad for each VISN, who can meet to benchmark, compare notes, and best practices.  Who work from home and visit the local offices in the VISN, reporting directly to your office with a copy to the VISN leadership.  Whose job is to build the Tiger teams needed to oversee, provide expert support, and practical analysis.  The idea is to help you gather real time data, improve implementation of VA-OIG recommendations, and meet the demands of Congress.  If a Tiger Team, with the functioning Flying Squad, can save one VA-OIG inspection in each VISN, by improving that VISN, medical center, CLC, etc. before it becomes a major problem on the sSix O’clock News, then the Tiger Teams have paid for themselves.

All veterans know of the Phoenix VA Medical Center debacle, where veterans died while waiting for appointments.  I fully believe that had the VA Secretary had a Tiger Team in place, the root causes of that incident would have triggered the necessary flags to save lives and avoid or mitigate the catastrophe.  Flying squads are the Tiger Team in action, and action should be the keyword for every member of the team.  The mission of the Tiger Team should be to find and fix root causes, repair trust, and implement change needed to improve VA operations at the Veterans Benefits Administration (VBA), the Veterans Health Administration (VHA), and the National Cemeteries.

The VBA is especially vulnerable, and in need of outside resources to support change.  Recently the VBA was involved in another scandal involving improper processing of claims for veterans in hospital over 21-days, resulting in millions of dollars either overpaid or underpaid to the veterans.  Training, managerial oversight, and proper performance of tasks was reportedly the excuse the VBA used, again, to shirk responsibility.  Tiger Teams can provide the support needed to monitor for, and encourage the adoption of, rectifying measures and VA-OIG recommendations, not just at the VBA, but across the full VA spectrum of operations.

Please, consider implementing Tiger Teams, from your office, assigned to a specific VISN, possessing the authority delegated to run the needed analysis, build support in local offices, and iron out the inefficiencies that keep killing veterans, wasting money, and creating problems.  I firmly believe the VA can be saved and improved, built to become more flexible, while at the same time delivering on the promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans.”

I-CareThank you for your time and consideration.

Sincerely,

Dave Salisbury
Veteran/Organizational Psychologist

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

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Uncomfortable Truths – An Open Letter to the Department of Veterans Affairs and the Congressional and Senatorial Representatives of the United States of America

I-Care

I write by way of greeting; I write by way of exhortation to action, as the current status quo is reprehensible and unacceptable.  Uncomfortable truths are those realities where bureaucracy has superseded logic and leadership, creating situations where the harm of the patient/customer is the first and only business.  There are good people at the Department of Veterans Affairs; but, these people are being crushed by the bureaucracy, the stifling mental inertia, and the lack of actionable leaders to propel change at the Veterans Benefits Administration (VBA), the Veterans Health Administration (VHA), and the National Cemetery.

An example of uncomfortable truths: I witnessed a veteran enter the emergency room of the VA Medical Center, and be actively, but passively, abused.  Because he was a regular, and sometimes came in and was obstinate, and because he was homeless, he had a history with this emergency room and staff.  The staff actively overlooked him, they talked bad about him, they cussed him out behind his back, and his service was suboptimal at best when he was finally treated.  As this veteran was not the only one being treated in this manner, this was brought to the attention of hospital leadership; the person reporting the abuse was terminated without cause.  This is a leadership issue, a process problem, and an excuse not to change.

Another example of uncomfortable truths: the VBA needs/wants “New and Material Evidence” to process/review/correct a claim.  The Primary Care Provider and all specialty clinics at the VA cannot provide “New and Material Evidence,” as they are not diagnosticians.  Thus, the veteran is left stuck between two bureaucracies that refuse to help, because the rules do not allow the providers to help; this a leadership problem and a process issue.  How can the veteran afford outside insurance to obtain the “New and material evidence?”

Earlier this month, the OIG sent out a report over death at the VA due to leadership inefficiencies and can be found here, VA-OIG report.  Over the last week, three more incident reports have been discharged from the VA-OIG.  Report 1: Has a veteran dying of suicide, because the decision-making process, a process designed specifically to improve communication to aid high-risk patients were not implemented, tracked, and reported properly.  The decision-making process is expected to employ a full patient-care team (PACT) in evaluating and making decisions that affect the patient’s care.  The process was not followed, and the veteran who is already at high-risk for suicide and known to the PACT was deactivated, leading to a veteran’s death.  The VA-OIG made a recommendation to improve the process, the same process that was disabled, leading to a dead veteran.  How does this make sense?

