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The power of complex services: foster, use, and abuse: Part 2 - On diagnosis, leadership, operational focus, and the power of a good metric

Examples discussed here include the doctor’s office, the surgical block, Shouldice hospitals, the Apgar score to measure to immediately measure the health of newborn baby, and the social emergency team intervening when children are at risk. “First do no harm” is an oath that all complex service provider should make their own. Largely determined by history, inertia, and drift, our operating units often mix together incompatible activities, and are thus unmanageable. Deconstructing these jumbled flows and rebuilding focused units makes management (appropriate balance between autonomy and control) possible. Quick response to emerging needs, by a multifunctional « commando » unit can trigger a paradigm changing breakthrough.