Transcript of Ep. 039 The Dance Begins: Curing Operational Blindness in Healthcare New

Bridge Builders. Before we get started today, I have an announcement. Operational Blindness, the book is officially out. I'm super excited about it. This book right here is our best work here at Sibs HealthCare. We talk about why healthcare leaders can't see what's costing them millions of dollars now to fix it, and how the industry currently right now is not dealing with a people issue. We're dealing with a system issue. We're having a hard time keeping our best people. If our most tenured talent are aging out, and we continuously deal with shortages, there has to be a systemic root problem, and not just what we're visibly seeing. We're not just seeing a shortage, we're seeing something else that we believe that in operational blindness we're going to talk about just with a subsector of the healthcare space. We hope that it can be a value add to anyone that is watching or listening. You can go to bred2lead. Com/blind. Bred2lead. Com/blind. You can get a copy of this book. If you find us live, we're speaking on stage somewhere, you invite us to your chapter or we're talking to you one-on-one, some of you also are awarded a free copy of Operational Blindness.

If you're out and about, and if you cannot afford the actual book right now, things are just tight right now. What I would encourage you to do, I would encourage you to just listen to this free podcast. There's so many valuable points that we pull out, and I use the podcast as a microphone to the book that was actually written. If you're newer to leadership, Bred to Lead is a great book to start with. If you're newer to SPD management, Leadership, Build to Bleed is the next great book. This is actually my, I believe, 11th or 12th book that I've written. You go to Amazon, you always see it. I I know some of you that are listening, you're not in health care. This book, Operational Blindness, is great for health care. However, there are nuggets that you can pull from it that doesn't necessarily cater to your industry because there are some things that are healthcare-specific. But there are lots of things that you can pull from. I know that there are tons of listeners that are listening that are not in healthcare, but you engage with the Bridge builders every single week. Some of you are in manufacturing, you're in tech, you run a logistics company or a operational services firm.

You found this podcast because you care about leadership and operational excellence. You might be wondering, is this book for you? What I would tell you is this book does use healthcare-specific studies as a case study because that's my current world that I'm in. That's where we're spending a lot of our time. However, I need you to know those that are listening that don't know me. I'm an operational turnaround specialist and reengineering inefficient systems and operational structures, some of the things that bring me the most joy. Operational blindness, the condition that we tailored and that we named is in every organization all over the country. Those are things that you can purchase to be able to support. I'm excited about that. Today, we're going into pretty much two things. The last couple of episodes, we talked about all types of stuff as far as the diagnosis. The first thing of today, I'm going to be painting you a picture of what transformation looks like and what becomes possible when you can dream outside of the condition that you're in. Then the second point, I'm going to give you a formal definition, the precise clinical diagnosis of exactly what operational blindness is, It's going to be the vision, then it's going to be precision, then next.

Until then, I will see you all because I'm happy to be back on Bread to Lead.

Let's get it. Since the age of 12, I've been bound. My father's been in this ever. Age of 30, he sent me to his vineyard.

Welcome back, Bridgebuilders. I am your host, Dr. Jake Taylor Jacobs. And yes, I am excited that you are around. And you're back again. In case you don't know, this is episode 39, season 3. This is the Read and Teach series from my newest book, Operational Blindness, with It was just launched. It's available on bred2lead. Com/blind. This is what I'm reading as we're going through this series. Let me catch you up. Episode 35, we were talking about the IBM lesson of Lou Gertzner, and how he proved that éléphants can dance, that stuck organizations can transform, and that if you change the system and not just the people, you can see transformation in the organization that most people dream of. Then we went on to episode 36, where we talked about the healthcare parallel. We showed how SPD is the upstream constraint everyone ignores, and named the Conditions, Operational Blindness. Episode 37, we talked about the dangerous comfort of invisible beliefs and why the beliefs you don't know are the ones that are actually controlling you. We talked about episode 38, the beliefs that bind four specific beliefs that are chaining health organizations and leaders in every organization to dysfunction.

And today, we're just bringing it all together. What does the future look like when we break free? And what exactly is the condition you're breaking free from? So let's get into it. I want to start off by addressing something directly.

Some of you are Johnny right now. You're listening to this podcast because you're looking for a lifeline.

