Upstream: The Quest to Solve Problems Before They Happen

by Dan Heath

When you spend years responding to problems, you can sometimes overlook the fact that you could be preventing them.

Downstream actions react to problems once they’ve occurred. Upstream efforts aim to prevent those problems from happening.

Expedia’s executives were not oblivious. They were aware of the huge volume of calls. It’s just that they were organized to neglect their awareness.

Notice what was missing: It was no group’s job to ensure that customers didn’t need to call for support. In fact, no team really stood to gain if customers stopped calling. It wasn’t what they were measured on.

“When we create organizations, we’re doing it to give people focus. We’re essentially giving them a license to be myopic. We’re saying: This is your problem.

Okerstrom’s point is that focus is both the strength and the weakness of organizations.

The specialization inherent to organizations creates great efficiencies. But it also deters efforts to integrate in new, advantageous ways. In upstream ways.

we get stuck in a cycle of response. We put out fires. We deal with emergencies. We handle one problem after another, but we never get around to fix...

That’s one reason why we tend to favor reaction: Because it’s more tangible. Downstream work is easier to see.

Easier to measure. There is a maddening ambiguity about upstream efforts.

How do you prove what did not happen?

In this book, I’m defining upstream efforts as those intended to prevent problems before they happen or, alternatively, to systematically reduce the harm caused by those problems.

But if the “problem” we want to solve is people dying from

drowning, then the life preserver can prevent that.

A telltale sign of upstream work is that it involves ...

The downstream rescue leads to the upstream improvement.)

prefer the word upstream to preventive or proactive because I like the way the stream metaphor prods us to expand our thinking about solutions.

In other words, you don’t head Upstream, as in a specific destination. You head upstream, as in a direction. Swim lessons are further upstream than life preservers. And there’s always a way to push further upstream—at the cost of more complexity.

Could we imagine preventing a burglary decades before it happened? Yes.

We’ll never run out of room upstream.

Downstream efforts are narrow and fast and tangible. Upstream efforts are broader, slower, and hazier—but when they work, they really work. They can accomplish massive and long-lasting good.

The US health care system is designed almost exclusively for reaction.

will be restored to your baseline health. But it’s hard to find someone in the system whose job it is to address the question How do we make you healthier? (As distinct from How can we respond to the problems that make you unhealthy?)

These are the fruits of investing in downstream action.

What about the flip side—the disadvantage of our downstream focus?

Norway is not spending more; it’s just spending differently. We cranked up the treble, Norway cranked up the bass. Our choice as a nation has been to get better and better at fishing drowning kids out of the river. We could choose differently.

To go upstream is a declaration of agency: I don’t have to be at the mercy of these forces—I can control them. I can shape my world. And in that declaration are the seeds of both heroism and hubris.

We tinker with systems we barely understand, stumbling into a maze of unintended consequences.

How can you detect problems before they occur?

How can you measure success when success is defined as things not happening?

And, by the way, who should we expect to pay for those things that do not happen?

First, we’ll grapple with the three forces that push us downstream, impeding our ability to prevent problems.

Then, in the heart of the book, we’ll study the seven fundamental questions that upstream leaders must answer.

Most of us would agree that “an ounce of prevention is better than a pound of cure,” but our actions don’t match those words.

THE THREE BARRIERS TO UPSTREAM THINKING

Problem Blindness

“You don’t wait for these bad things to happen,” said Elliott. “Instead, you look for the signal that there’s a risk there, and then you act on

“problem blindness”—the belief that negative outcomes are natural or inevitable. Out of our control. When we’re blind to a problem, we treat it like the weather. We may know it’s bad, but ultimately, we just shrug our shoulders. What am I supposed to do about it? It’s the weather.

Problem blindness is the first of three barriers to upstream thinking that we’ll study in this section.

When we do...

problem, we can’t solve it. And that blindness can create passivity even in the face of enormous harm. To move upstream, we mu...

Every system is perfectly designed to get the results it gets.

To succeed upstream, leaders must: detect problems early, target

leverage points in complex systems, find reliable ways to measure success, pioneer new ways of working together, and embed their successes into systems to give them permanence.

Remember, though, that for anything to happen at CPS, leaders first had to awaken from problem blindness. You can’t solve a problem that you can’t see, or one that you perceive a...

Not many: 20 out of 24 missed it entirely. They had fallen prey to a phenomenon called “inattentional blindness,” a phenomenon in which our careful attention to one task leads us to miss important information that’s unrelated to that task. Inattentional blindness leads to a lack of peripheral vision. When it’s coupled with time pressure, it can create a lack of curiosity. I’ve got to stay focused on what I’m doing.

Yep good point!

Problem blindness is as much a political phenomenon as a scientific one.

Sometimes we convince ourselves to address the wrong problems.

The escape from problem blindness begins with the shock of awareness that you’ve come to treat the abnormal as normal.

A Lack of Ownership