The theme of the conference was “the power of ecosystems,” and it very much reflected my longstanding interest in managing in complex (rather than just complicated) environments. While it would be too much to offer an overview of the whole conference, there were some great nuggets in all of the conversations.
A panel featuring two of my favorite people, Whitney Johnson and Rahaf Harfoush, explored the essentials of managing yourself. A major “aha” from that panel was that we are all deeply connected to our environment and that we can’t think in terms of managing just ourselves without thinking of the ways in which our environment has an influence on us. Whitney in particular focused on how as you gain mastery of different aspects of your world you need to launch yourself on your next “S curve” in order to grow. Rahaf’s recent book is Hustle and Float: Reclaim Your Creativity and Thrive in a World Obsessed with Work, in which she warns us that too much hustling and not enough time to take a creative breather is no way to live.
The Buurtzorg Story
I hadn’t heard of Buurtzorg before encountering Jos de Blok at the Thinkers50 event where he won the “Ideas into Practice” award for the groundbreaking work he has been doing at Buurtzorg. At the Drucker Forum, Marie Ringler of Ashoka moderated a panel of different leaders from the healthcare sector, in which he told their story.
The organization has gone from a startup to nearly 1,000 self-organizing nursing units since its founding in 2007, and interestingly reports both more manageable costs (40 percent fewer hours of care required than the standard) and higher patient satisfaction levels. The principles of Buurtzorg (which means “neighborhood care” in Dutch) stemmed from de Blok’s dissatisfaction with the way nursing care was delivered in Holland. It uses independent nursing teams to care for sets of patients in their own community. Its underlying principles are:
- Social healthcare — delivered in the community
- Focus on relationships
- Solutions instead of indications
- Separated care and back office processes
- Transparent communication and metrics
- Scale of the neighborhood
Unlike more traditional systems in which nurses would perform more high-skilled work and lower-paid people do other tasks, the Buurtzorg teams are responsible for every aspect of a patient’s care, while the back office processing of payments and other transactions are handled through an IT layer. The company’s revenue has gone from €400 in 2006 to around €500 million today, and it employs over 15,000 nurses. It does all this without a CFO, managers, or much of an organizational structure. Nurses do not report to a manager, rather they are provided with coaches who can help them overcome problems. They’ve been growing rapidly, and received the prize for the best marketing in healthcare, to which de Blok remarked, “But we don’t do any marketing!” Among their innovations was sponsoring a walker race which is held in the Olympic stadium.
Women and Inclusion
Andrew Hill from the Financial Times, a gifted moderator, led a fascinating session on the human potential of innovation with a real all-star group of panelists, including Bart Weetjens, a social entrepreneur and Zen priest, and Avivah Wittenberg-Cox, CEO of 20-first.
Avivah Wittenberg-Cox spoke about gender in companies, a topic she has long been researching and writing about (she’s one of my favorite authors). She started out by saying, “I’m going to talk about babies.” The Austrian fertility rate, she noted, was down to about 1.5 babies per woman. The replacement ratio for countries is 2.1. What we’re seeing in the world today is 46 countries that are shrinking demographically and the vast majority of countries are aging and not giving birth. She noted that Peter Drucker observed that some technologies take decades for their effects to be known and posited that the birth control pill is among them. “Women,” she said “are increasingly voting quietly with their wombs, and so the ecosystem of our humanity based on rebirth and recreation is being halted because, I would suggest, countries are not adapting and organizing for the last 50 years which has seen the massive arrival of women into talent pools, labor forces, and financial independence.”
A generation or two ago, she pointed out, if you forced women to choose between work and family, they chose family. Today, they’re choosing work. They may not even be getting married, particularly in what she calls “women unfriendly” environments. Women were allowed in to the labor force, but the organizations didn’t adapt very much, meaning that women were successful to the extent that they behaved much like men. She argues that instead, leaders need to learn the language and culture of women, becoming gender bilingual (as opposed to gender blind). She commended the Drucker Forum for being one of the most gender balanced management conferences she’s attended, and closed with, “Well this is what it feels like—what do you think?”
Hero Rats and the Global Humanitarian Mine Action Market
Weetjens told the fascinating story of his journey “of love” from being a product designer to pursuing a life of purpose and meaning at an organization called APOPO. As he traveled in Africa, he said he was baffled by dependency of subsistence farmers to tackle one of the biggest scourges they face, which is the problem of unexploded landmines. It causes people to have to flee their local villages as well as enormous damage. As he continued to think about this, he read an article about an experiment done with rats that made it possible to train them to sniff out land mines. That’s what he did—started a research program, developed this technology to correspond to international mine standards. By using the “hero rats,” the cost to clear sections of land from landmines can be lowered dramatically and the whole process can be made much faster. They cleared the whole of Mozambique 2 ½ years more quickly than the initial plans had called for.
As Weetjens said, in response to Hill’s question about the blockers and frustrations of the process:
“You would expect that if you come up with a technology like this that immediately it would penetrate the market and it would be adopted everywhere. However the humanitarian mine action market is not your typical market and market mechanisms don’t apply. It basically is a private and public funded philanthropic donor-funded market. It’s a small market, about $400 to $800 million going every year to humanitarian mine action. And there is a handful of organizations competing for that basket of funding….instead of looking at the outputs we want to achieve which is a world without landmines, a world without fear, where subsistence farmers can enter into their villages and their agricultural land. Instead of looking at that, there is huge investments of these organizations in capacity building around fundraising, where the resources should actually be used to alleviate the problem….if we could collaborate, we could rid the world of landmines in about 30 years, but then these organizations would be out of business. There’s the difficulty, is it our own interests we are working on or is it the ultimate goal we are working on?”
A sad commentary on how incentives can distort even a proven, affordable solution to a major global problem.
Wrapping Up With a New Management Paradigm?
Johan Roos of Hult International Business School, Julian Birkinshaw of London Business School, and I were part of the closing panel of the whole conference, summing up some of the themes. Julian argued that many of the themes of the conference could be traced back to Peter Drucker and other thinkers back in time. What is changing is the practice of management, as digital allows more experiments with new ways of working, even in traditional companies. Further, that if there is a single switch we have to make mentally it is the notion that the value of the firm is its existing assets and resources—value is longer in those assets as in network of relationships. Finally, that markets are an alternative to bureaucracy (a point I also made in this Sloan Management Review article).
I used the example of Best Buy and its CEO Hubert Joly who wanted to use his deep understanding of the customer to get on the right side of an ecosystem that had gone against them. He started off by spending two weeks working in the stores, which gave him insight into what customers needed. He also figured out how to obtain a revenue stream from his vendors. I argued that the connection to the customer and the customer’s issues were what made the turnaround possible.
I concluded with the observation that today it’s nearly impossible to talk about strategy without talking about innovation, and increasingly that also means incorporating a digital perspective. You can watch a video of the closing session here.