You're exhausted, you're frustrated, you're wondering if anything will ever change. Maybe you're an SPD director. You can't understand why Maybe your hard work never seems to be enough. Maybe you're an OR director, tired of managing workarounds for problems you didn't create. Maybe you're a COO who's invested in efficiency initiatives that keep hitting the same ceiling. Maybe you're a plant manager, maybe you're a CTO. Whatever your role, whatever your industry, if you're stuck, if you keep hitting that same wall, I want you to know something. It's not your fault. You've been operating inside of a system that makes success impossible. You've been measured on things that don't reflect your real impact. You've been held accountable for outcomes that you couldn't see or control. And that's not a personal failing, that's a system failing. But here's the other side of the coin. Now that you know it's a system problem, you have a responsibility. You can't just throw up your hands and say, It's the system, while continuing to operate the same way.

Once you see the cage, you have to work to escape it.

And today's episode is about what escape looks like and what exactly you're escaping from. I'm going to read to you a section in the book that's called The Dance Begins. It starts on page 30. I'm going to read from page 30 to page 32. The dance begins. It says, Let me return to that hospital conference room where we started. Picture the CFO with unexplained cost overruns, the COO fielding complaints from surgical services, the CNO worried about quality metrics, the SPD director offering explanations that explain nothing. Now, picture something different. Picture an SPD leader who can see downstream impact, who knows exactly how their department's operations affect ORE efficiency, surgical outcomes, and organizational costs. Picture a team that operates proactively rather than reactively, anticipating needs instead of responding to crisis. Picture a department that speaks the language of outcomes, not activities, that can translate what they do in terms the C-suite understands and values. Picture the surgeon who stops hoarding instruments because they trust the system to deliver. Picture the CFO who can finally trace costs through causes. Picture the CNO who sees quality risks declining instead of accumulating. This isn't a fantasy. It's what's possible when operational blindness is cured.

And everyone told Gerstner that IBM was too far gone to save. Everyone told him the culture was too entrenched, the bureaucracy too thick, and the problem was too deep. Everyone said, Elephants can't dance. Well, Lou Gerstner, prove them wrong. And your hospital can prove them wrong, too. Let's begin. What is operational blindness? I want to tell you about two SPD directors I've worked with. I'll call them Maria and David. The stories illustrate something important about the problem we're trying to solve. Maria ran the thorough process in Department of a 400-bed regional medical center. She had been in the role for eight years. Her team respected her. Her metrics were solid. When I first met her, she walked me through her operation with obvious pride, the turnaround times The turnaround times, the productivity numbers, the process improvements she had implemented over the years by any conventional measure, she was doing her job well. Then I spent a day in the OR. What I saw didn't match what Maria had shown me. Cases were delayed, waiting for instruments. Surgeons had personal stashes of equipment they had accumulated because they didn't trust the system. Circulating nurses spent significant amount of time hunting down missing items, and the OR director was frustrated.

When I asked about the relationship with SPD, she just shook her head. They tell us everything is fine, she said. The numbers look good, but we're struggling every day. When While I shared these observations with Maria, she was genuinely surprised, not defensive, surprised. She had no idea. The dysfunction I witnessed in the OR simply didn't appear on any report she received or any dashboard she monitored. From where she sat, the operations was working. David's situation was a bit different. The details were identical in the pattern. He directed SPD at a large academic medical center, a complex operation with high volume and demanding surgeons. David was sharp, experienced, and genuinely committed to excellence. His department had invested in new technology, implemented learning processes, and tracked a dozen metrics. And yet the CFO kept asking why instruments costs were climbing. The quality team kept flagging near miss events. The surgical services leadership kept complaining about reliability. David had all the answers for it: staffing challenges, physician behaviors, supply chain issues, volume growth, But the answer never seemed to resolve the problem. When I analyzed this operation, I found the same thing I found with Maria, a profound disconnect between what the department could see and what the organization was experiencing.

