Mohammad Al-Ubaydli’s blog

Another day, another mistake, this time with LinkedIn

Posted in Management, People / organisations by Dr Mohammad Al-Ubaydli on September 30, 2008

One of my heroes, Esther Dyson, likes to say that one should always make new mistakes. I follow her advice every day but today I thought I would share my latest mistake in case it helps others.

There are lots of articles praising the ability of LinkedIn for reference checking. The company even has a dedicated tool for this. So I merrily used this after interviewing someone. I did this in a hurry because I really liked the person and wanted to reference check quickly. And I only spoke to the people who had publicly added positive comments about the person’s LinkedIn profile.

But I did not ask that person in advance if this was OK to do.

I know that venture capitalists do this all the time as part of due diligence. But there was no need for me to make the calls before checking with the person, especially as I liked him.

Fortunately, he is such a class act that he called me afterwards and explained to me why what I did was wrong. He appreciated my need to check, but my unannounced calls made it look like I either did not trust him or he was disorganized. Neither is true.

As it happens, all his colleagues mentioned how honest he was; that he would calmly and honestly speak his mind if he saw something wrong. He demonstrated this in spades when he spoke to me and now I want to work with him even more.

Notes on Nursing

Posted in Books, History, Medicine, People / organisations by Dr Mohammad Al-Ubaydli on September 11, 2008
Book cover for Notes on Nursing

Book cover for Notes on Nursing

In my opinion, England’s greatest contributions to medicine were the creation of the nursing profession by Florence Nightingale, the invention of the hospice by Cicely Saunders, and the discovery of antibiotics by Alexander Fleming.

The main reason I include Fleming is that his discovery was only possible because he was so sloppy in his lab work, giving me hope that I too can one day do something useful. Saunders started as a nurse, trained as a doctor so that her reforms would be accepted, and eventually became Dame Sicly in recognition of her work. But if I understood correctly Nightingale was vilified by anti-feminists in her lifetime.

So it is with great delight that I finally sit down and read Notes on Nursing by Nightingale. The Univeristy of Pennsylvania has the complete version on the web, nicely hyperlinked, but I am reading the Kindle Edition of course. I usually highlight interesting and noteworthy sentences on the Kindle but I find myself highlight almost every sentence within the first few pages.

This is a charming book and I recommend you read it.

Here is my favorite quotation so far, a footnote about the fact that “one in every seven infants in this civilized land of England perishes before it is one year old? That, in London, two in every five die before they are five years old? And, in the other great cities of England, nearly one out of two”.

Upon this fact the most wonderful deductions have been strung. For a long time an announcement something like the following has been going the round of the papers:–”More than 25,000 children die every year in London under 10 years of age; therefore we want a Children’s Hospital.” This spring there was a prospectus issued, and diverse other means taken to this effect:–”There is a great want of sanitary knowledge in women; therefore we want a Women’s Hospital.” Now, both the above facts are too sadly true. But what is the deduction? The causes of the enormous child mortality are perfectly well known; they are chiefly want of cleanliness, want of ventilation, want of whitewashing; in one word defective household hygiene. The remedies are just as well known; and among them is certainly not the establishment of a Child’s Hospital. This may be a want; just as there may be a want of hospital room for adults. But the Registrar-General would certainly never think of giving us as a cause for the high rate of child mortality in (say) Liverpool that there was not sufficient hospital room for children; nor would he urge upon us, as a remedy, to found an hospital for them.

Her grasp of what to do with statistics is better than that of most doctors. I see from the Wikipedia article about Nightingale that she had “had exhibited a gift for mathematics from an early age and excelled in the subject under the tutorship of her father and later the tutorship of mathematician James Joseph Sylvester“.

I am struck by two other ideas from the beginning of the book. First, she keeps on putting forward the view of disease as a reparative process

disease, at some period or other of its course, is more or less a reparative process, not necessarily accompanied with suffering: an effort of nature to remedy a process of poisoning or of decay, which has taken place weeks, months, sometimes years beforehand, unnoticed, the termination of the disease being then, while the antecedent process was going on, determined?

