Management vs Leadership

Though times require good management ...


... but only great leadership can make a difference in the long run.

I once have been told to be brave and bold: I will.
Thanks boss!

Tracking and measuring everything

It's clear that if you had to manage 300M$ worth of medical equipment, that goes rented in hospitals all over the USA, you would have to find out a way to track where every single piece of equipment is at every single moment: isn't it? And if you had to service equipment at a rate of more than 200 a week, you'd be very careful in knowing what's going on: wouldn't you? Well, this is what the guys at UHS do in their local office in Minneapolis (and in the other 85 offices across the country): for every piece of equipment that they manage, they know at every time where it is, who has touched it, how much time it took to fix it, what spare parts were necessary, how much it costed to repair it, etc. And every specific indicator is clearly showed in a dasboard and benchmarked against the performance of the other UHS offices (I'd call it "positive competition"). And part of the bonus compensation of the employees is determined according to how good their performance had been: I assure you the guys here keep track of anything, and strieve to do better and better!
I can guess this is not only good management practices, but it's something that roots in the american culture. Have you ever seen a baseball match (the same applies to football, basket, anything) on ESPN or any other tv channel? At every moment they show you batting average, run batted in, home runs, wins, strikeouts, etc. etc.
So, keeping track and measuring things is both a matter of culture and good management: in any case it can be done, and there's no excuse not to do it!

Next stop ... London!

So, my week at RTKL in Dallas is over now. Thanks to all the great people that welcomed me, and put up with me and my tons of questions (some of those not too dumb, at least I hope ...). Thanks to Debbie (and Marty often connecting with us from Saudi), Lorraine, Pippa, Mike and Keith (with me in the picture taken today shortly before my departure)! And to Steve, Gary, Pam, Jennifer, Melody, John, and all the other colleagues of your great team.
Next stop London, then! Looking forward to meeting Lorraine and Pippa there and doing some great work together!

A picture is worth a thousand words ...

An old phrase by Frederick R. Barnard used to say "One look is worth a thousand words"; in fact it was stolen from the original chinese proverb saying that "A picture is worth ten thousand words" (and if you google the phrase you'll find at least other 5 claimed origins ...). So, how many words may a 3D rendering of your new operating room be worth? And a computer graphics live animation? But the guys at RTKL go beyond all of this, so here you are with a complete mockup of the new operating room, filled with equipment and furniture. And a group of nurses and surgeons visiting it (at a 6.30am meeting!), using the equipment, moving the lamps, making suggestions and coming up with the final decisions ready for the architectural construction drawings. And there were two of these mockups to explore, good for the medical staff to compare the different layouts, plus patient rooms. Wow! And now let's go back to the whiteboard ... oops ... to the CAD station ...
PS You may have read of how Apple used to design its new retail stores a few years ago ... Apple had a full store mock-up hidden in a San Jose-area warehouse for a year prior to opening an actual store, so they could test out various layouts and designs. They continue to tinker with the formula-- furniture, lighting, merchandise mix, so-called "collateral" (those brochures and cards, etc.), placement of objects, etc.
Pursuing excellence ... sounds familiar?

It's nice to be nice

During these days of intense "watching and learning" at RTKL I sometimes happen to spend some time on a desk just checking my email or going through the notes I took during the day. Today I occupied Shalenta's desk and I immediately noticed a framed sheet of paper welcoming her at her new company. How nice it must have been getting welcomed by your new colleagues and managers that handwrote phrases as "We are so glad to have you on board and look forward to working with you", or "We are glad you have joined our team. Welcome".
And what to say of the recognition as "employee of the quarter"! It may cinically mean little to somebody, but I think that being given a boost is good for anyone of us (not just for the egomaniacs...).
Final remark for any HR department (and for any employee welcoming a new colleague): it's nice to be nice!

2nd-5th of August 2010 - RTKL, Dallas, TX

Partnering with the guys at RTKL will require a lot of thoughtful action and bravery on both sides, but it’ll be a lot of fun, also!
To express my feelings these days here in Dallas, dealing with Debbie, Marty (on call from Saudi), Keith, Mike, Lorraine, Pippa, … and a lot of other great professionals (the best medical equipment planning team you could dream of doing work with), and trying to figure out how to take the best reciprocal advantage of the partnership between our companies, please let me quote Seth Godin a little bit (it’s easy to look smart when quoting smart people …)

Business Development is a mysterious title for a little discussed function or department in most larger companies. It's also a great way for an entrepreneur or small business to have fun, create value and make money.
Good business development allows businesses to profit by doing something that is tangential to their core mission. Sometimes the profit is so good, it becomes part of their core mission, other times it supports the brand and sometimes it just makes money. And often it's a little guy who can be flexible enough to make things happen.
The thing that makes business development fascinating is that the best deals have never been done before. There's no template, no cookie cutter grind it out approach to making it work. This is why most organizations are so astonishingly bad at it. They don't have the confidence to make decisions or believe they have the ability to make mistakes.
Business development people are exploring the unknown. That means that there's more than cash on the table, there's bravery and initiative and excitement. The best business development people I've ever worked with are able to capture the energy in the room and amplify it. They'll build on the ideas being presented, not make them smaller.