David's metrics measured activity. The organization's pain came from the outcome, and there was no bridge between them. Maria and David weren't bad leaders. They weren't lazy or incompetent or dishonest. They were experienced professionals doing their best inside a system that kept them blind to their own impact. They couldn't fix what they couldn't see, and they couldn't see what this system didn't show. This is operational blindness. And once you understand it, you'll see it everywhere. I want to expand on what you just heard. What transformation actually looks like. I painted a picture in that section, but I want to be more vivid. I want you to imagine an SPD leader who can answer with data whether the OR got what it needed yesterday. Not we process 400 trays, but we achieved 97% first case readiness contributed to zero instrument-related delays in support of 52 surgical cases with 99. 8% trade accuracy. That's a different conversation. That's outcome language. That's visibility. Imagine a surgical services team that actually trusts the SPD.

The surgeon who used to hoard instruments in their office, they stopped because they don't need to.

The system delivers what they need when they need it. The OR director who used to spend half their day managing workarounds, they're focused on strategic strategic initiatives now because the upstream constraint has been relieved. I want you to imagine a CFO who can trace costs to their root causes. The instrument replacement budget that used to be a mystery Now there's data showing exactly why those costs are climbing and what operational changes would reduce them. The premium labor that used to be just how things are. Now there's visibility into what's structural and what's needed to be addressed immediately. Imagine a C&O who sleeps better, the quality risk they used to accumulate invisibly.

Now they're surfaced early, addressed systematically, and prevented rather than caught.

The near-missage that used to go unreported. Now there's a culture where reporting drives improvement. This isn't fantasy. I want to be clear about it. What I just described isn't fantasy. It's not motivation or vision. It's designed to make you feel good. It's real, and it's happening in health care organizations right now. I built these organizations. We've seen these transformations. The same people who are struggling become successful. The same departments that were failing become reliable. The same relationships that were adversarial become collaborative. Nothing magical happened. The system changed. I want to pull you back to the universal What's your principle here, because this applies far beyond health care. Every organization has some version of this story. Manufacturing. Imagine a plant manager who can finally see how upstream production decisions affect downstream quality metrics, who stops getting blamed for defects that originated three steps early in the process.

And technology.

Imagine the infrastructure team that can demonstrate with data how reliability investments prevented outages that would have cost the company millions, who moved from cost center to strategic enabler in the leadership box. In professional services, imagine back office operations team that can show exactly how their processes accelerate or constrain client delivery. Who gets investment instead of cuts because their value is finally visible?

In retail, imagine the supply chain team that can connect their inventory decisions to the same store sales performance, who stops being squeezed for efficiency and starts being optimized for revenue impact.

The specifics vary. The principle is constant.

When you make the invisible, visible, everything changes.

When upstream functions can see their downstream impact and communicate the impact in terms leadership understands, they stop being overhead and they become strategic. When leadership can see the true cost of underinvestment, not just the line item savings, but the downstream consequences, they make different decisions.

When the system enables success instead of guaranteeing failure, the same people produce different outcomes.

That's the dance. That's what becomes possible.

Now, what I just described was destination, but you need the map to get there, and that's what the book provides.

It's not just a diagnosis It's the complete framework. The cost, the cost quantification, the transformation methodology, the road-specific playbook. That's what this book does. Go to bread2lead. Com/blind. The second portion that I wanted to read of the book is pages 33 through 35. And then 33 to 35, it's the formal definition. It says, Let me be precise about what I mean by operational blindness because What's your decision matters? You're naming a problem that most people don't know exist. Operational blindness is a systemic condition in which leaders cannot see the dysfunction in their own operations because the measurement systems, reporting structures, and feedback mechanisms they rely on do not surface them. Several elements of this definition are important. First, it's systemic. Operational blindness isn't a person failing or a personal failing. It's not about individual incompetence or lack of effort. It emerges from the structure of the operation itself, from how information flows, what gets measured, and what gets reported. You can replace every person in the department and still have operational blindness if the system remains unchanged. The leader is affected by operational blindness. This is the second definition, especially with visibility capability, is that the leaders affected by operational blindness often have the skills, experience, and motivation to fix problems.

If only they could see them. The limitation isn't their ability to act, it's their ability to perceive. They're making decisions in the dark, they don't even know that the lights are off. Third, it operates through measurement systems. What you measure shapes what you see. What you see shapes what you manage. If your measurements are disconnected from outcomes that matter, you optimize for things that don't matter while critical problems go unaddressed. The metrics become a camouflage, making dysfunction invisible by directing attention elsewhere.

