Recently the administration at the hospital where I work announced their intention to become a cardiac “Center of Excellence.” Certification requires a considerable amount of employee education on 12-lead telemetry and the like.
If you’ve ever worked in a hospital, you know that “employee education” equates to a bunch of photocopied “inservice” handouts, mostly on stuff that’s completely unrelated to your job and with post-tests you can pass without remembering any of it five minutes later.
That got me thinking about a number of things: About how irrelevant most of the material is to the jobs of most of the people studying it. About how irrelevant the metrics of the people in charge are to what they are supposedly trying to measure. About how opaque genuine standards of excellence, and the work being judged, are to the people making policies. About how such “certification,” like ISO-9000 and JCAHO, is a gimmick designed mainly to impress yokels on the outside who don’t know any better.
The people who regulate what you do, in most cases, know less about what you’re doing than you do. It doesn’t matter whether it’s nominally a “public” or “private” organization, or how smart the people running it are as individuals. No matter how smart the people in charge are, they are systematically stupid in their organizational roles, because of the dynamics of information flow in hierarchies (as described by Robert Anton Wilson, for example).
Organizations are pyramids, and the people at the tops of the pyramids tend to communicate much more effectively with each other than they do with those at the bottoms of their own respective pyramids. That means that most organizations are riddled with “best practices” based almost entirely on feedback about how well they worked from people at the tops of the other pyramids. And those latter people have almost no valid knowledge of how the policies actually worked in their own organizations.
Remember the story of the Emperor’s new clothes? Large organizations are designed to insulate naked emperors from unpleasant feedback. That set of clothes must look good, because the emperors at the other organizations all have a set just like it, and they can’t stop talking about how great they look!
The state, by promoting centralization and hierarchy and insulating bureaucratic organizations from the competitive consequences of their inefficiency, causes such irrationality to predominate in our society. We’re living in the world of Terry Gilliam’s “Brazil.”
Once you view the people making the rules as people like you, just using their own judgment based on their subjective assessment of events, it’s pretty hard to respect “the rules” as something handed down from Mount Sinai. You view the rule makers as your equals, and their rules as suggestions to be judged based on your own assessment of the reasoning behind them.
And more often than not, you find the judgment of the people making the rules is inferior to that of the people in direct contact with the situation.
Once you take this view, you’re likely to resist attempts to force you to substitute someone else’s authority-based rules for your own judgment, or to promise not to do anything before you’ve had a chance to assess the situation for yourself. You’re likely to treat rules imposed by people not directly involved in the situation as a form of irrationality, and to treat bureaucratic irrationality as an obstacle to be routed around by the people actually doing the work.
For example, every time I drive over the Boston Mountains in western Arkansas, I see endless “suggested speed limits” signs. But I can tell by the feel of the truck under me, as it handles a curve, whether the suggested speed limit is a reasonable one. And I would guess that I’ve driven that route a lot more times than the person who set the limit.
Another good example is Robert Pirsig’s account, in Zen and the Art of Motorcycle Maintenance, of how a technical writer composes the assembly instructions or manual for something like a bicycle. Generally the foreman takes the most dispensable worker off the assembly line to “advise” the writer based on his personal judgment, from just looking at the parts, of the best way to fit them together.
Despite the common view of “The Dictionary” as some sort of superhuman authority, dictionary definitions, standard pronunciations, etc., are determined by lexicographers based on field observations of how a majority of educated people actually use the words.
All these “rules” and “instructions” are based on the subjective judgment of people just like you. So when it’s a choice between authority-based rules and your own lying eyes, go with your lying eyes.
I can confirm the part about hospitals, almost to the word, because I work as a medical interpreter. According to the rules, I can't touch patients (let alone provide care) or computers. However, according to other rules, I have pass tests on sharps disposal, pathogen transmission, proper use of portable computers, etc.
This is a little off-topic, but a classic example nonetheless.
Lest you all think this behaviour is limited to the age of computers, consider the development of the Wright R-3350 radial engine (same as in a B29). It is said that more B-29 engines were lost to Curtiss-Wright than the Japanese!
Numerous problems with the reduction gear resulted in various gear contact ratios being tried, various bearing assemblies, different numbers of planetary teeth, different bearing material, different size main gears, etc, etc.