The uncomfortable truth is multi-faceted in this case.  Leadership does not do record audits to ensure the deactivation of high-risk patients does not become “lost” in the bureaucracy.  Leadership is not flagged when the PACT disagrees with the treatment of a patient.  Finally, the VA-OIG has no teeth to reprimand, insist, and improve compliance; they can only make recommendations after the fact.  Congressional representatives and Senators, you allowed the VA to have its own dedicated inspector general, why?  What will you do to enhance the leadership at the VA?  Do not tell me again; we will hold “Committee Meetings.”  These committee meetings have been, and continue to be a feckless waste of taxpayer time, money, and never addresses the core issues apparent.

Report 2: Covers a veteran needing an appendectomy and had to wait for three hours for the surgeon to become available to perform the surgery.  The VA-OIG confirmed the delay in care, but essentially settled for, “Well, the patient lived, so no problem here.”  If that statement seems overly simplified of the process, tell me why the patient had to wait.  Why pay records and timekeeping records were messed up for a single month (May 2018), and how pay and timekeeping records got messed up in the first place.  The VA uses a national system for reporting time worked, but not all employees use the same payment system.  If true, why aren’t all employees, to include residents, surgeons, and staff using the same pay system?  The wait is blamed on poor communication, communication in scheduling surgery, communication between resident and surgeons, and communication because the “appropriate documentation” was insufficiently maintained.

I know from sad experience that there are nurses and doctors who write things down in notebooks, on scrap paper, and on paper charts, when the computer on wheels (COWS) is readily available.  The excuse is always, “I am too busy to use that thing.”  I know the VA has spent an excessive amount of money to get digital records, installing digital records, getting digital records to work when needed, and delivering the digital record available to mobile stations to document what is happening with the patient.  I have some grave concerns for checkbox medicine; but, blaming a surgical delay on improperly maintained documentation remains a wholly inexcusable and unacceptable statement in an official investigation.  Why was this lame excuse allowed to stand?

Report 2, exemplifies a multi-faceted problem presenting a need for a multi-faceted approach to correction.  Leadership at the hospital must be actively engaged, ensuring processes and procedures are optimized to deliver the “I-CARE” customer promise.  Communication chains are a leadership tool, and when broken, correction demands accountability and responsibility to resolve correctly.  Reporting is a leadership function to ensure liability and corrective action as a normal operating procedure.  Did anyone ask why the documentation was not maintained?  Was this lack of documentation maintenance a design flaw to hide what happened during this incident as an extension of designed incompetence?

Report 2, demands answers on two distinct issues double-dipping, and the continued practice of collective design incompetence. Double-dipping by providers working for the VA at the same time they are working at other medical institutions, is this occurring?  Why?  I understand there is a provider shortage at the VA.  I know doctors need to make money, and doctors make money by seeing patients, surgeons make money performing surgery.  The VA-OIG report appears to gloss over the practice of double-dipping e.g., on-call from one hospital while working at another, or working at another hospital while the VA expects you to be at their hospital.  Senators and Congressional representatives, are you investigating the potential for double-dipping?  Will it take a dead veteran before you even care about double-dipping occurring?  I make no accusations; I am asking honest questions on this issue in an attempt to learn more.  Will you do the same?

One of the most egregious problems at the VA is designed incompetence to allow a malefactor the ability to hide behind bureaucracy to avoid accountability and responsibility.  Designed incompetence remains a significant problem and I do not see any of the mid-level managers, leaders, supervisors, trainers, etc. acting to eliminate designed incompetence to the improvement of the Department of Veterans Affairs.  During President Obama’s Administration, I watched a Congressional Committee meeting where whistle-blowers were invited and testified about the designed incompetence that allows for an individual to pass the buck, duck responsibility, and protect their jobs and power at the VA.  I keep discussing design incompetence, because the mid-level managers, directors, and supervisors at the VA refuse to address and correct this issue.  Senators and Congressional Representatives, why do you allow this practice to continue?  Did you know that this is the primary method for discriminating and harming whistle-blowers?  Of course, you did.  I have seen several committee meetings where this exact issue was discussed, and the bloviation from the committee does nothing.  You are the leaders in our Republican Society, when are you going to act, in concert with Secretary Wilkie (who’s doing an exceptional job), correcting and insist these practices cease?