Fourth, It's self-perpetuating.

Because leaders can't see the dysfunction, they don't know what to fix and how to fix it. Because they don't fix it, it persists. And because it persists, it becomes normal. Because it becomes normal, it stops registering as a problem, even when this effects are felt through the organization. The blindness sustains itself. It's almost like you're having a headache, but you've been having the same headache for a decade. At first, it was an issue you wanted to fix, but you didn't fix it the right way or using the remedy that you thought will work. You just figured that you would just live with a headache for the rest of your life versus going to get an expert and figuring out what's going on and fixing that problem. You lived with a headache for the remainder of your life without even knowing what triggers it. It That's exactly what this is. This is why operational blindness is so dangerous. It's so difficult to address. It's not a crisis that announces itself. It's a slow leak that everyone gets used to. The organization adapts to the dysfunction rather than fixing it, and the adaption itself makes the dysfunction harder to see.

All right, let's break this down piece by piece, the former definition. The former definition of the operation of blindness is a systemic condition in which leaders cannot see the dysfunction in their own operations because the measurement systems, reporting structures, and feedback mechanisms they rely on do not surface it. We talk about the systemic conditions, which is element one. It's talking about how operational blindness isn't a personal failure. It's not about individual incompetence or lack of It emerges from the structure of the operation itself, from how information flows, what gets measured, and what gets reported. And this is critical and crucial.

You can replace every person in the department and still have operational blindness if the system remains unchanged. I've watched the organizations literally cycle through directors, cycle through consultants, cycle through technology, implementation, cycle through technicians, cycle through supervisors, cycle through chief executives, and then the right where they started. Because they kept trying to fix people and replace people and remove people. But nobody actually said, Wait a minute, our system is still the same. So it's producing brokenness because our system was built in broken parts. People come and go. But if the system is broken, the outcome remains broken regardless of who's operating within it. Let me make this universal. In any organization, manufacturing, tech, services, retail, health care, you'll find functions where leadership has cycled through managers repeatedly, and nothing improves. The instinct is to say, We don't keep hiring their own people or people aren't the same anymore. The reality is, usually, we keep putting people in the same broken system. Systemic means the problem is the architecture, not the individual. And the issue that we're dealing with in health care is that we're just throwing people into broken systems and wondering why they're even coming out broken.

I want my leader to do more, but I have nothing to actually give them to help them more. They just need to already have more. From broken system to broken system to broken system. And everyone's just plugging the little spark of little successes you're having. You're taking these little sparks and you're just putting it together with missing parts. Imagine putting a car together with all different parts that don't even fit each other. Does the car drive? Yes, it drives. Does it stop? Yes, it stops. But all those parts are built to actually work together? No. But it's okay because this is something that we've always done. And these are the issues that we deal with in organizations in every industry, where we stop trying to find the truth because we want to stand on our version of the truth that fits our narrative of our story of our position versus allowing the truth to say, Hey, what may have worked in the past doesn't work in today's time. So it's okay to evolve and get better. Yes, your idea was a great idea 10 years ago, three years ago, two years ago. But when the idea or the truth changes, the facts change, so do you as a leader.

What I believed in a decade ago, after evolution of engineering and process improvement and system manipulation, you begin to realize with the more data sets you have, the more you can get actual truth. And the more truth you have, the more efficient and productive you can become at the thing that you do. But if I don't have any progression in that stage or in that phase, and I'm staying 20 years ago, today, you're the bottleneck of your organization. You're causing the harm and the concern. And yes, I'm saying people first systems always. I'm saying people first, yes, I'm not saying that people don't need development. What I am saying is that if your organization has no development structure from beginning to end to actually improve your organizational growth or your actual people in your organization, it's funny. It's funny that it seems as though when you're farming, farmers care more about the well-being of their animals than just the output of the work that they can do for them. But if we go into the workforce, we say, Hey, man, I pay you to do your job. Yes, you're paying them to do the job.

