Talking to Members Counts as Research, Too

This post from Scott Anthony got me thinking. Especially this piece about the drive to gather data through research before deciding on a course of action.

It's not that the research wouldn't provide insight. It's just that most of these efforts are resource constrained, and it's clear that teams will get more bang for their buck talking to customers, developing prototypes, sharing those prototypes with customers, filling key leadership team gaps and so on, than they will from rigorous data.

I thought it was an awesome perspective--and an important push-back against the de facto data-driven strategies that seem to overwhelm so many association experiments. Acting with a knowledge of what your members need and want is important to innovation. Gathering endless data or, as is more often the case, expending tremendous resources in the pursuit of what turns out to be very little data, is an impediment. Think of Seth Godin, who is always stressing the need to ship.

Just last week I had an experience that stressed this point. We were talking about the launch of a new association program. It would be targeted to a certain subset of our members, but we had next to no information from that subset about how they would respond to the new program, or whether it was even needed.

"Let's get some feedback from those members," I said. "No promises, but introduce them to the idea and see what they think. How would they design it if they had the chance?"

The next day a draft of a survey appeared in my inbox. Two of my program managers had put their heads together and come up with a list of questions to ask. "Looks good," I replied. "But I doubt any one will take the time to complete it." It was too long. Trying to put myself in the shoes of our typical association member, a realized that a thoughtful response--the kind on which we would like to base our action--would require them to gather information from different parts of their organization and give some thought as to how to compose that information into the format we were seeking.

Confronted with this, the program managers had a great response. "Why don't we just call a few of the members we know would be willing to talk about the idea and see what they think?"

Great idea. Pick up the phone and talk to someone. Especially at the early planning stages of a new program, that can be some of the best research there is.

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Learning Innovation from the Mayo Clinic

Here's another great HBR post describing another set of "principles of innovation." I say "another," of course, because of my work with the WSAE Innovation Task Force, where we helped define four key principles of innovation from the case studies we examined in the for-profit sector.

The HBR post describes several strategies employed by the very famous and very innovative Mayo Clinic. It's worth a full read, but here are two that resonate the most with me and our effort to better define innovation for the association space.

Unofficial Activity
One key aspect to Mayo's innovation infrastructure is its new Center for Innovation (CFI), which exists to help people across the organization take their new ideas to the next level of development. We have found that allowing employees to engage in unofficial activity is one of the most agreed-upon conditions for innovation. Rather than saying that innovation is someone else's job in the organization, it signals to people that they are allowed and expected to spend a proportion of their workweek imagining better solutions.

This sounds a lot like Google's famous 20% time--where employees are encouraged to spend 20% of their time working on unofficial projects aligned with their own interests. But I think Mayo goes one step better.

Born in 2006 as the brainchild of Dr. Nick LaRusso, the CFI was first called the SPARC Lab (with the acronym standing for its methodology: see, plan, act, refine, and communicate). Its mission is not to create innovations directly, but to provide employees who are otherwise occupied with day-to-day business with the resources they need to move something forward: time, money, experts, input from leadership and colleagues, and the company's knowledge base. In fact, the CFI itself owes its existence to some very unofficial activity: LaRusso recalls that the idea first arose in 2005 at a happy hour with colleagues.

Giving employees the freedom to explore is definitely a culturual issue for any organization. The leadership has to be serious about it, model the same behavior, and go out of their way to define it as part of what the organization does. But as Mayo's CFI illustrates, it was also very much a process and resource issue for your organization. Letting people explore is one thing. But those explorations have to be communicated and leveraged so that the organization can take best advantage of them. Any way you slice that, that takes time, people and money--above and beyond what the 20% time is costing.

Combination Innovation
A structural support for innovation at Mayo is the Department of Engineering — the modern iteration of Dr. W. Mayo's "instrument shop." The shop was created in 1915, back when Mayo was forced to build many of its own tools. They quickly perceived how collaboration between engineers, scientists, and physicians created phenomenal new things. The shop helped to pioneer "safe surgery" for the world by combining anesthesia and sterilization. Later, it created the first centrifuge for testing G force tolerance in fighter pilots.

This was hits a little closer to home for me. It seems that more and more of the typical association's products and services are being outsourced these days. Web hosting, association management software, public relations, meeting planning, finanical services--the list goes on and on as many associations struggle with shrinking budgets and higher member expectations.

But in one of those key areas my association has decided to pull the service back in house and re-learn how to do it ourselves. Like Mayo, we're creating our own "Department of Engineering" and learning how to make the tools, not just use the tools manufactured by others. And now we're starting to see some of the advantages the HBR post attributes to Mayo's strategy of combination innovation.

