MORE IDEAS FROM THE BOOK
Measures can fool you in three ways:
In 2014, the C-section rate in Brazil was 57%, the highest in the world. In the country's private health system, 84% of children were delivered by C-section. The system was designed to prefer C-sections. After educating doctors and patients, the upstream solution caused a 40% increase in natural childbirth.
The move away from problem blindness is the shocking realisation that you've come to treat the abnormal as normal.
Organisations have a tendency for downstream thinking. To succeed, leaders should change the focus to upstream thinking.
Find new ways of working together:
When you spend years responding to problems, you can sometimes overlook the fact that you could be preventing them.
Banning plastic bags in San Diego caused serious unintended consequences.
The deadly 2017 hepatitis A outbreak in San Diego is attributed to the lack of plastic bags. Homeless people used the bags to dispose of their own waste. But when the bags became hard to come by, the alternatives were much less sanitary.
Downstream actions are reactions to problems. These efforts are fast and tangible.
Upstream actions attempt to prevent those problems from happening in the first place by systematically reducing the harm caused by those problems. These efforts are slower and broader. A sign of upstream work is that it uses systems thinking.
Example: You can offer a homeless person a meal today, but to figure out how to reduce evictions so that people don't become homeless might take years.
Take the goal you didn’t achieve and try a different approach. Doing the same thing over and over to achieve your goal is the definition of insanity.
Your heroes miss their goals too. What makes them stand out is that they don’t give up. The fun of goal-setting is knowing that you’ll fail.
"If I had an hour to solve a problem and my life depended on the solution, I would spend the first 55 minutes determining the proper question to ask, for once I know the proper question, I could solve the problem in less than five minutes."
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