Finally! JAMA agrees with YoMamma

In the 15 Dec 15 issue of the Journal of the American Medical Association (jama.com), there is a fascinating article, From Shame to Guilt to Love, that delivers a treasure trove of cultural commentary about "How to Fix America" simply by reflecting on the contrast between information and true wisdom.

For non-US readers, or more specifically those who are not from the American South, Yo' Mamma is the local parlance for your mother. Since before recorded time, wives and mothers have been the backbone of civilization. It's often said that left to our own devices, men would still live in caves, albeit with stable 3-cycle power—how else are you going to play video games? (Wild howling & cackles commence off-stage…)

Pronovost and Bienvenu remark that "The emotional components of patient safety are barely regarded yet essential if we want the evolving technical components to succeed." Two of the many Achilles' heels of the American fiction called Healthcare are:

• greed trumps logic
• ego trumps pretty much everything else.

Good mothers teach their children that doing the supposedly right thing for the wrong reason rarely, if ever turns out well. That will be just as true in 2018 as it was when Sigrid Unset received the 1928 Nobel prize for Literature:

"Facts may be true, but they are not truths—just as wooden crates or fence posts or doors or furniture are not 'wood' in the same way a forest is, since it consists of the living and growing material from which these things are made."

The way we treat people has everything to do with the results we get!

Lincoln's oft-repeated story about a dog's leg is actually a calf's tail, none-the-less, like all parables, the message is as profound as it is simple: "calling a tail a leg doesn't make it one."

In her Nobel autobiographical sketch, Undset highlights the hypocrisy of progressive ideas; she realized even at the tender age of 14, that those setting themselves up as authorities must demonstrate both internal consistency and the central tenet of community: forgiveness with a path back to full participation.

Citing St. Augustine's response securus judicat orbis terrarum ('the verdict of the world is conclusive'), to the 4th century heresy of Donatus of Cas? Nigra, Undset matures her teenage belief through continued study and practical application, eventually joining the Roman Catholic Church at age 42, which created a sensational scandal in Norway.

From her study of Augustine, she had come full circle from the agnostic belief that man created God to the understanding that God's grace infused ex opere operato (from the work having been worked) gave her, her children and the communities of which they were a part, the full communion of both spirit and life which allows creativity and civil order to flourish.

As with most any myth that dehumanizes, the destructive fantasies prevalent in modern healthcare persist only when upheld by oppressors, be they

• governing committees ruled by MBAs,
• doctors whose middle name is arrogance, 
• vile members of congress who pass sloppy laws that guarantee corruption,

among the many bad actors. These myths collapse when forced to compete in the marketplace of ideas, which is why the 'fight to reform healthcare' includes so many half-baked ideas that have previously failed elsewhere and so few plain, simple, direct solutions that have worked everywhere they've been implemented. It is not news that vested interests are stridently against being divested.

Delivering Common Sense Uncommonly Well

Like Unset, I grew up with a mindset that distrusted or discounted those who dehumanized, but even moreso, those who simply didn't know how to teach the whole person. As a lifelong Catholic middle son of two teachers, I've only realized much later, as I became a leading teacher myself (50 classes a month, across 22 subject areas), that any technology solution must put people front and center or you sink your ship before she has even set sail.

One can never tell a venture capitalist that your innovation has no competitors, because they will rightly dismiss you has hopelessly na?ve. In talking with scores of modernists who are interested in only a software solution (because it makes the most money, they say), I've learned to describe Systemkey? Risk Solutions as a dialog-driven risk discovery framework, powered by Semantic Compression? software standards. Such a mouthful disrupts their status quo just long enough to plant the seeds for an actual conversation.

The Systemkey? Risk Modeling Language (SRML) was designed to transform how risk is measured and managed by delivering more granular detail on risk exposures. Every language has a syntax and a grammar:

• The syntax is the unchanging rules for making meaning.
• The grammar is the fabric of business intelligence woven from practices unique to a trade, a locale, a host of traditions, requirements, cultural adaptations and so forth.

When we give people a language to express the emotional commitment they have to truth and meaning, the results can be startling! To date, SRML has been through five (5) field trials, of which the running average return on investment (ROI), is 850x! Those astonishing returns are the ordinary, expected result when we engage the whole brain of your whole workforce, rather than serve as enablers for petty tyrants to persist in their oft-tried but so untrue ego-driven practices. They're also why participants must qualify for Systemkey? implementations, because one cannot push a rope: there has to be commitment to genuine improvement, which involves genuine change, or we're wasting each other's time.

Unlike Pronovost and Bienvenu, I've seen that shame has its place in improving American healthcare, just not in teaching or in implementing process improvement. Rabbi Daniel Lapin's timeless article, "In Praise of Shame", (National Review, Vol XLVIII, No. 17, 25 Sept 1995, p. 87), addresses some of the cultural underpinnings outside the scope of my musings, but it's well worth the read. If you're too busy to read it, then you need to read it twice and have your team discuss it for an entire week. It's that rich, that meaningful.

The authors are right that love is the bridge to crossover the River Chaos to the undiscovered country of sustainable performance improvement.

Heart Speaks to Heart, 
Before Mind is Open to Mind

Whether our mentor is Unset or Gawande, whether we follow Mother Teresa or Joel Manby, the stellar results are the same: Listen to your Mother, especially today, New Year's Day, the Feast of Mary, Mother of God.

New Year's Blessings to all who encounter this message!