Purposive Drift

Management by measure can kill

I make no apologies for once again urging you to read Simon Caulkin's column in last Sunday's Observer. As so often he highlights a significant piece of research which casts doubt on some of the crude management clichés that get spouted as if they represent deep wisdom. I have include a long chunk of his piece, because I believe it contains a lesson we need to absorb and act with some speed. So, please read the extract and then go to the source:

"... All too often in a kind of Gresham's law (which said bad money drives out good), the easy-to-measure drives out the hard, even when the latter is more important. Strategy writer Igor Ansoff said: 'Corporate managers start off trying to manage what they want, and finish up wanting what they can measure.
'
What happens when bad measures drive out good is strikingly described in an article in the current Economic Journal. Investigating the effects of competition in the NHS, Carol Propper and her colleagues made an extraordinary discovery. Under competition, hospitals improved their patient waiting times. At the same time, the death-rate following emergency heart-attack admissions substantially increased. Why? As targets, waiting times were and are measured (and what gets measured gets managed, right?). Emergency heart-attack deaths were not tracked and therefore not managed. Even though no one would argue that the trade-off - shorter waiting times but more deaths - was anything but a travesty of NHS purpose, that's what the choice of measure produced.

In other words, what gets measured, matters. Measures set up incentives that drive people's behaviour. And woe to the organisation when that behaviour is at odds with its purpose. Imagine the cost to NHS morale (one of Deming's unknown and unknowable figures) of the knowledge that managing to the measure resulted in more deaths - the grotesque opposite of its aims. Hospitals are the extreme example of a general case. As such, they allow us a definitive rephrasing of our least favourite management mantra. What gets measured gets managed - so be sure you have the right measures, because the wrong ones kill."