But the extra additive is that you as an executive, as a leader, you're also paying extra investing in also the future of that person. You're paying them for the job they're doing now. The investment is in the growth that they'll have in your organization for later. The investment in your people never stop. The problem is that there are leaders in every organization I've ever been to in every industry that I've been to that says, Hey, I pay you for your job, so do your job. So you want to pay somebody for their job, but they have to invest in their own future? But you want them to take the investment of their own future and put it in your organization when you put nothing into them. That's what a development pathway says. It says, Hey, I'm invested in your future. I'm paying I'm paying you for today, but I'm investing in you staying. So I need to develop you. I need to curate you, and I need to show you that within our organizational structure, we do have room for you. And even if you don't have a position for them, you can have development for them.

At least while they're there, can they get everything that they can get? This is the big piece systemically that we're missing. Because historically, healthcare has used the military as as a big piece of their recruitment mule. So a lot of people that were in health care came from the military. So they naturally had order, structure, and system. But you forget that somebody invested in that development. Someone invested in those skillsets. Someone invested in those soft development skills that are needed, that brought structure to health care. Because historically, health care didn't have systematic structure until the military came back The vets came back from the military, and nurses, and surgeons, and a lot of the surgeries we know today actually were founded and created on the battlefield of war. So they brought those mechanisms to the hospital system, thus making the hospital system a revenue driver, i. E. 60 to 70% of revenue of hospitals are made up of surgeries, surgeries that were created in things that were built or the industry that was created from being at war. So knowing that history, now we can understand, okay, we're outdated. Our system is outdated. And that's the solution that we're bringing health care.

We're saying, Hey, we have such great talent here. But has anyone just actually looked at the system? It doesn't matter. The new body set that you put on that car is still a 1920 Camero. You can put the new kit on a 1920 Camero. It's still going to drive like a 1920 Camero. And element Two, the leaders cannot see this function. This is about visibility and capability. The leaders, affected by operational blindness, often have skills, experience, and motivation to fix problems. If only they could see The limitation isn't their ability to act, it's their ability to perceive. Think about it like this. You may have a brilliant SPD director or a talented plant manager, a skilled IT leader that knows how to solve the problem. They've done it before. They want to succeed, but they're making decisions in the dark. They don't even know that the lights are off because they've been in the dark their entire life. My brother has been blind since birth. Literally, my little brother has been blind since birth. He has never seen a light a day, so he doesn't know how to operate in the night or the day.

So when the lights are off and he's making decisions, he doesn't even know that the lights are off because his lights have always been off. Do you all get it? So a lot of leaders are being asked to make decisions based on the darkness that they're already used to. So they see what the measurement system shows them, and they manage whatever is seen, whatever is in the darkness that they're used to. You How do we create the metrics around that? Because those metrics are disconnected from outcomes that matter, they optimize for the wrong things while critical problems go unaddressed. Here's what makes this so insidious. The leaders don't know that they can't see. They think they're seeing clearly. They have dashboards, they have reports, they have data. But what they don't have is the connection between what they are measuring and what the organization actually is They're measuring activity. The organization is experiencing outcomes. The gap between them is blindness. For an example, it's like in sports, in the NBA, right? People that have played ball, you know the feel of a game. You know the look of a player.

You can see it because you played in those shoes.

But you have people that are really great at analytics that brought analytics to the game of basketball. And those analytics, yes, it does work, but it doesn't tell you the full story. The analytics, yes. If I'm measuring wingspan and speed gaps and closing gaps and where I shoot best on what days, yes, That has an element to it. But the data, the true read of that data is what I'm physically seeing. It's like The data can show you you have a star, but only a feeling can let you know if that person can feel stardom. I can look at data and say, Oh, this guy should be a star. But when I look and I feel them and I think about the magnetic pull, it's not that of a star. It's the exact same thing. Data can only show you data based on the data that you want to see, not on the measurements that need to be seen. It's all subjective. And your data can be subjective based on what you choose to see, but it doesn't mean what you choose to see is the right data that you should be looking at. You have the measurements, you have the systems, you have the reporting structure, you have the feedback mechanisms, and these are all the machineries of blindness.