Report 3: Involves 60,000+ veterans, is this number sufficient to warrant permanent action on the proper billing of insurance companies and veterans, or does this number need to exceed some other level before it warrants your attention.  If a different level is required, what is that magical number?  I guarantee that veterans from all states and territories are involved here, as their representatives, what will you do?

Directly from the VA Website, we find two different uses for funds collected:

  • “VA is required by Public Law 87–693; 42 USC. 2651, commonly known as the Federal Medical Care Recovery Act, to bill the health insurance carrier that provides health care coverage for Veterans to include policies held by their spouse. The money collected goes back to VA medical centers to support health care costs provided to all Veterans.
  • Funds that VA receives from third party health insurance carriers go directly back to VA Medical Center’s operational budget.”

You, the elected officials of the Republic of the United States of America, enacted these laws and improper billing of veterans and insurance companies, causes financial harm and distress; this is your problem!  Do you understand that even if money is returned to a veteran, the financial injury has been done?  Those veterans who have paid a bill, or the insurance company that paid a statement, they didn’t need to pay is an interest-free loan to the government, and this is wrong!

There are literally tons of money at stake here; I know my local VA Hospital said, “The funds collected when we bill insurance companies come directly to this hospital for construction projects, renovations, new equipment, and so forth.”  Report 3 is but one of how many VA-OIG reports where improper billing is occurring. Incorrect billing drives the cost of healthcare up.  Hence, Obamacare costs more because the VA is not accurately billing.  Medicare costs more because of improper billing.  You the elected officials are directly responsible for ensuring proper billing occurs as an aid in reducing the costs of healthcare.

Where are you? Will you act?

 

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Hopelessly Confused: “Peace Be Still.”

I was casting around for a topic to write about and came across regarding leadership and decision-making when two topics, combined into the same single strand, thought, came into focus. Addressing the question, “how does one change their mind?” From one of my favorite authors, Robert Fulghum, author of “Everything I need to know I learned in Kindergarten, Uh-Oh, and several other books” comes a thought, “Hopelessly Confused.” This was a sign a woman was holding in Mr. Fulghum’s neighborhood witnessed by the author several times over a period of days/weeks and discussed in the book referenced.

The other topic comes from the final phrase in James Allen’s “As a Man Thinketh” (1903) treatise on the mind, how the mind matters, and philosophy of thinking. Mr. Allen discussed the “tempest-tossed souls,” “whose thoughts are controlled” by the winds and storms of life instead of the other way round where control of thinking improves the steadiness and serenity of the individual. The idea is that one’s thoughts influence outcomes and becomes reality.

For many months, I have had as a status on my student profile at the University of Phoenix, the following, “Thoughts become things. QED how we think determines success.” I taught a class where we discussed this exact topic. Thoughts leading to words, words becoming actions, actions producing a product, and that product in turn, generating more thinking, thus fulfilling the cycle and moving the soul further down a path, regardless of whether that path is valued as good.

James Allen adds another interesting aspect to this puzzle, “Serenity is the last lesson of culture; it is the flowering of life, the fruitage of the soul.” “Peace be still!” Bringing to point the idea, choices and thinking remain relevant to the one who would enjoy serenity. Peace is a choice; thoughts, properly controlled, are choices; developing that choice, protecting, harboring, and controlling the ability to choose drives the choice and the result is serenity.

If the thoughts driving action are based upon choice, then “hopelessly confused” was a choice. The woman holding the sign chose to be confused, and the endless running of that thought placed her in a position to become “hopeless.” Let us take a moment to explore these two words for a moment. “Hopeless” as defined by Webster includes the terms “inadequate; incompetent; feeling despair.” Confusion as defined by Webster, contains the following: “the state of being unclear in one’s mind, lacking understanding, and embodying uncertainty.” Hence, the reader is left with a state of mind regarding personal inadequacies or incompetence leading to despair.