It took me a few repititions before I understood what she meant because I was still in the mindset that disease is a pathological process that doctors treat. Instead her thinking is of diseases as the manifestation of the body’s attempts at healing, attempts that nurses try to help along. This reminded me of a program to help the elderly look after themselves during the winter months as so many die from hypothermia. The social workers tried to teach that, since 25% of heat is lost through the head, wearing a hat indoors is a good thing to minimze heat loss. Few wore a hat. But when they rephrased this as 25% of cold gets through the head, and that a hat prevents entry of the cold, many more of the elderly participants put their hat on.

Second, I am fascinated by her insistance on good ventillation

The very first canon of nursing, the first and the last thing upon which a nurse’s attention must be fixed, the first essential to a patient, without which all the rest you can do for him is as nothing, with which I had almost said you may leave all the rest alone, is this: TO KEEP THE AIR HE BREATHES AS PURE AS THE EXTERNAL AIR, WITHOUT CHILLING HIM. Yet what is so little attended to? Even where it is thought of at all, the most extraordinary misconceptions reign about it. Even in admitting air into the patient’s room or ward, few people ever think, where that air comes from. It may come from a corridor into which other wards are ventilated, from a hall, always unaired, always full of the fumes of gas, dinner, of various kinds of mustiness; from an underground kitchen, sink, washhouse, water-closet, or even, as I myself have had sorrowful experience, from open sewers, loaded with filth; and with this the patient’s room or ward is aired, as it is called–poisoned, it should rather be said. Always air from the air without, and that, too, through those windows, through which the air comes freshest. From a closed court, especially if the wind do not blow that way, air may come as stagnant as any from a hall or corridor.

Her book was published in 1860, so soon after Pasteur was forumlated germ theory and a year before Semmelweiss lost his sanity from trying to explain to doctors how germs spread to patients. (Hint: it’s was iatrogenic.) This was a wonderful woman, well ahead of her time.

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Parkinson’s Law

Posted in Books, Management by Dr Mohammad Al-Ubaydli on September 8, 2008
Parkinson's Law

Parkinson

One of my favorite books is Parkinson’s Law. Its eponymous law, “work expands so as to fill the time available for its completion“, is famous even though most people do not know that they are quoting the first chapter of this obscure book.

But my favorite chapter is the third, titled “High Finance, or The Point of Vanishing Interest”.

When I have described the chapter to my friends they always have recognition depression: they recognize the depressing phenomenon that the chapter discusses, and they want to hear no more about the book because it is so depressing. But if you persist until the end there is useful insight.

The chapter recounts a committee meeting. Bear with me. The first item is the most important, namely whether or not to approve the £10 million contract to build a power station. The book is from the ’50s so the sum was supposed to have been astronomical.

However, only two people in the committee know anything about power stations. The others have no clue, and are to embarrassed to admit it, so they ask no questions lest they reveal their ignorance.

Of the two people who do know, one person wants to object, yet again, to the choice of contractor. The chairman says this will be noted, but that it is too late now to go back. The second person has a whole range of questions, starting from why the cost is a suspiciously round £10 million. However, he knows that no one else will understand his questions, much less the answers necessary, so he just sighs and gives up.

The team spent just a few minutes on the £10 million agenda item.

The next item on the agenda is the building of bicycle shed. All the people who were ashamed of their ignorance would now like to justify their place on the committee by “contributing” to the debate. Furthermore, everyone has some level of understanding here as they would have had to make similar decisions with their personal finances. It takes 45 minutes of arguing before the decision is made about £2000 of spending.

Next item: how much to spend on coffee? Even more opinions are volunteered as everyone has an opinion about coffee. It takes 75 minutes to decide what to do about less than £100 and the decision is to research more information in time for the next meeting. In other words, the time spent on each item is inversely proportional to its importance.

Does this sound like the last meeting you attended?

Here is the clever bit. Parkinson says that there is a point of vanishing interest, a cost below which there is no interest by committee members in debating further. So, if you want to get your budget spending approved, find out what that threshold is and divide your budget into several milestones, each of which is below the threshold.

This is more powerful than it sounds. For example, lots of software is entering the enterprise because of software as a service (SaaS) business models. It begins with a small spend for a small team. The small spend is not worth discussing in a budget meeting; it is small enough for one person to pay with their credit card and have reimbursed.