Finally, after massive government pressure from Senator Harry S Truman, Wright got one highly skilled machinist to manufacture the entire assembly himself. It worked perfectly. It turned out that no-one had bothered to measure tolerance stack-up and the planetary gears were up to 0.014” out.
So the original design for ~2000hp was capable of transmitting up to 3000hp to the propeller.
Overheating was even worse (there were far more fires than broken prop trains).
If Wright had have bothered to use the research done by NACA on air-cooled engines then the R-3350 may have been producing 3500hp by 1944 instead of melted nacelles and aircraft wreckages. Curiously the Focke-Wulf 190 suffered from relatively few cooling problems; perhaps this was because German engineers had copies of the relevant NACA air-cooling reports on their desks in the late 1930’s.
Steve: That's hi-larious, as Ross Perot would say.
One of my favorite examples of routing around bureaucratic irrationality is the memo we got a year ago in August warning us that parking rules would be strictly enforced, and employees would thenceforward be ticketed for parking in forbidden lots next to the building. As far as I know, just about everybody on my ward threw their employee parking sticker away when they were hired, and park wherever the hell they want (a parking sticker's supposed to entitle you to park somewhere; why would anyone display a sticker that *reduced* their discretion and made it easier for management to keep track of them?). Every time I think of those idjits sitting around their conference tables making policies, and thinking they're really keeping a tight rein on things, I think of the casual contempt with which their edicts are ignored and just about bust a gut laughing.
Uncle Yarra: That B-29 engine story is a keeper. The cumulative deviation thing reminds me of the fictitious stovepiping I described here:
http://c4ss.org/content/1599
Maybe Wright should have hired some of the part fitters GM used to hammer defective parts into place, decades after Henry Ford supposedly figured out how to cut precision parts from hardened steel.
Well, at least this country's corporate-state-military establishment hasn't matched the Soviet track record (the Strategic Rocket Forces getting their electricity cut off, the Murmansk fleet's ammo magazine blasting itself into the stratosphere because of improper storage, etc.)–so far.
This is a bit more on-topic….
The Plan
In the beginning was the plan.
And then came the Assumptions.
And the Assumptions were without form.
And the Plan was without substance.
And darkness was upon the face of the Workers.
And they spoke among themselves, saying,
“It is a crock of shit, and it stinketh.”
And the Workers went unto their Supervisors and said,
“It is a pail of dung, and none may abide the odor thereof.”
And the Supervisors went unto their Managers, saying,
“It is a container of excrement, and it is very strong,
such that none may abide by it.”
And the Managers went unto their Directors, saying,
“It is a vessel of fertilizer, and none may abide its strength.”
And the Directors spoke amongst themselves, saying one to another,
“It contains that which aids plant growth, and it is very strong.”
And the Directors then went unto the Vice-Presidents, saying unto them,
“It promotes growth, and it is very powerful.”
And the Vice-Presidents went unto the President, saying unto him,
“This new plan will actively promote the growth and vigor
of the company, with powerful effects.”
And the President Looked upon the Plan, and saw that it was good.
And the Plan became Policy.
Kevin,
In just the first 2 paragraphs alone, had you not mentioned hospital or had I not known of your employment background already, I'd be tempted to ask in what department in my company do you work? LOL! And I think this just goes to prove the point of how widespread the very thing you are pointing out truly is. Nice work and enjoyed the piece!
"Maybe Wright should have hired some of the part fitters GM used to hammer defective parts into place"
Sounds like what we'd call a "friday special" in Australia. You know, the inexplicable lemon from a model that is reasonably good, but just happened to be assembled late on Friday afternoon.
Oddly enough, the Rolls-Royce engineer who went over to Packard to assist with their production of the Merlin was very impressed by a union rep who went ballistic at a guy who had a hammer in his toolbox. Apparently it was a dismissable offence.
The USA gave up on attempts to produce the Merlin as US quality control wasn't up to the precision needed. US industry had a production engineering culture/skills base/installed plant base that was more oriented to mass production of lower precision goods.
P.M.Lawrence,
You are incorrect. Packard produced many Merlins during WW2.
They even designed a different supercharger drive based on a a planetary gearset.
I suggest you peruse http://www.aehs.org for more information.
Employee education is just another way of securing compliance. Compliance is what employers pay for, not your actual passion and talent.
My recent post Is Wind the New Coal? West Butte Wind Power Controversy Gives a Feeling of Déjàvu