Full story at:
http://sethgodin.typepad.com/seths_blog/2009/09/understanding-business-development.html

Dealey Plaza, Dallas - November 22, 1963

How strange is it being today in a place where sometime in the past an event occurred that changed the history of a Country and maybe meant even more? So much has been written about this place and so many things are yet to be revealed. I wasn't even born when President Kennedy was shot in Dallas, but I feel the grieve for the man (remember the picture of little John at his father's funeral) and the emotion of History, here today, in the form of a hundred meters of a street and a couple of grassy knolls.

For where your treasure is, there your heart will be also

This phrase from the Bible echoed in me today as I was wandering alone around Dallas in a hot saturday afternoon, far from home and family with one whole more week before seeing the ones I love again. All in a sudden I heard a distant though familiar sound of bells, and following it I got to the beautiful cathedral "Shrine of the Virgin of Guadalupe". I entered with other people approaching the church and attended the Holy Mass; it was in spanish, but the structure of the service is exactly the same everywhere, so I could easily follow it. The Holy Gospel of today was about putting attention to what really matters in life, and the priest preached the importance of friends and family, and how important it is to pay them time and attention.
They say that nothing happens by pure chanche, and today I had another confirmation of how this is really true! I miss my loved ones, but I'm not here by chanche, nor it was a pure chanche hearing that bell in the distance ... getting to an unexpected familiar place in a stranger and so different country.
We shall all put attention to what really matters to us, where our treasure is. In case of doubt, ask your heart, he knows the answer!

Visiting the ECRI Institute

What does it feel like when you have the possibility to visit the “home” of someone you’re a true fan of? If I could take my daughters to the house of Hello Kitty or make them have a ride in the Scooby Doo minivan, they may be less amazed than I was today visiting the ECRI Institute in Plymouth Meeting near Philadelphia. Thanks to Jim Keller (Vice President of Health Technology Evaluation and Safety) who guided me through their offices and laboratories, I have seen the place where medical devices get tested, scrutinized and compared, and I have met the people that write the reports and guidelines that are worldwide respected and recognized. In this place you can feel the passion for contributing to better healthcare and patient safety through unbiased health technology assessment and evaluation. Thank you Jim, you and your team are doing a great job!

Balance

Humans tend to be very unbalanced. We can't sort out how to address our "minds," our "bodies" or our "spirits." We certainly are at a loss over any rational balance between our professional and personal lives (work and family). We are unbalanced, that that is wasteful, sad and dangerous. Life gets shorter every day --- most of us act like we are in training for some great happening that will occur in the future - we totally forget to live in the "now." Certainly most of us have to work to pay the bills, but a life that is all work and no play --- well, is not much of a life. I guess these few days here under the subtle influence of the various Indian Philosophies of Hinduism, Buddhism and Jainism are having their effect on my easily impressionable mind.

Fortunately, my compatriots on our expedition here to India are aware of this serious human condition, and do attempt to seek balance, as you see in the picture above, where we are attempting to keep the "temple that is our body" in proper condition; and we are also engaged in endless intellectual debate on a vast range of topics including the relevance of terms such as Biomedical Engineering and Clinical Engineering; considering if the addition of "winglets" to the top of a sailboats mast would reduce a theoretical vortex drag (the de francesca hypothesis); and also the gender of god.

We are seeking balance --- of course we are not there --- but in respect of this search - I am now off to dinner.

Brian

Delhi -- a decade later

I was last here in Delhi in 1997-98 -- it remains a fascinating place - though on the surface, it looks and feels pretty much the same as it did a decade ago. For better writing than mine - visit: http://en.wikipedia.org/wiki/Delhi

The hazy view is from my hotel room. It is hotter then you would expect - around 41 degrees Celsius. Imagine having to peddle a bike around in that heat, as the fellow in the picture has to. We are quite fortunate.

Brian

Learning about the local culture

We all know how important it is to be sensitive to local cultures - and with that, or Grand Master Pietro today took us to The Red Fort to better understand the richness and history of this area. Read: http://en.wikipedia.org/wiki/Red_Fort to learn much more about the fort and to see some great pictures. Based on our visit today, we believe we may have found the new location for the TBS offices in India - and a suitable residence for Roy.

Brian

WOW - that is all I can say about this place

A few days ago we visited the Narayana Hrudayalaya Institute of Cardiac Sciences.

It is rare when I don't say much - but on this visit - I sat spellbound - they are performing magic.