The measurement system determines what you track, what you measure shapes what you see, what you see shapes what you manage. And if If you measure turnaround time but not readiness, you're optimized for turnaround time, even if faster processing of the wrong things makes readiness worse. If you measure output per labor hour but not downstream impact, you're optimizing for speed, even if speed creates quality problems that cost more than efficiency gains. If you measure cost per transaction but not value-enabled, you cut costs. You'll cut costs even if those costs reduce value that exceed the savings, the measurement system creates the frame. Everything outside of the frame now becomes invisible. That's why we have to be careful even what we measure. When we talk about reporting structures, The reporting structure determines what information flows where, who sees what, what gets elevated, and what gets buried. If SPD reports through operations while surgical service reports through clinical, there's no structural connection. The information doesn't flow between them. The upstream can't even see the downstream, and the downstream can't see the upstream. If the IT reports through finance while product reports through the CEO, there's a structural gap. It becomes a cost to be minimized rather than enabled or to be optimized because the CEO is not seeing both sides.

The reporting structure creates information silos, and what happens in one silo, it stays invisible to the other unless the other wants to interpret or want to include. Now, if you talk about the feedback mechanisms. Feedback mechanisms determine whether systems learn. Does surgical services have a way to provide systemic feedback to SPD about their experience? Not complaints when things go wrong, systematic data about what's working and what isn't. Does the customer-facing team have a way to provide systemic feedback to the back office about how their processes affect customer experience? If the feedback loop doesn't exist, the system can't learn, it can't adapt, and it can't improve. The absence of feedback mechanisms is in self a form of blindness. You're not just unable to see the problem, you're unable to see whether the solutions are working. So we talk about technology, AI, algorithms that read and talk back to each other and get smarter. Well, what does the algorithm of AI mimic? It mimics humans. It mimics biology. It mimics how things can duplicate itself one to another. So our feedback mechanisms doesn't have to start with technology. Our feedback mechanisms can start with process and systems that hold everyone accountable to these feedback mechanisms to get smarter.

And the only thing different about technology versus humans is that technology doesn't get frustrated when technology forces itself to get smarter because it read new data. It fixes the data, it recodes, it retrains itself. Now it operates on new data. With the human component, humans get frustrated when there's a course correction or new data that states that what we've been doing is no longer the most efficient or the best way. So we need to counsel those things. Humans say, Hey, I've been doing it this way, even with this new data, this way works best for me, so I refuse to get better, and thus the conflict happens there. That's the only difference between technology and humans. But the humans that can actually progress and process like technology, your system becomes technology without the electronics.

That's what I'm trying to tell you.

Electronics are what make technology. Technology. Technology is built through people. That's why we say people first, systems always. So now we have a self-perpetuating system that doesn't know how to fix itself. So dysfunction that begets dysfunction that begets dysfunction. Disfunction that happens over and over again, and that's exactly how blindness sustains itself. So if we think about those implications, the organization adapts to the dysfunction rather than fixing it. The workarounds become standard operating procedure, Here, and firefighting becomes the job, complaints becomes the background noise. New employees join and learn how things work here. They absorb the dysfunction as normal. They stop questioning what veterans stopped questioning years ago. And the system perpetuates itself across generations of employees. The beliefs are hardened, the assumptions calcified, the blindness deepens. And this is why operational blindness is so dangerous. It doesn't announce itself. It doesn't create visible It's a slow leak that everyone gets used to until the building floods and there's mold everywhere. And this is the thing that we have to see and have to understand. So if you want to look at some of the reports that we've done, our newest and latest report is our Operational Blindness Index, where we, personally, 101, surveyed 189 perioperators.

And I think that you will be surprised about the report that received about how many hospitals were actually operating in the blind. Go to cipshealthcare. Com/obi10. Cipshealthcare. Com/obi10 to get access to Report. Here's the teaching part, and here's the teaching part. Here's the application across all industries. I want you to pull this. I want you to take this. I want you to roll it away.

And this is how to spot operational blindness in any organization.

Before I close, I want to give you something that you can actually use. I got you. Five questions. First question, can your upstream functions tell you with data How their work affects downstream outcomes?

Can SPD tell you how their operations affects ORE efficiency? Can Can the upstream tell you how production decisions affect customer quality scores? Can IT infrastructure tell you how their investments affect application performance? If the answer is no, If the upstream can only report on their internal activity, you have a visibility gap.