Soon, another team hears about how well your team is doing with the new tool and wants the same. They make the same decision, and so on for a few more teams.

Eventually, it is time for a big decision. Should the whole enterprise get the software? By that point, however, so many people are using the software that switching to another tool is an expensive proposition. This is the CIO’s nightmare but the problem is only getting worse. On the other hand, if you are trying to make change happen (not always a good idea) in how your team does its work, SaaS software is making the process cheaper and easier than ever before.

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Wiki best practices

Posted in People / organisations, Technology by Dr Mohammad Al-Ubaydli on September 6, 2008

I am on the excellent Refresh Cambridge mailing list and another member asked for advice about wikis. I gave a long reply and a few people recommended that I share it with others.

First, there is the question of which wiki to select. I have a strong preference for open source wikis to minimize vendor lock-in. If you ever do decide to migrate to another wiki vendor in the future you are more likely to succeed if you began with open source software.

MediaWiki is charming but the user interface is too uncomfortable for most people, especially the subject matter experts you want to do the most writing. The advantages of open source are outweighed by the usability issues. On the other hand, I have heard someone cheekily saying that the reason the Wikipedia is still high quality is that its MediaWiki software puts off authors below a certain intelligence.

Socialtext is a brilliant open source wiki, but installing your own version is hard and pricing is for enterprise customers. So I personally like Deki Wiki because although it is open source, the user interface is Microsoft Word-friendly and administering the software is very easy with their hosted version.

By contrast I hate Confluence because it is a massive proprietary content management system, and because its user interface encourage each author to make a large stand-alone office document rather than richly interconnected web pages. This habit is pernicious and difficult to reverse so you must be vigilant early on in a deployment to teach everyone the value of interconnected web pages.

At any rate, I regularly use all four of these wikis and I know that I am in the minority in my aversion to Confluence. I would never choose it, but I can see that great results are possible with.

So how do you get great results with a wiki? Here are nine tips from my experience:

  1. Everyone in the group must commit to using the wiki, and to the wiki being the version of record. It is dispiriting for junior people assigned to write on a wiki to see the real decision makers discussing elsewhere and to understand that none of the seniors will use the wiki.
  2. To get that commitment without a big change effort, it is better to have everyone in a small group of ten using the wiki than it is to have a couple of people from each of five groups doing so. The good folks of Common Craft have an excellent video explaining the advantages of wikis.
  3. Have your debates about the contentious issues on the wiki, for all stakeholders to see, not in private conversations, and resist the temptation to make private decisions through messages between insiders in your group
  4. Everyone will have their own excuse for keeping material away from the wiki, often citing “security”. But in general, most people’s bias is towards under- rather than oversharing, so there needs to be a strong champion who has the opposite bias.
  5. Use the wiki to take minutes of any meetings you hold. Have someone in charge of writing the minutes during the meeting, with the output projected on the screen. A lot of misunderstandings are cleared up that way as people can see straight away if they have been misunderstood and can make correction there and then with the group watching and learning.
  6. A wiki is not a reason to have no meetings, rather it is an easy way to have a version of record as decisions are made in these meetings.
  7. The best thing about Socialtext is that it sends everyone a daily update by default. This seems a subtle difference but it really motivates everyone else in the team to see a message of what their colleagues did the previous day. If you use a different wiki, switch to this default.
  8. To get over the initial period of colleagues who do nothing in the beginning, make sure you write something every day so that your colleagues feel guilty enough to do start doing something.
  9. Instead of answer e-mail questions and then trying to summarize the consensus on the wiki, write your thoughts on a wiki page and then send the link to everyone else you want to have a consensus.

A final note about my first comment about junior people being assigned to write on a wiki. This is both a strength and a weakness. I like to show juniors that contributing to the wiki is an excellent way for them to learn about the organization, and to show the organization how much your are willing to contribute to its success. On the other hand, if you give out signals that wiki work is of minor importance and that is why you are parcelling it out to junior people of minor importance, you will get an unused and useless wiki.

People get the wikis they deserve.