In an area where there are hundreds of vendors offering hundreds of different off-the-shelf products, we're finding success in experimenting with our own technology and adapting it directly to our needs and the needs of our members. The finished product is better aligned with our objectives than any off-the-shelf product I've seen, but more importantly, the learning process required is being embraced by staff as something that helps them do their jobs better. It's opening us up to new ways of doing things no one would've previously anticipated.

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Surprising Barriers to Membership

Shelly Alcorn interviewed me last Friday for her Association Executives: Provocative Proposals for Future Change project. She asked me 10 questions that she refused to show me in advance, and I gave her my unrehearsed, top-of-mind responses. I surprised myself (and her, too, I think) with my answer to:

What barriers are keeping your association from achieving 100% membership market penetration?

In other words, what's keeping those people eligible to be members of your association from becoming members of your association? Based on my experiences, here's what immediately came to my mind:

1. Bad blood. It's time we put this one of the table. We don't like to talk about it and we like to dismiss its importance, but every association I've ever worked for (and most that I'm familiar with) have at least one other association in its same industry or profession, competing for the same members. Back in the days when I worked with medical specialty societies I called it "the College vs. the Academy" syndrome because, regardless of the specialty, there was always one association called The American College of XYZ and another association called The American Academy of XYZ. And guess what? There were people in the College who hated the Academy and there were people in the Academy who hated the College--and no amount of slick marketing and personalized approaches was going to convince a College person to join the Academy, and vice versa. Somewhere along the way they had developed a dislike for the other organization, based on the personalities of the people who were once in charge, or the segment of the profession they catered to (academics vs. practitioners), or the fact that they had had the audacity to start another association in direct competition with their own beloved organization.

There's no convincing these people. In my current world of trade associations I see the same dynamic, and my strategy with these businesses is simply to put them on a watch list, waiting for a change in leadership at the top that may signal a willingness to take another look. But sometimes even then the old culture is preserved. The better strategy is to focus on what your association is trying to achieve and do it the best you can, recognizing that those who appreciate what you do and want to beneift from it will join--those who don't won't.

2. Time. Not my time, theirs. Like a lot of association leaders, I do a fair amount to welcome and on-board new members into our organization. I want to get them plugged into some immediate benefit so they see from day one the wisdom behind their decision to join the association. But some new members are notoriously hard to reach. They don't respond to my emails or phone calls, and they don't attend any association meetings in their first year. When dues renewal time rolls around and they show up on my call list because their payment is late I try even harder to contact them. And when successful, the answer is usually time. I'm sorry, they say, we see the potential value of membership, and would like to take advantage of the benefits, but we just didn't have the time in the past year to get engaged, and we don't think we will in the year ahead.

We all know how busy our lives are getting. We all know how fast the pace of business is accelerating. But it's experiences like this that convince me we in the association world have no idea how fast things are really moving. We'll always be chasing members. That's what we do. But some of them are moving too fast for us to catch.

3. Us. And especially our own knowledge of the industry we serve. Are you satisified with the status of your prospect list? Do you even know what 100% market penetration looks like? We don't. It's not uncommon for a new prospect to pop up on us, perfectly suited for membership, been in business for twenty years, and we've never heard of them before. Shelly was kind. She said that's the sign of a vibrant and growing industry, and I'd like to think she's right. But I wonder. I wonder if there isn't something else we should be doing--something beyond the Google searches and member referrals and product directory listings and trade show canvassing we already doing to get our arms around the size of market and really assess how well we're doing. Whatever it is, I'm sure it's complicated and a lot of work, and maybe that's why it keeps falling down our priority list. How serious are we really about 100% market penetration vs. keeping those members we do have engaged and satisfied? And in a world of tough choices, which one should we be focused on anyway?

What do you think? What's really keeping you from getting every member you can?

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The Strategic Corporal

Here's an interesting HBR post about something the U.S. Marines call the "strategic corporal."

One of the first concepts to which I was exposed in the Marines was the idea of the "strategic corporal." The lowest ranking non-commissioned officer in the Marine Corps, a corporal typically has at least two years of service and leads small teams of three to nine Marines. When deployed overseas, corporals often lead their teams and squads on patrols in dangerous places that are at times far from direct supervision. Corporals have to make quick decisions, some of which can carry strategic implications.

Does this describe the staff people in your association? If they’re anything like the people in my organization, they’re making decisions every day that carry strategic implications. Have you ever thought about the context in which those decisions are being made?

As young lieutenants, we learned that we needed to set the example, communicate the commander's intent, and then empower our corporals and sergeants to operate in places where they may not be able to ask, "What do I do next?"

This is absolutely how I try to lead the people in my organization--and it is often a challenge to communicate that "commander's intent" because the way forward is not always clear and there are plenty of unanticipated obstacles. But the goal is always for them to feel confident in making the decision on what to do next, rather than feeling they have to check back with headquarters every time the landscape changes.

How else will we be nimble enough to innovate?