Since confusion is a state of mind, correcting thinking on the individual’s part remains a concrete action to be personally undertaken to end the current state of mind and discover a new state of thinking and acting. Yet, what would be the impetus for beginning this process of mental change, choice. Some religions would call this agency or the individual’s personal ability to choose. Many choices remain transactional in nature; we as individuals see value in a different track or course of action, and from that desire for increased value comes the motivation to exercise agency and choose.

At this moment in the choice cycle, the individual does not know that value will come and improve the current situation. The individual has simply completed a mathematical formula and discovered potential for a higher value in a different course of action. The next step moves from inaction to action, from thinking to doing, taking the information gleaned and applying it in a fundamentally different way to realize the desired, but still elusive, potential. By taking action, the individual has shifted slightly and this shift, while ever so slight, over time has energy to achieve greatness.

A religious leader, President Dieter F. Uchtdorf (2008), himself a pilot, described the change as “a matter of a few degrees.” Using an airplane analogy, the young pilot is only off a minor tenth of a degree, then corrects the course, then drifts ever so slightly to a new heading. Over time, the plane is now several hundred miles off course and the young pilot in serious trouble. The same can be said for the confused person, the slight change in position, over time, brings innumerable changes in thinking, understanding, and action into a life. While failure to change, drives the same individual further and further down the path of “hopelessly confused.”

Regarding highways, the degrees needed to change from one highway to another without a cloverleaf is generally 10-15 degrees. Starting small, tenths of a degree, time and distance become the variables of great change. Provided proper planning for the lane changes are made, the movement from one highway to another can be done quickly, easily, and safely, without undue wear and tear on the vehicle at highway speeds, which places the next step firmly into the thinking process, planning. Proper prior planning of thoughts takes understanding the variables, naming the problems, and plotting change.

Planning new thinking entails knowing what the end goal should look like. For example, if the starting point is “hopelessly confused” and serenity is desired, then serenity is the end goal or state of mind. This holds true for all desired end states; to plot and plan effectively, one must first know where to go. The second step in planning is knowing that which motivates the change. For example, what condition is driving a desired change in thinking; name the variables or individual desires feeding the change. Planning requires understanding these motivators on a level deeper than intimacy. Finally, the best plans remain flexible but fixed. While this might sound like a paradox, it is not.

Fixed but flexible speaks to the desired end state, not the journey to that end state. While the desired end goal remains serenity, understanding that the journey will involve and necessarily require setbacks, reroutes, and difficulties. The end desired goal thus remains fixed, and the journey to that end desire will fluctuate. This is the same thinking military commanders use when attempting to overcome obstacles. Fluidity in planning and flexibility in application provides for making mistakes, for opposition, and is a learned thinking trait that must be trained into operational thinking.

Finally, James Allen provides the concluding actions in changing mental states. “Self-control is strength; right thought is mastery [of self]; calmness is power [to break the mental chains which bind]. Say unto your heart, “Peace be still.” The mental change does not happen overnight, rarely occurs with the first attempt, and will always resemble the pattern of an hourglass, but like the hourglass, moving between areas is possible, requiring both effort and time. As the narrow neck that limits change becomes closer, understand this constriction, sometimes experienced as restriction of choice, and lack of growth is only temporary. Change is coming and with change comes freedom. This hope for additional freedom is required to maintain that effort to change. Agency starts the adventure of change, hope sustains the journey, motivation and desire feed the fires of hope, and the power generated by hope’s fuel propels the change. To thy heart, “Peace be still.”

 © 2016 M. Dave Salisbury

All Rights Reserved

 

References

Allen, J. (1903). As a man thinketh. New York, NY: Grosset & Dunlap.

Fulghum, R. (2007). What on earth have I done? Stories, observations, and affirmations. New York, NY: St. Martin’s Press.

Uchtdorf, D. F. (2008, April). A Matter of a Few Degrees. Retrieved June 20, 2016, from https://www.lds.org/general-conference/2008/04/a-matter-of-a-few-degrees?lang=eng&_r=1

Shifting the Leadership Paradigm – Escalation of Commitment

The question exists; does “rational escalation” exist? How does a leader capture the power of commitment without inducing irrational escalation issues in team actions? Rational escalation remains a fallacy in decision-making and remains an excuse to create illogical paradigms for business processes and pretend non-rational escalation does not exist. If a decision begins as irrational, or an escalation of previous decisions without conscious need and new logic, denying the rational does not change the problems created.

