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Management Consulting for Clinical Research

The 11-Day Week and the 23-Day Month

And on the seventh day, the Lord rested. If only we could have her schedule! For many of us in clinical research, we find ourselves working part of every day. Our regular work days are filled with meetings and teleconferences, our nights and weekends are filled with “real work”: reading, writing, planning, thinking. And all too little of the latter, because we are too busy following through on “action items” from all those meetings.

Meaningful process improvement in clinical research is hindered by a cultural cataclysm: a Julian calendar in a Digital age. We are still scheduling our time by the rhythms of the planets, while communicating in digital time. This cultural dissonance results in two fatal flaws: the unnecessary weekly meeting, and the under-use of enterprise information which could take its place.

The Myth of the Weekly Meeting
The reason why our work days are filled with meetings is the tyranny of arbitrary frequency. When we get our department or team together, what is the first thing we talk about? We decide to meet once a week! Why? What is the meaning of seven solar days to the needs of the work at hand? Maybe we should be meeting every 3 days. Maybe we only need to meet every eleven days. We never consider these possibilities; instead we book yet another weekly meeting into our PDAs. The result is that we are either meeting too often, or not enough — rarely “just right”.

Unnecessary meetings are perpetuated for several flawed reasons. One is the tyranny of the team, something I have written about previously. Indeed, it is often hard to tell which is worse — the teams, or the meetings they generate. We also suffer through “meetings of habit.” Think about the spectrum of your weekly meetings, and ask yourself: when did this meeting first begin? There may have been a good reason for it originally, but is there still? Or are you meeting out of habit, because it’s the way we always do it. When I was once running a large organization with a number of senior managers as direct reports to me, we of course started meeting once a week. After a while, the meetings were getting thin in content; mostly we talked about the latest gossip or personal news. I realized the management team was running well enough that we didn’t need to meet, and changed it to a “meeting on demand” schedule: any of the managers could call a management meeting when each other’s counsel was needed. As long as I did my job correctly, of staying in touch closely with each of them individually, this new system worked very effectively, and an hour of the work week had been liberated.

We also suffer from “meetings of inclusion”, not dissimilar from the ubiquitous team meeting. These are the meetings we have when we don’t want to leave anybody out, or hurt someone’s feelings. We want to keep up with corporate political correctness, or we’re trying to be inclusive of others. Inclusion is only worthwhile if it is sincere, and if so, it can be insightful and mind-bending. If we are including people for the wrong reasons, you can be sure they will feel it very quickly, resent the waste of their time, and thereby undercut our original cynical purpose.

The worst sin of course, and most common, is having meetings where people look at each other and have nothing to say or learn. Many observers have advised cogent fixes to this problem. In the words of one successful manager, “if people need an agenda for a meeting, they don’t belong there.” One of the famous and most effective ways to make meetings efficient is to hold them in rooms without chairs. It’s amazing how fast those meetings go.

The Frequency Flaw
But beyond making meetings more efficient, we have to question their frequency. Our work rhythm is no more dictated by the rotation of the earth and moon than any other natural phenomenon. So why are we meeting every week?

What is a week? A biblical invention perhaps. It is at best an arbitrary subdivision of the lunar cycle, adjusted to the frequency with which the sun rises and set, the two cycles of which do not line up mathematically. And anyone familiar with the tortured history of the creation of the Julian calendar will remember that our months are even more arbitrary (indeed the calendar looks very much like the product of a committee meeting!).

Similarly, when we ask for reports, we ask for them monthly. Why monthly? Is that frequently enough? Is it too often? Who knows? We let the moon decide how frequently we will summarize and communicate information. What’s important is that meetings, and reports (i.e., information), are tightly interrelated. If we had more timely information (reports), do we need the meetings?

Well, sure, you are saying, but weeks and months are what everyone is used to and it’s easier this way. Weekly meetings for instance, are the safest way to fight that fiercest of corporate battles — booking the conference room! But to accept these arbitrary schedules as inevitable is a cop-out.

From Daily Work to Weekends and Back Again
Before the rise of the corporation in the twentieth century as the dominant form of employment in industrialized societies, we all worked every day. We had to, to keep animals fed, wood chopped, water carried. But we had a lot fewer meetings! And each day had a rhythm which naturally included some fresh air, exercise, family and quiet. In the last century we became boxed into the structure of “the work week”, creating the phenomenon of “the weekend”. No longer did we have a fluid continuum of daily tasks with little discrimination; instead the lines were clearly drawn between work and leisure, and an artificiality was introduced.

With the advent of ubiquitous, intrusive and all too easily accessible communication technologies, our weekends have now all but disappeared. The globalization of clinical research, and its resultant round-the-clock phone calls and its air travel demands, have further eaten into what’s left of “free” time. Thus is the price of the Digital Age. But if our world is digital, why are we still meeting once a week?

If technology has ruined our free time, it is because we are keeping both behavioral archetypes in place: the Julian and the Digital (the weekly meeting and the cellphone). The bottom line is that I suspect most meetings do not have to happen weekly, and that most reports are needed more often than monthly.

In Business, Digital Wins
In clinical research, all of our operational processes are about generating information, some of it of a defensive nature (regulatory record-keeping), and some of it mission-critical to enterprise decision-making (keep developing the drug or kill it?). Most organizations have long recognized that information technology — listen to the semantics of that phrase! — can help “manage” this information. Unfortunately, as anyone who has tried to acquire or design a good CTMS knows, these software applications have focused much more on getting the data in than on getting useful information out. Once we get better at this, we can envision information when we need it, not prepared on a schedule determined by a cold white orbiting celestial body.

Perhaps technologies can be put into service to restore free time, and a near-agrarian rhythm to our lives, by enabling “just-in-time” meetings and “real-time” reports. Instead of double-booking unnecessary weekly meetings (whose agenda is often filled with speculation about information unavailable because we don’t have our monthly report yet!), we can start meeting only as often as needed. And the meetings we will have will be so much more informed, and therefore shorter, because operational data will be at our fingertips.

For the soundtrack of The Lion King, Elton John wrote:

* From the day we arrive on the planet
* And blinking step into the sun
* There’s more to be seen than can ever be seen
* More to do than can ever be done.
Let’s not waste that time in unnecessary meetings, scheduled by the arbitrary rhythm of our planet. There is so much to be done.

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