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.

The effort to reduce call volume at Expedia was a successful upstream intervention.

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

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. Define your mission and create your strategy and align your resources to solve that problem. And you have the divine right to ignore all of the other stuff that doesn’t align with that.”

So, what’s right, upstream or downstream? Should we stop a burglary with an alarm system—or by nurturing the mother of the future “criminal”? The first and best answer is: Why in the world would we choose? If corporations can mount multiple levels of protection to prevent network downtime, then surely, we can invest in multiple levels of protection against crime and other important problems.

for every $1 we spend on downstream health care, most of us think it would be wise to spend $2 upstream.

if you add together what nations spend on health care plus what’s called “social care”—which is basically upstream spending, ranging from housing to pensions to childcare support—you find that the US is unremarkable. We’re 9th out of 34 countries in total spending,

There are knotty problems that upstream leaders must untangle. How can you detect problems before they occur? How can you measure success when success is defined as things not happening?

who should we expect to pay for those things that do not happen?

“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 it.

The Freshman On-Track work “changes the nature of how teachers see their jobs. It changes relationships between teachers and students,” said researcher Elaine Allensworth. “It’s the difference from ‘I put the work out there and I assign the grades’ to ‘My job is to make sure all students are succeeding in my class. So I need to find out why they’re struggling if they’re struggling.’ ”

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.

You can’t solve a problem that you can’t see, or one that you perceive as a regrettable but inevitable condition of life.

At the first international urban planning meeting in New York City in 1898, the horse manure crisis was the talk of the conference.

The seed of improvement is dissatisfaction.

The upstream advocate concludes: I was not the one who created this problem. But I will be the one to fix it.

What’s odd about upstream work is that, despite the enormous stakes, it’s often optional. With downstream activity—the rescues and responses and reactions—the work is demanded of us.

The first force, problem blindness, means: I don’t see the problem. (Or, This problem is inevitable

A lack of ownership, though, means that the parties who are capable of addressing a problem are saying, That’s not mine to fix.

the question is not: Who suffers most from the problem? The question is: Who’s best positioned to fix it, and will they step up?

“what often prevents people from protesting is not a lack of motivation to protest, but rather their feeling that they lack the legitimacy to do so.”

Perhaps what the Interface story illustrates is not that efforts at preventing problems always pay for themselves, or that good intentions are always rewarded—neither is true—but that we should push against complacency.

What harms do we accept that we’re capable of changing?

The question they asked themselves was not: Can’t someone fix this problem? It was: Can we fix this problem? They volunteered to take ownership.

she started by stating, “I’m accountable for this. Let me tell you how I’m responsible. I’ve heard rumors that you weren’t getting along, and I’ve heard from your boss that there was trouble. You know what I did? I looked the other way. I thought, They’ll work it out. I ignored you and I’m sorry.”

When people are juggling a lot of problems, they give up trying to solve them all. They adopt tunnel vision. There’s no long-term planning; there’s no strategic prioritization of issues. And that’s why tunneling is the third barrier to upstream thinking—because it confines us to short-term, reactive thinking. In the tunnel, there’s only forward.

tunneling isn’t just something that happens to poor people—it can also be caused by a scarcity of time.

“Scarcity, and tunneling in particular, leads you to put off important but not urgent things—cleaning your office, getting a colonoscopy, writing a will—that are easy to neglect,”

“Their costs are immediate, loom large, and are easy to defer, and their benefits fall outside the tunnel. So they await a ti...

We all have colleagues who actually seem to relish those manic “stay up all night to meet the critical deadline” adventures. And it’s not that the day doesn’t need saving, sometimes, but we should be wary of this cycle of behavior. The need for heroism is usually evidence of systems failure.

How do you escape the tunnel? You need slack. Slack, in this context, means a reserve of time or resources that can be spent on problem solving.

sense of idle time. Rather, it’s a guaranteed block of time when staffers can emerge from the tunnel and think about systems-level issues. Think of it as structured slack: A space that has been created to cultivate upstream work.

We’ve got to create an urgent demand to fix a problem that may not happen for a while. We’ve got to make the upstream feel downstream,

The first thing to realize is that “creating urgency” is basically coopting the power of tunneling for good. Rather than try to escape the tunnel—as with the discussion on slack—we can try to use the extreme focus it provides to our advantage.

problem blindness (I don’t see the problem), lack of ownership (That problem is not mine to fix), and tunneling (I can’t deal with that right now).

the first step, as in many upstream efforts, was to surround the problem—to recruit a multifaceted group of people and organizations united by a common aim.

all the cases in which a woman had been murdered by a husband, boyfriend, or ex. (If a woman is murdered, there’s a nearly 50% chance that the perpetrator fits one of those descriptions.)

What all these people had done up to that point, primarily, was pass the baton to each other in the course of their work: The hospital would refer a victim to the advocates; the advocates would tell the police about a violent abuser; the police would refer a case to the DA; and so on. But they’d never sat at the same table to work together—and certainly not with an eye toward prevention rather than reaction.

When you design the system, you should be thinking: How will this data be used by teachers to improve their classrooms? How will this data be used by doctors and nurses to improve patient care? How can the local community use the information? But that’s rarely how the systems are designed.”

groups do their best work when they are given a clear, compelling aim and a useful, real-time stream of data to measure their progress, and then… left alone.

“Data takes you away from philosophical insights. You move away from anecdotal fights about what people think is happening to what is happening,”

“You can’t solve a dynamic problem with static data.”

Rachel Louise Snyder in the New Yorker tells the story of Dorothy Giunta-Cotter—and the Jeanne Geiger Crisis Center—at greater length.

There are healthy people in low-life-expectancy areas and sick people in healthy neighborhoods. With tremendous effort and support, individuals can transcend bad neighborhoods. Every year, we read about a kid with every strike against her who is admitted to Harvard. We rejoice for her. But should we? “Every year I read that story, I get irritated,” said Iton. “Of course, there are smart kids of color in the inner city! There are millions of them. We’re celebrating this one kid—who deserves to be celebrated—but we’re not asking the real question: Why is this such a rare story?”

Upstream work is about reducing the probability that problems will happen, and for that reason, the work must culminate in systems change.

What would the world look like if we extended half of the same concern to our neighbors’ kids and their futures?

There is no true equivalent of DonorsChoose in other countries, perhaps because their schools pay for the supplies that students need.

Should DonorsChoose shut itself down for fear of enabling an unjust system? By the same logic, should we criticize food pantries because they make it easier to sustain an inadequate social safety net? It does not seem fair to withhold food from today’s needy families—or supplies from today’s students—while we wait for reforms that may never come.

(Small talk leads us to favor “likable” candidates—in other words, candidates who are just like us.)