Non-Rational Escalation of Commitment is best defined as, “the tendency to base new decisions on previous decisions.” This quote sums it up well: “If at first you don’t succeed, try, try, again. Then quit. No use being a damn fool about it.” W.C. Fields. (ThinkExist.com, 2009) In the most simple terms, people make a decision, get used to the consequences of the decision, become complacent in the known outcomes of the decision, base more decisions off the current model, and then repeat ad nauseam. Political decisions regarding the Federal Medicare Program are perfect examples of non-rational escalation of commitment. Politicians know there is waste, abuse, and issues within the system; but because it looks good to support Medicare, no one wants to begin to question the problems, advance solutions, or threaten withholding funding until the problems are fixed.

Since the problems with Medicare touch sensitive nerves with voters, politicians prefer a favorable electorate. Each year waste and abuse reaffirm the theory of non-rational escalation of commitment. “… Medicare’s administrative costs are shockingly low, below 2 percent of costs, because Medicare is shockingly unsupervised. The amount of fraud and waste is huge, and supervision of the quality of medical care provided recipients is largely nonexistent (NY Times, 1997, para 1).”

The emotions surrounding many decisions lead people or decision makers into trouble. Pride, confidence, fear, greed, a desire to do good, etc., are emotions that provide the impetus for making a particular decision. Continuing on the same path of that decision, whether right or wrong, leads to an escalation of the decision; thus, ensuring the risks of failure becoming larger as time passes. We see this currently on the ObamaCare Health Debate in Washington. Politicians have invested a lot of time and energy into the President’s “signature issue” and refuse against all logic to stop, examine the needs of the people, and accept it might be better to start over again. “… [A]sk people with direct ties to healthcare negotiations, who have put their lives on hold to get a bill passed, and they have no idea how to move forward (FoxNews.com, 2010, para 2).” The same problem exists today in 2015 as in this 2010 proclamation simply due to emotional investment and irrationally escalating poor decisions.

Escalation is non-rational for one reason: it always leads to trouble. Going back to Medicare waste, leaders recognize the problem, realize there is tremendous abuses of the system occurring, but refuse to stop escalating the amount of money to spend and force change due to fear. As shown with both ObamaCare and Medicare, when fear is the motivating factor for a decision, basic human emotions are the only force and the most difficult force to overcome. Logic has fled, reason is hiding, and chaos is gaining speed. Consequently, in the Medicare system the American people have tremendous unfunded liabilities with no possible method for making good on the commitments. Since there is momentum in sustaining the poor decision, momentum in continuing to escalate the non-rational decision-making process, and momentum to perpetuate abuse and fraud without recourse, the cycle of escalation and abuse will continue, thus fulfilling W.C. Fields quote from above, “If a first you don’t succeed, try, try, again. Then quit. No use being a damn fool about it (ThinkExist.com, 2009).” The “quitting” part of the decision paradigm needs attention. Einstein adds a special note here on non-rational decision making practices, “Insanity is doing the same thing over and over again, expecting different results (Brainy Quote, 2008).”

            Understanding the irrationality in the escalated decision making process provides the impetus to leaders to begin changing the process of gathering data to improve decisions. The smart leader would halt the current decision-making process, ask probing questions about performance, customer service, and sustainability, then proceed to either justify continuing to make the decisions to engage without change or change the decision track to achieve different outcomes. I have heard the following too many times, “Taxpayers would be scared if the government was efficient, not wasteful and productive.” I disagree; elected leaders must on-board basic leadership principles, shun management philosophy, and then communicate in a two-directional manner their ideas, their reasoning, and logic. The expectation is for business leaders to act in this manner; why do elected officials get a pass on leadership?

