Process Triaging COVID-19

Note: This 3/10/2020 post was last updated on 3/13/2020 to reflect my latest thinking.

How we think about caronoviruses is important. They are a deadly threat to the immunologically compromised. This post applies the ProcessTriage® Protocol to the COVID-19 virus epidemic. Here’s my triaging narrative so far:

The COVID-19 epidemic is a Process Pain Point. In no particular order, it inhibits business and community performance. It is a repeating event that disrupts our business by delaying supply chains, suppressing retail customer traffic, increasing employee absences, overwhelms medical ICU capabilities and is fatal to a specific demographic at rates quite higher than seasonal influenza (.1%), to perhaps +10x that, perhaps 2%, about half of what the 1918 Spanish Flu recorded.

Panic? Absolutely not. Pay attention? Absolutely. At this writing, it has an exponential growth rate about 1.15 (meaning each subsequent day’s infections will be 1.15 times the previous day’s) with an unknown inflection point date in sight (where the growth rate is 1.0, after which it will decline exponentially). Here is the latest data from Johns Hopkins University. A most sobering analysis of COVID-19 is Joe Rogan’s interview with infectious disease expert Michael Osterholm (March 10), Dr. Osterholm asserts “This will not be a flu blizzard, but a flu winter with potentially 480,000 deaths.” This is NOT the flu, although both are respiratory infections. There will not be a vaccine anytime soon. Unfortunately, forty percent of the US population have mitigating risk factors of obesity and high blood pressure, that increase their risk of complication, with an amplified risk to the elderly and those with weaker immune systems. The CDC’s Dr. Anne Schuchat gives a good summary as well (3/12/2020), from Senator Bill Frisk’s podcast (See episode #42).

Do we know the most likely cause? Yes, enough. COVID-19 is highly contagious and lasts from a few hours to perhaps ten days on surfaces. It originated in Wuhan, China, likely from a wet market.

Do we have a best practice that, if followed, addresses the pain point? Yes. During the epidemic’s expansion phase: SLOW IT DOWN until enough people recover from exposure until is stops spreading. It’s all about reducing the R0 ratio — the number of adjacent individuals a contagious carrier infects, thereby flattening the curve. Establish and maintain social distance. Avoid crowds. Practice good hygiene, diet, and exercise. Strengthen one’s immune system. Focus locally. Since the virus is spread by breathing, an R-95 grade breathing masks is required to prevent breathing it. One can be infected and contagious for typically four days before showing symptoms. If one is appears symptomatic, self-isolate and get tested if possible. Be especially aware of the immunologically compromised such as the elderly.

At some point, the strictness of this social separation can collapse the economy. Most hourly workers in all industries that serve gatherings of people will be unemployed. Schools, in-person entertainment, in-person sports, restaurants — the entire social services sector will collapse.

(Do not panic. Neurobiologically, keep your consciousness parked in your prefrontal cortex, where it’s emotionally safe. Focus on watching the empirical data — your local city and neighborhood numbers (not the numbers of places you’re not not going to visit, other than the trend lines). By focusing on the facts, we avoid the amygdala’s fight-flight-freeze lizard-brain panic; we suppress that nasty cortisol.)

Does this best practice need training or learning? YES. We need to TRAIN and ENFORCE this best practice with an effort and focus proportionate to the virus exposure rates within our neighborhoods and public places we frequent.

Is this triaged solution a Small (task size) or Big (project size) effort? Small for us individually, from a pre-infection viewpoint. Dealing with a serious COVID-19 infection individually or within one’s family will be a Big (project).

Let’s follow our best practice and lead by example, but be patient. This will take months to resolve. It will take a national strategy to stockpile the supplies needed for infectious disease outbreaks.

The above triage result focused on our individual-level solution. A similar triage from a national perspective yields a different solution: It’s a BIG DESIGN (and IMPLEMENT) a capability to detect and manage COVID-19 virus infected individuals. We must be patient and recognize our response will be clumsy and mistake-prone until a learning curve is completed enough. Since COVID-19 has a 10x+ morbidity rate than seasonal flu and it there is no vaccine, we will have to design and establish COVID-19 intake facilities based on the volume of serious infections. The best case is we size and deploy these facilities and staff in a flexible, scalable manner. Establishing dedicated facilities will answer itself depending upon severe infection frequency. Some things will never be the same, such as nursing home access; every visitor and staff member will have to cleared to enter. Obviously, we must decouple the medical supply chain from China and return all manufacturing of essential medicine and medical supplies to domestic manufacturers as a matter of national security.