And I finally found a way to slip myself into one of these pictures. You see the guy standing in front of the television monitors; he is Abhay P. Singhavi - CEO Preventive Health (and telemedicine) services) If you look closely into the monitor behind him - there I am in the middle in the grey suit.

Also here you see Pietro and Carlo equally spellbound by what is being done at Narayana. Visit: www.narayanahospitals.com to learn more. Really - check them out.

Brian

Columbia Asia

Columbia Asia (http://www.columbiaasia.com/) is a company started by Rick Evans many moons ago. They were a client of mine in Malaysia and they are doing very innovative things for healthcare. We visited Rick at his offices here in Bangalore (no, Rick is not in the pictures) and we hope to be doing some business with them.

Rock Stars

It is not all wining and dinning --- unfortunately.

Here you find Pietro, Ven (the leader of TBS India), Roy (The Voice From the Kingdom), and Chevla (the guy who really gets things done).

I am not sure I am so happy about being the picture taker --- my ego and vanity are bruised.

A really great start to things here in India.

Brian

Blogging is hard work...

I don't know how Stefano kept up with this. Bravo to him.

We had the first TBS INDIA board meeting on Tuesday. Notice the TBS Logo in the back ground of the fascinating picture of Pietro and Paolo.

The meeting went well - we are off to greatness.

Bad day for flying

Panic after Air India plane skips landing

In Mangalore
Heavy rains, no landing system forces Air India Express plane with 150 on board to land in Kozhikode
M Raghuram. Mangalore

Memories of the May 22 air crash of Air India Express's Dubai-Mangalore flight IX-812, heavy rains and a yet-to-be-repaired Instrument Landing System (ILS) at Mangalore's Bajpe Airport are making it extremely difficult for pilots to land at this aerodrome which is claimed to be an all-weather one.
On Wednesday, this became evident when, again, an Air India Express flight on the same Dubai-Mangalore route was forced to abort landing during heavy rains at Bajpe at 6.10am and made to proceed to Kozhikode instead.
The flight with 144 passengers and six crew members approached the Bajpe airport runway and tried to land in heavy rains, Chellam Prakash, station manager, Air India, said.
Poor visibility, heavy rains and a fear of an encore of the May 22 air crash when the ill-fated flight overshot the runway and crashed into the ravine beyond the runway killing 158, forced the Mangalore air traffic control (ATC) to ask the pilot to abort landing at Bajpe airport and diverted the plane to Kozhikode.
Airport Authority of India (AAI) officials told DNA that the ILS, which was damaged during the IX-812 flight's crash at Bajpe airport, was not yet functional as the system engineers had not fixed it. An airport official told DNA: "Visibility had come down to 100 metres due to heavy rains. Air India pilots are not allowed to land unless there is a clear visibility of 2,000 feet from the landing threshold. In the absence of a working ILS we could not permit pilots to land at Bajpe and asked them to come back later."
The flight then landed safely at Kozhikode at about 7.15am.


... but the TBS buddies are dauntless and won't get threatened so easily! Our brave spirit is best described by Freddie Mercury words:

Don't stop me now

Tonight I'm gonna have myself a real good time
I feel alive
And the world, I'll turn it inside out yeah
I'm floating around in ecstasy
So don't stop me now
Don't stop me
'cause I'm having a good time
Having a good time

I'm a shooting star leaping through the sky
Like a tiger defying the laws of gravity
I'm a racing car passing by like Lady Godiva
I'm gonna go go go there's no stopping me
I'm burning through the sky yea
Two hundred degrees that's why they call me Mr. Fahrenheit
I'm travelling at the speed of light
I wanna make a supersonic man out of you

Don't stop me now
I'm having such a good time
I'm having a ball
Don't stop me now
If you wanna have a good time
Just give me a call
Don't stop me now
'cause I'm having a good time
Don't stop me now
Yes I'm having a good time
I don't wanna stop at all

I'm a rocket ship on my way to Mars
On a collision course
I am a satellite
I'm out of control
I'm a sex machine ready to reload
Like an atom bomb about to oh oh oh oh oh explode!
I'm burning through the sky yeah
Two hundred degrees that's why they call me Mr. Fahrenheit
I'm travelling at the speed of light
I wanna make a supersonic woman of you

Don't stop me don't stop me, don't stop me hey hey hey!
Don't stop me don't stop me ooh ooh ooh
I like it
Don't stop me don't stop me
Have a good time good time
Don't stop me don't stop me

I'm burning through the sky yeah
Two hundred degrees that's why they call me Mr. Fahrenheit
I'm travelling at the speed of light
I wanna make a supersonic man out of you

Don't stop me now
I'm having such a good time
I'm having a ball
Don't stop me now
If you wanna have a good time
(all right) Just give me a call
Don't stop me now
'cause I'm having a good time
Don't stop me now
Yes I'm having a good time
I don't wanna stop at all

Morning in Bangalore

The day is just starting and I wanted to get this posted before the day started. The team started arriving yesterday from various points in Europe - I got to the Hotel around 2am - so it is a sleepy start for the day - but the rest of the team arrived even later - so it will be an interesting start of the day for everyone.