Question two.

Do your measurement systems track activity or outcomes? Are you measuring turnaround times or readiness? Are you measuring output volume or customer impact? Are you measuring cost per transaction or value creation? If you're primarily measuring activity, you're probably optimizing for the wrong things. Because you can't just look at someone's activity and then decide, based on activity, that they're a value enabler. When somebody can stay busy 40 hours a week, and that makes you happy because you're looking at productivity, but they They created no new value for the company. They just appeased your productivity log. This is why it's very important to be careful. What you pay attention to will be what you measure, and what you measure will be what you manage. What you manage will be what you have to grow.

Question number three.

Do systemic feedback loops exist between interdependent functions? The surgical services provide regular structure feedback to SPD, not just complaints, but data. And how does SPD receive it? Does customer success teams provide regular input to product development, not just escalation or patterns?

And how do they receive it?

Does sales provide systemic feedback to operations about what's affecting those close rates? And how is it received? If feedback is ad hoc as I want to, or complaint-driven, or absent, the system can't learn itself. You have to build a core culture that's okay with being short sometimes because that's what makes the system get better. What I always say, problems create new policies that we can now govern and regulate. So if a problem is new and we don't have a policy I can now put a process for it, I can now put a process together for it in a policy to regulate the process. Therefore, we now have a governing loop. Now we're protected on that end. What was once a liability is now a legal strength. Question four. When things go wrong, do you look for people to blame or systems to fix? When the OR is pressure with SPD, do you fire the director or do you examine the measurement systems? When production quality drops, do you retain the workers or redesign the process. When IT projects fail, do you blame the team or do you investigate the structural constraints? If your instinct is to blame people, you're probably missing systems.

You're probably missing sustained system problems.

And the last question, how many times have you replaced leadership in a function without seeing sustained improvement? If you cycle through multiple directors, managers of EPs, and the outcome stay the same, You don't have a people problem, you have a system problem. The people keep changing, the system stays the same, and the results stay the same. That's the clearest diagnostic indicator of operational blindness.

Right there.

People keep changing, the system stays the same, but the result is the same. So if the people change and the system has stayed the same the entire time, and I keep getting the same results, odds are it's not the people, it's the system. Fix the system, new people, same results. So your system is what produces your same results, not people.

But here's the good news. I want you to take this away. Operational blindness is common. It's pervasive. It exists in organizations across every industry, but it's also curable. You can build visibility systems. You can connect upstream activity to downstream outcomes. You can change measurement systems to track what actually matters. You can create feedback loops to enable organizational learning. You can structure reporting relationships to bridge information silos. You can challenge the beliefs that have calcified over years. The elephant can and dance, Bridge Builders. But first, you have to see the chains. When you can see the chains that's holding you back, holding your organization back, you're going to realize You're tied to a small stake. You can just pull it apart. You can do that.

Now that you have a vision of what transformation looks like, you have the definition of exactly what operational blindness is.

The question now becomes, how do you actually cure it? That's what sterile by design is. Sterile by design is our operating system that we built, specifically to cure operational blindness. It addresses every element of the definition. It's systemic. It changes the system, not just the people. It creates visibility, connecting upstream operations to downstream outcomes. It builds measurement systems that track what matters. It establishes feedback mechanisms that enable learning. It breaks the self-perpetuating cycle by surfacing what has been invisible. We've implemented it across healthcare organizations, and the principle applies beyond health care, but specifically for the OR and Sterile Processing Department. If you want to see a demo of what this look like, and you're running a hospital that has a surgical department, please go to cibsehealthcare. Com for a demo. Let's talk about what the operation of blindness has caused your organization and what it would look like to cure it. Everyone, this is Dr. J of Bread to Lead, the business of Health care. We're talking about operational blindness today, and we pulled a little bit out the book. I hope you took some of these nuggets. This is a podcast, not a podcast.

Our whole purpose is to educate and train you, not to just entertain you. Most importantly, I love you. There's absolutely nothing you can do about it. Now, see you on the very next show. Peace.

Since the age of 12, I've been buying my father's business at the age of 30. He sent me to his vineyard.