How Business Can Be the Highest Expression of Righteousness

I have often closed my Process Triaging for Executives talk and exercise with a reflection on my father’s (OBM) commentary on the Declaration of Independence. Because business processes are constantly stressed and break as the company succeeds and grows, continuous process improvement is a pursuit, not an objective one satisfies. As dad admonished, the pursuit of happiness is a miserable existence that implies one is not happy in the moment, only chasing what one doesn’t have. Instead, find pleasure in the toil and hard work of life — find happiness in every moment; in every item on the to-do list. And occasionally everything comes together for truly superlative, joyful celebrations — like icing on an otherwise very good cake.

This happiness of pursuit is an excellent anchor, psychologically and emotionally. As a habit, it builds resiliency and courage. However, it must rest on a foundation of purposefulness. Pursuing anything with the intensity it takes to lead a business requires transcendence. Might this be charity?

The medieval Jewish sage Moses ben Maimon (a.k.a. Maimonedes) — the Rambam unpacked the concept of tzadaka, often translated as charity. But charity doesn’t do it justice; a more nuanced word is righteousness that expresses an alignment with purposeful virtue. With our Divine raison d’être — why we are here. The Rambam offered a list of righteous actions ranked by degree — all good but some more equal than others. The highest form of tzadaka is all why we devoted to this business of business:

  1. The least expression of righteousness if to give unwillingly. The giving is good, nevertheless.
  2. A better expression is to give gladly, but inadequately. The giving is good, nevertheless.
  3. A better expression is to give to a poor person after being asked. The giving is good, nevertheless.
  4. A better expression is to give to a poor person directly to his or her hand before being asked.
  5. A better expression is to give, but not know who receives it, so the receiver is not shamed.
  6. A better expression is to give, knowing the receiver but the receiver does not know the benefactor.
  7. A better expression is to give in a manner the benefactor and receiver do not know each other — such as giving to an anonymous fund. There is a necessary obligation to be satisfied with the fund’s administration.
  8. The greatest expression of righteousness is to endow someone with a gift or loan or entering into partnerships that finds them employment or a livelihood.

There is no greater expression of tzadaka — of charitable righteousness than creating and sustaining a business that provides someone employment and a livelihood. This is beyond teaching someone to fish — it is to help and enable them become a professional fisherman.

So in our happiness of pursuit, let’s pursue that which is most purposeful.

Hat Tip to an Amazing Vistage Chair

Not long after I hung the ProcessTriage® company shingle, an early successful client introduced me to Vistage International chairperson Jeff Hutsell. We outlined a talk and practical exercise in Business Process Triaging for Executives and tested it with one of his peer advisory groups. This promising start in 2013 led a satisfying presence on the Vistage speakers program. I’ve given 85+ executive presentations with good review scores and followed on to work with well over a hundred Vistage member teams in all sorts of enterprises.

I’m reminded that we ride on the shoulders of our parents and mentors. My company’s customers would not have benefited from my company’s contributions, however small or big, without the Jeff Hutsell’s and the Vistage chairs who have offered sage advice. Here’s to a great organization!

With the amazing and gracious Vistage Chair Jeff Hutsell

Beginning 2020 with Thankfulness

The beginning of a new year is a fitting occasion to pause, facing forwards with an optimistic anticipation, out feet grounded in rational calculation. We expect to succeed. We will focus on the important, sweat the details and live our core values.

One of these values includes “Make every touch a referable experience.” So hat tip to our EOS® Implementer family and many Vistage International chairpersons — we are humbled by your kind referrals.

We are in business to add to the community around us by improving our clients’ core process teams’ ability to accomplish their organization’s vision and purpose. We do this by improving their situational awareness and emotional empathy and accountability to each other. To identify and present issues accurately and in a mentally safe way that fosters collaboration and enables all of them to be smarter than any one of them. To enable them to focus their leaders on the right next improvements constantly. To be amazing process triagers.

We are thankful for 2019’s best-year-yet successes and what makes ProcessTriage® and our triaging workshop experience possible: Each client’s success supported by our certified triage facilitators. Thank you for the opportunity to make a contribution, however slight or significant. Here are some of our new (2019) and what we hope are friends for life (logo’s link to home pages).

We wish our ProcessTriage® community a prosperous 2020. Remember, cosmetic updates to your process maps are free (PDF’s) with a modest reprint and shipping fee.

A CEO’s Perspective: The Most Critical Thing I learned From Process Triaging

One of our Core Values at ProcessTriage® is to measure ourselves by our customer’s successes. Their celebrations drive our celebrations.

