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October 30, 2019 - February 9, 2021
No Heroics.
Enough with the Stupid Policies.
No Assholes.
Strive for Flow.
Plan Reality, Not Fantasy
Barriers such as the appearance of inconvenience.
One of the things they wanted to do was put a pharmacist on the telephone with the patient—a
a pharmacist who was familiar not only with the drug being described, but with all the drugs being prescribed to that patient.
Let’s create specialized pharmacies in five different sites spread across the country.
And because the pharmacists will have comprehensive insight into the patient’s condition, they’ll be able to let doctors know when there might be contraindications. Let’s say someone is diabetic. They’re more likely to be overweight and, possibly, to have liver issues. As a result they’ll metabolize drugs differently. So if a new doctor prescribes a blood pressure medication, the Medco pharmacist might call the doctor and recommend that he or she run a liver panel on the patient and adjust dosage if need be.
What’s more, Medco would guarantee the cost savings.
While Klepper had checked with his managers that the idea was technically possible, he hadn’t obtained details on how long this plan would take to implement.
The people who would actually make it happen only found out about it after their president had promised Wall Street that the new system would be put in place on July 7, 2007. Come hell or high water.
In Medco’s five gargantuan plants filled with four thousand pharmacists processing prescriptions, robots whizzed about pulling pills while other robots handled packaging and mailing, and all those systems had to talk to one another with 100-percent accuracy, or someone could die.
idea was that Klepper’s brave new plan would give Medco a chance to update their aging systems and stay a step ahead of their competitors.
Why it took them six months to figure out that they couldn’t do it in time is something that bears examination.
It was because they made a very basic mistake. They thought they could plan everything ahead of time.
As I’ve said previously, the very act of planning is so seductive, so alluring, that planning itself becomes more important than the actual plan.
the map is not the terrain.
It really is one of the best feelings in the world.
Unfortunately, that calculation phase can be a garbage-in/garbage-out process.
The people involved may be highly intelligent,
and yet they typically won’t realize that what they’re feeding into their planning charts is...
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It was not trivial.
Buried in there somewhere was what actually needed to be done, but no one actually had a plan for how to do it.
“deadlock.”
You can use pain and fear as your ally when you walk in as a consultant.
‘Hey, you can do things the way you’re doing them, stick with the status quo, and you’ll deliver late, and that’ll be fine.’ And they said, ‘That’s not fine.’ ”
No, e-mail wasn’t okay; we wanted physical paper.
“How many of you have actually read all this?”
Silence.
More awkward silence.
They’ve set up a system that forces them to endorse a fantasy.
“Here’s what we’re going to do,” Brent said. “We’re going to go through these stacks of paper and cut out everything that is actually something that needs to be done to complete this project. Then we’re going to stick them on the wall.”
But I taught them a quick and dirty method that is the best of a whole bunch of bad ways of doing it, and they went at it.
An unreadable stack of paper had become understandable pieces of work.
“How do you eat an elephant? One bite at a time.”
We simply said for this task to be done, it had to meet those goals. We baked that into the project at the work-item level, rather than waiting for everything to be done and then finding out that we weren’t
in compliance with some federal regulation or internal quality metric.
“Definition of Done.”
prioritize the work.
What will bring the most value to the project? Let’s do those things first.
The lists stretched the length of three sides of the room.
Wedding Planning
a wedding.
something that you think will take hours gets banged out in fifteen minutes.
And, boy, are we bad.
The low and high estimates differ by a factor of sixteen.
Which is why, in my opinion, Waterfall-type planning is a really stupid way of doing things.
But the key is to refine the plan throughout the project rather than do it all up front.
