David Brooks’s “Drilling for Certainty” correctly captures the challenge and a failure mode of managing complex systems, but the article misses the prescriptive element for achieving great success.
He gets the challenge of unknowability right—that incorporating ever more sciences and technologies, connected in increasingly convoluted, interdependent ways, makes it impossible to know how a system will [...]

It would be a terrible mistake for Democrats to abandon comprehensive health care reform just because voters in the Massachusetts Senate race last week decided that they liked the Republican, Scott Brown, more than the Democrat, Martha Coakley.
– “Don’t Give Up,” NY Times, January 26, 2010
Does the NY Times think we had a popularity contest [...]

Read the NY Times or listen to NPR and you would conclude a little known state senator won the Senatorial seat long held by Ted Kennedy due to the faults of Democratic contender, Martha Coakley.
Not so. Scott Brown made one promise to vote against ObamaCare.  People listened, believed him, and he rode to victory.
The “Martha [...]

The question was asked; In times of budgetary pressure, what quality initiatives should be sacrificed.
Asking that asks the wrong question.  The right one is asking what can be done to better design and operate care critical processes to advance quality, affordability, and access simultaneously.
The first question reflects unwarranted arrogant pessimism, the latter better justified humble [...]

In a recent e-mail, Jim Womack urges the lean manufacturing community to get beyond Toyota, implying that what can be learned from Toyota has been, in particular tools of shop floor production control.
That is the wrong challenge, in my view.  The real challenge is to expand beyond understanding lean as a set of tools, and [...]