Merideth Shay, CEO of InCord®, a custom safety netting manufacturer and Vistage® International member sponsored a Process Triage session last spring. We triaged their core Lead-to-Cash process. Merideth reports the following outstanding results:

The team was able to complete every single issue that arose! I had to remind them to celebrate as the were just focused on working the next set of issues. It was a huge accomplishment and it brought together people from different departments in ways that they didn’t necessarily have the language or understanding of how to connect, or how they affected each other, before the process triage. [The triaging workshop] trained our team on the art of discussion, listening and negotiating priorities and concerns with each other. Now we have a way to prioritize the concerns related to a project and mitigate risks — everyone is heard.

We have positive growth with sales without changing the number of employees.

Most importantly, we have a company excited about sales, knowledgeable about the process from Sales to Cash, and empowered to make decision now that they know what considerations they need to make for the other departments / parts of the process.

The most critical piece of knowledge I learned from ProcessTriage® is that it is okay and natural, that as you grow the process will break at some point in it and need to be fixed. It’s given me the language and the confidence to assure our employees that the heart of InCord — our culture, doesn’t have to change, but our process will continually change as we grow.

Meredith’s insights and observations are almost point-for-point what we — ProcessTraige® represent in our marketing and messaging. We strengthen team collaboration, accountability, and emotional intelligence around their shared processes.

The InCord Triage Team (Courtesy InCord, Inc.)

P.S. A special shout-out to Will Henrickson, Merideth’s Vistage Chair for introducing us.

What a ProcessTRIAGE® Scalability Profile™ Reveals

Most of this blog’s readers are familiar with the ProcessTriage® process pain point solution categories — ANALYZE, DESIGN, TRAIN, and ENFORCE. That ANALYZE and DESIGN (and IMPLEMENT) solutions highlight process design flaws that inhibit scalability, while TRAIN and/or ENFORCE best practices are operating system and human factor opportunities that otherwise assert the process ought to be scalable. We examine each triage session’s list of process improvement proposals, calculate the proportions of these categories and assess the process’s scalability. While the sample size is small — 20 or so proposals per triage, scalability patterns develop over scores of triage sessions.

For example, intuitively, a generally healthy growing company should be following proven best practices while making occasional process design improvements as productivity (process volume) increases. This reflects the reality that “If you’re growing, your processes are breaking.” The majority of improvements should be operating system and human factor focuses with a lesser share of proposals focused on process design opportunities.

Here’s what this profile looks like. The client identifying data is redacted:

A ProcessTRIAGE® Process Scalability Profile™ of a healthy, growing process.

Healthy, growing process highlights:
Most of the improvements are quick win action item Small Now’s (89%)
Most of the improvements are operating system focused TRAIN and/or ENFORCE best practices (79%)
All the process pain point causes were well understood — no ANALYZE root cause requirements.
There were some process DESIGN (and IMPLEMENT) updates — 21% (1 in 5) recognizing the process is
stressed. This growth breakage is normal and healthy.

If you would like to see how scalable your core processes are, we welcome a conversation. If we agree that triaging is a fit, we’ll make quick work of it.

How to Read a ProcessTriage® Action-Result Style Process Map

I’ve posted a short video How to Read our Process Triage Maps — the essentials in about six minutes. I review the process triage results notation afterwards. This includes an overview of process triaging.

Wow! Job Tracking With A Process Triage Map (Case Study)

One of the more popular deliverables of our Process Triage workshop is the Action-Result style process map. The map is an easy-to-build and read illustration of the triage team’s process. It’s designed to last one to three years with occasional cosmetic updates. It shows the essential tasks and their outcomes, typically from Opportunity to Cash — from the first conversation with an interested prospect all the way to payment for products or services.

We had the privilege to triage with Goosetown Communications, in Congers, New York in mid-2017. David Gottlieb sponsored and Jason Schlesinger hosted and led the implementation. They’re also running on EOS®, a branded operating system we enthusiastically support based on our experience with post-triage successes.

While planning a triage on a different process, I noticed Jason’s triage map behind him during our video call. It’s fascinating —

CLICK ON IMAGE to view Jason’s insights (2:32)

After successfully implementing the Process Capability Improvements that our Process Triage developed for us, I discovered that the large Process Map that I had hung up on my office wall could serve an additional purpose.  It could be the perfect visual aid for tracking project status throughout the Process.  I took some sticky pad notes and quickly wrote down some job names and numbers and stuck them up on the wall to indicate where they were in the Process.  As the jobs progressed, I would move the sticky note down the map until completed.  Within a few weeks, I had close to 100 sticky notes plastered across the map.