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Culture Change is Hard Work

At one point in my association career I worked with medical specialty societies. They were very academic in their orientation, and invested a lot of their time and resources in creating, supporting and sustaining new training programs for their specialties. They cared passionately for the subject. As it is for many such societies, training young residents to be the next generation of specialists was critically important to them.

The principal aim of medical residency in the United States is to prepare recent medical school graduates to practice medicine independently. A fundamental require¬ment of resident education is in-depth, firsthand experience caring for patients. Dur¬ing the three to seven years of this training, residents often work long hours with limited time off to catch up on their sleep. They can experience fatigue on the job, which research shows is an unsafe condition that contributes to increased errors and accidents. However, many medical educators believe extensive duty hours are essen¬tial to provide residents with the rich and varied educational experiences necessary to become competent in the complexities of diagnosing and treating patients.

That’s the first paragraph from a brief on a special report published by the Institute of Medicine (IOM) in 2008. It succinctly states one of the fundamental challenges that medical residents face in learning how to be specialists—the long duty hours they are forced to work without sleep. Depending on the specialty, shifts of 24 or even 36 hours are not uncommon. As part of its report, the IOM asserted that revisions to medical residents’ workloads and duty hours were necessary to better protect patients against fatigue-related errors and to enhance the learning environment for doctors in training. In addition:

The report recommends that residency programs provide regular opportunities for sleep each day and each week during resident training. In addition, it recommends that the Accreditation Council for Graduate Medical Education provide better monitoring of duty hour limits and that residency review committees set guidelines for residents’ patient caseload. Patient handover procedures and supervision of residents should also be strengthened. Until these changes take place, residency programs are not providing what the next generation of doctors or their patients deserve.

It’s a fascinating report to read, especially from the point of view of a non-physician who, not steeped in the culture of academic medicine, didn’t exactly need a report from the IOM to be convinced that forcing young and inexperienced doctors to stay awake for 36 hours at a time might possibly result in poorer patient outcomes.

What’s more interesting, however, was the reaction by many of the physicians in my societies when they heard the IOM was preparing such a report. The IOM? many of them said dismissively. More government bureaucrats sticking their noses in where they don’t belong! Who are they to tell me how to train my residents? I learned how to be a specialist this way, and by god, so will they! Every doctor didn’t react that way but, to my way of thinking, a surprising number of them—especially those in senior leadership positions—did.

I don’t work with those societies anymore. My career has moved on, but I’ll occasionally stumble across something that reminds me of the dedicated people I worked with and the way they looked at the world. I was once sure the IOM was barking up the wrong tree, so imagine my surprise when I saw information about a press release from late last year announcing that the ACGME had approved new requirements for residency programs, based on the recommendations of the IOM report.

Wow, I thought, and wondered exactly what the ACGME had approved.

Following parts of specific duty hour recommendations from the IOM: The maximum number of work hours remains at 80 hours per week, averaged over 4 weeks; moonlighting, now both internal and external, is counted against the 80-hour weekly limit; and duty periods are limited to 16 hours (although only for first-year residents by ACGME).

I’ll be honest. This didn’t impress me. 80 hours a week…averaged over 4 weeks…moonlighting included…duty period limits only for first-year residents—it struck me as enough change to say something had been done, but not enough change to really fix the problem. One of the doctors in the ACGME tipped their hand, I thought, when he called the IOM’s recommendation for an uninterrupted 5-hour sleep period “unworkable.”

This is not a post about what it takes to become a doctor and whether or not working them long hours helps them or hurts patients. As the title suggests, this is a post about how hard it is for organizations to change their cultures. Despite all the evidence cited by the IOM on the link between long duty hours, resident fatigue, and medical errors, the decision-makers—highly-educated, vastly experienced, humanely-motivated physicians trained to let evidence guide their decision-making—were only willing to tweak their rules rather than change their culture.

There’s a lesson in there for all of us.

Artwork by John Herring, MD

Same Goes for Board Agendas

Here's something thought-provoking from Hugh MacLeod.

When I saw it, my first thought was, "Same goes for blogging." This whole Hourglass experiment, after all, isn't an attempt to make money. It's an attempt to engage a certain group of professionals, whose voices aren't frequently heard, in a dialogue around a set of leadership issues I believe are getting short shirft in current blogosphere.

But upon further reflection, I came up with something more practical for the current association leader: "Same goes for Board agendas." With apologies to Hugh, I would paraphrase his sentiment as: "You don't set Board agendas to manage your association. You set Board agendas to define the ground on which you want your Board to act."

It's a lesson that sometimes takes a while to learn. If you want your Board to deal with strategic issues, make sure you are putting strategic issues on their agenda. It's harder than it sounds, but really not that much.

And by the way, if you haven't subscribed to Hugh's daily cartoon email, you really should. He's got a knack for speaking to directly to the artist in you and helping you connect those passions to the things you do for a living.