Letter from the Editor

The Rewards of Repetition


As I mentioned before, I'm obsessed with elegant workflows.

It all goes back to a book I read before I started healthsystemCIO that had a phenomenal impact on my thinking. In “The E-Myth Revisited: Why Most Small Businesses Don't Work and What to Do About It,” Michael Gerber made the case that only businesses that have well-documented and repeatable processes can succeed.


Then, from Gordon Ramsay's Kitchen Nightmares show, I took away the message that excellence demands narrowing your variety. The volume can stay high; the range needs to shrink. Henry Ford must have been onto this when he famously said, “Any customer can have a car painted any color that he wants, so long as it is black.”


These things sound like common sense once absorbed, but many don't absorb them at all. They think variety is not only the spice of life but the key to business. In the restaurant industry, they create catch-all menus that they hope will catch all diners, but the problem is when you try to be a jack of all trades you invariably prove to be a master of none. (Yes, that's a lot of expressions, but they all came out naturally.) It's hard to trust lobster tails at the diner when they sell one a month.


So I started with the premise of doing a few things to the highest degree of excellence: that's the small menu idea. Then I added on Gerber's notion that the only way to achieve consistency is ruthless documentation. One of the greatest compliments my wife and I have for a restaurant is: “It's the same every time!”


Today we're going to talk about how to get that documentation. How to, as I like to think of it, smooth the edges to create the perfect shiny diamond of workflow that produces the same result every time.


My wife has asked me during a dinner out: “How do they keep doing it all these years, they can't have the same people working here all this time.”


And my response is: “They probably have it down to a science. If you are sourcing your food from the same places, and you are using the same kitchen equipment, and you have your recipes and processes WRITTEN DOWN, then all you have to do is hire people who can read,” and that is a low bar indeed.


But I digress. Back to the point at hand. To get the diamond perfect, you need to go through the process many, many, many times. Now, remember, improvements are iterative. All you want to do is just get it a little better each time through. I read an excerpt of an interview with the online influencer MrBeast about making YouTube videos and he advised, “Make 100 videos and improve something small with each video. Doesn't matter what, just improve each vid.”


That sentiment is also echoed by Malcolm Gladwell's “10,000-hour rule,” popularized in Outliers, which contends that mastery requires 10,000 hours of practice. Excellence comes from repeated, deliberate improvement over time.


So, we need to do things many times to be great at them. Of course, since there is so much time involved, we want to make sure we've decided to achieve mastery of the right things: that we've selected the right diamonds to shine. Once we do that it's time to get to work.


I often think about how volume relates to excellence when the fall and spring conference season rolls around. There are services that we offer only around those shows that, of course, I only do once a year. And though I've done them for years, and though I'm obsessed with documentation and capturing learnings, I'm never as comfortable as I am when, let's say, producing a webinar or an interview, which I do with exponentially higher frequency (webinars 2-4 times a month and interviews double that).


I think about this dynamic for you around pilots. You know you need to be great at executing pilots and though I know excessive piloting (pilot fatigue) is an issue for some, I suspect under-piloting is an issue for others. If you wind up piloting with a low frequency, you likely never get quite comfortable. Upping the volume can be a conscious decision that moves you towards excellence.


Here's the small-menu idea applied to your world: more pilots, but fewer types of pilots. If your pilot portfolio is too diverse, the learnings don't accrue. Each one becomes a one-off rather than a contribution to a single body of expertise.


Here's one more nuance to consider. It is very difficult to capture learnings in a coherent way when you have multiple projects going at the same time. So if you are running multiple pilots in parallel, it's a yeoman's task to ensure you are injecting learnings from all into each other as well as into the master. Thus, I've always preferred, if possible, to run new workflows consecutively rather than concurrently, at least until you get a little polish on the diamond.


The idea of pushing volume in pursuit of excellence is a little like the idea that getting better at public speaking requires continually getting on that stage no matter the dread, knowing that with each trial, you're one step closer to competency. Keep this in mind: design a small menu, use repetition as your sandpaper, and turn up the frequency volume, because only practice (apparently 10,000 hours) makes perfect.


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Annual Sponsor Updates


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