The engaged leader will take the decision-making process and implement the following steps to improve decision-making performance as a step to improving organizational outcomes:

  1. Ask “Why.” This is a basic and simple step to take that possesses great potential to improve organizations. Asking “Why” leads to other basic questions arising, namely, “How,” “Who,” “What,” etc. Follow the string of logic and an irrational and escalated decision will be forthcoming.
  2. “Be strong and of a good courage,” remains a passage from the Christian Bible, repeated several times, that holds the key to improving decision-making, regardless of religious flavor. Think about the question asked. The leader is asked to stand for principled action and then boldly move forward in the direction chosen.
  3. Practice being aware. Being aware calls for the leader to be and remain engaged in the people, not the business, of the decision-making process. Tom Clancy, in the “Jack Ryan Novels,” made clear that the problem in Washington D.C. is not the politicians who change but the staff of the politicians and the special interest groups pushing a narrow agenda. The same process occurs in business organizations. People carve out a niche, develop power, gather those like themselves into a micro-network, and then influence organizational change and non-rational decision-making as a means to continuing in power.
  4. Make a decision, Act, Measure, Correct if necessary, Repeat (MADAM-CR) remains an acronym to remember and follow. Leaders make timely decisions, act, and then review for potential course correction changes or hold the course. MADAM-CR remains the pattern for making logical decisions, provided the first three steps discussed have been included.
  5. GIGO (Garbage In equals Garbage Out). GIGO remains the umbrella principle in decision-making. GIGO with non-rational escalation provides the input and product from the decision-making process. GIGO stands as the ultimate caution, not to halt action but to improve measuring for success and properly preparing.

Reference

Brainy Quote, (2008). Albert Einstein Quotes. Retrieved December 5, 2008, from BrainyQuote.com Web site: http://www.brainyquote.com/quotes/quotes/a/alberteins148814.html

FoxNews.com, Initials. (2010, January 22). Congress contemplates scaled back healthcare; obama slams door. Retrieved from http://congress.blogs.foxnews.com/2010/01/22/congress-contemplates-scaled-back-healthcare-obama-slams-door/

NY Times.com, Initials. (1997, August 01). Fraud and waste in medicare. New York Times, A-30.

ThinkExist.com, Initials. (2009). W.C. fields: quotes. Retrieved from http://thinkexist.com/quotation/if_at_first_you_don-t_succeed-try-try_again-then/227395.html

© 2015 M. Dave Salisbury

All Rights Reserved

A Consideration for Organizational Leaders

            Kahneman (2011) in discussing decision-making expounds upon heuristics and biases in showing how intuitively reached decisions usually are not intuitive at all. This process of decision-making advances through understanding Miles and Snow (1978) discussion regarding how structure and process constrain strategy. Miles and Snow (1978), quote fellow researchers March and Simon (1958) and Cyert and March (1963), on how organizations limit uncertainty in decision-making through the structure of the organization and the processes in the organization. This is a bedrock principle to understanding how any organization reaches a decision, whether the decision is to produce a certain product or hire a particular employee, Miles and Snow (1978) suggest that decision makers are so influenced by the structure and processes that limits and boundaries become more important than the idea. Miles and Snow (1978) begin their work with a discussion, based upon Chandler’s (1962) work, that strategy and structure link eternally and that the structure of the organization imposes both an adaptive cycle and strategic-choices upon an organization. These principles of strategy, discovered before leaps forward in desktop computing, have not changed with the human interaction to high technology, only enhanced by human technology. Thus, a bias in decision-making is the organizational structure and if the organization desires to improve decision-making by lower level managers and employees’, reducing the bias influence of the organizational processes remains crucial. At this point, many might claim, the dated materials from Miles and Snow (1978) render the argument null and void, except when examples emerge of this philosophy in action. For example, ENRON, the organizational structure purposefully changes to fit the new leadership style of the incoming CEO. Shortly after the new CEO takes the helm, lower-level employees begin making decisions based upon the new organizational structure mimicking the decisions of higher-level managers, directors, vice presidents, and the CEO. When this occurs, ENRON begins to come apart at the seams as an organization and ethical practice replaced for the flaunting of rules and regulations. The organizational rot or organizational cancer spread from the CEO to every employee along the organizational structure, until the problem became so big and engrained that only complete destruction of the organization could save the employees, the community, and the customers (Dandira, 2012; & Miles and Snow, 1978).

References

Dandira, M. (2012). Dysfunctional leadership: Organizational cancer. Business Strategy Series, 13(4), 187-192. doi: http://dx.doi.org/10.1108/17515631211246267

Kahneman, D. (2011). Thinking, fast and slow. New York, NY: Farrar, Straus and Giroux.

Miles, R. & Snow, C. (1978) Organizational Strategy, Structure, and Process. New York: McGraw-Hill

 

© 2014 M. Dave Salisbury

All Rights Reserved