Two things became immediately apparent:
I, or anyone else in my office, could swing around in my chair and quickly see the general status of any particular project.  If more specifics were needed, I could always look the job up in our CRM software, but for a quick at-a-glance look, this was by far the fastest way to review large quantities of projects in short order.
Much like pain-points become clustered together in problematic parts of the Process during our Triage, I also noticed that I could quickly see at which part of the process jobs were stalling, and allocate labor accordingly.  If I had sticky notes of several jobs stuck in the “punch-list” phase, or the “order parts” phase, I could check in with those departments to encourage the backlog to move along more efficiently.

The Process Triage map, which is so helpful in keeping jobs moving through the Process, now also serves as a means for me to quickly track the status of those jobs within the same Process.

Jason Schlesinger, Goosetown Communications.

For Jason’s size of company — with scores of custom engineering and installation in process, here’s a way to show projects-in-process, from opportunity all the way to cash.

If you’re a custom manufacturer or construction trades contractor, with about scores of jobs in progress, consider Jason’s approach.

We welcome your call.

PE Investors: THE BIG IDEA for Stress Testing Businesses with Process Triaging.

Buyers and investors in businesses insist on factual proof that the company is scalable.  Scalability comes from processes that have a scalable design (execution) and a scalable operating system (support and oversight). Process Triaging is an effective way to stress test a company’s core processes and assess scalability.  An additional deliverable of this stress test includes a set of process improvement proposals for immediate action that, when implemented, improve the business’s scalability.

Process Triaging also exposes key person concentration risks.  It provides a framework for identifying key person understudies and pre- or post-sale staffing requirements.

For more info, shoot us a note.

Two Things Master Executives Provide Highest Performing Teams.

A lot of your executive leader effort focuses on championing your enterprise’s goals — what you measurably want to achieve, and your culture — how you want to go about, in terms of motives, morays, and morals.

Physically and tactically, this involves designing, building, and sustaining scalable business processes (how valuable things get made) and the expert teams that run them. Well designed processes deliver business results when trained and enforced. They are repeatable, scalable, sustainable, and affordable. If you design your processes to express your culture and values, they will achieve this as well, remembering culture trumps everything, but cash pays for it, and processes deliver it.

The idea is to get your business processes right, then staff, train, and run these processes with go-to teams of individual skill experts who, together, can continually improve the process. Bottoms up. With every improvement course-correcting closer to your goals, objectives, and culture.

It means those experts closest to the work are responsible for improving the work processes. Not you — not top down. It’s work you must find a way to delegate.

You must provide your process teams with two things your executive position gives you by virtue of your top-of-the-pyramid position: situational awareness and emotional empathy.

Situational awareness is knowing how everything in the business model fits and the dependencies between things – for example, from how a raw lead is generated, then handed off to sales and then on to fulfillment and ultimately accounts receivable to post the cash. It’s being aware of tools and technologies and who and what does what, and how all these things consume or create cash. Situational awareness is necessary for process triaging, and nothing expresses this awareness like a well crafted process map, one designed for issue processing. The best triaging map uses the terms and language of your go-to team members who live the process. This ensures their situational awareness is expressed in a clear and common language, and issues triage quickly.

Executive Sponsor Karl Houston reviews a process team’s findings. The team’s process map is in in the background. Courtesy NetSync Network Solutions®.
Joseph Rosenberger, ProcessTriage® Facilitator.

Emotional Empathy includes the ability to understand and anticipate how teammates personally impact each other in and by their process. Team members are the more fulfilled, purposeful and productive — yes, happy, when others understand what they need and do, and vice versa. They know — on an emotional level, how what they do affects those down stream, as well as when to reach upstream and share insights that will help things run better. This empathy is developed by solving process problems — triaging together, collaboratively defining and measuring process pain points and working through solutions. In the plainest language, it means when it comes to core business processes, the teams that live in them must own the performance monitoring and issue processing. It has to be delegated out of the executive suite.

Process Triage team members sign up to lead and mentor their prioritized pain point solutions at the close of a ProcessTriage session.
Courtesy NetSync Network Solutions®. Joseph Rosenberger, ProcessTriage® Facilitator.

When we delegate this successfully, day-to-day operational problems are handled with a more nuanced, technically feasible and emotionally supportive solutions, all with strategic fit. The executive team has more time available for exclusively executive work, such as business development and longer horizon opportunities.

That’s what Process Triaging does.  It gives teams situational awareness and develops emotional empathy — two things master executives provide their highest performing teams.