You can learn more about Bangalore at: http://en.wikipedia.org/wiki/Bangalore It is the Silicon Valley of India - but you cannot really tell that from this picture.

I will do my best to keep this blog updated while here - but I am cannot promise to be as diligent and interesting as Stefano was on the expedition to The Kingdom of Saudi Arabia.

Setting the TBS flag here in India was a visionary strategic move on behalf of our company CEO. While it will of course be challenging to support our ever increasing geographic scope of services - I am confident that years from now, India will prove to be a cornerstone to our global operations.

Stay tune for more ... and as always -

Be Brave !!!

Tbs lift off for India

Next Stop - INDIA

Just a quick note --- Team TBS will make its next dent in the Universe in/at India.

Stay Tuned

Pride and Prejudice (and Productivity) – by Brian de Francesca

First – I need to thank the great evangelist of our cause - Stefano Bergamasco - for constructing and continually filling this blog with wonderful and valuable words and images from our visit to the Kingdom of Saudi Arabia (KSA). Stefano – you truly “get it”, and I am proud to be on your team.

The title of this final blog entry is modified from the novel Pride and Prejudice by Jane Austen. I have spent many years traveling to different countries doing work - I normally try to avoid dragging people along with me, because many people believe that showing up for work each day and staring at a computer is the same as being productive. And they also tend to sadly believe that you should not enjoy your work, or certainly not have any fun while working. Showing up for work is not the same as being productive or creating value. Consistently working until 7 and 8 o’clock at night, is not a sign of being a dedicated and productive person – it is a symptom of an inefficient system that does not permit people to have balanced lives. Many people believe that sitting in endless meetings with no clear agenda or follow-up action steps actually create shareholder value. Productivity is measured by output – not by serving time. On our recent trip to the Kingdom of Saudi Arabia, I was joined by three persons who clearly understand the meaning of productivity, value creation and appreciating the miracle of our lives. Thank you Stefano, Roberto (BOB) and Youssef for having me along for the ride.

For weeks prior to our trip – they (Stefano, Roberto and Youssef) planned out the program – and shared the schedule with our partners in KSA using Google Calendar – the intention was to fully book our time in KSA and hit the ground running – which we did. During this pre-trip time, I did very little – so they truly deserve the credit for our success. Our local partner in KSA tried to explain to us that we would be lucky to have 2 meetings each day in KSA for a total of maybe 10. Interestingly, I had a conversation with a salesperson yesterday, who said that she had 3-5 sales meetings PER WEEK! During our 5 days in KSA we had over >15 productive meetings in two different cities! That is a productive WOW! Here is partial list of who we had the pleasure of meeting:

King Fahad Medical City (Ministry of Health): Engr. Turki B. Alharbi

King Khalid University Hospital (Teaching): Eng. M. Nazieh Osman, Eng. Mohammed S. AL-Garni, Eng. Ahmed M. Al-Asmari, Eng. Ali Abdulaziz Almasoud

Dallah Hospital (Private): Shameen Haq

GE Medical Services (Company): Ali T. Saleh

National Guard - Health Affairs (National Guard): Abdulrahman Saleh Al Shuail, Lloyd Schawsmidth

Protecta Vision (Company): Eng. Hani Z. Faddah

Security Forces Hospital Program (Ministry of Interior): Engr. Adel Abdullah El Eidan, Jamal Yousef Aseafan, Engr. Tariq M. Al-Zahrani

Dr Sulaiman Al Habib Medical Group (Private): Ibrahim Abu-Mushref

RTKL (Company): Marty McIntire, Jeff Davenport

Directorate of Health Affairs (Government): Dr. Sami Ba Daood

Saudi German Hospital Group (Private): Dr. Ezz El Arab Mohd. Ahmed, Eng. Ahmed Hassan

King Fahad Military Hospital: Colonel. Abdullah Al Utaibi

King Abdulaziz University Hospital (Teaching): Eng. AbdulHaleem Al Jawi, Eng. Lowai Masoud

Dr. Soliman Fakeeh Hospital (Private): Eng. Ayman Galal Fahmy

Dr. Bakhsh Hospitals Group (Private): Ms. Rania A. Taha Bakhsh, Dr. Abdalla Salem Omayer

AHCSC: Hosam Afifi, Essam I. Essa, Majid Batterjee, Ahmed Bakeer, Khalid Mohd. Al-Ghamdi, Eng. Mohammed Mahmoud, Mohd. Akhtar Shaikh, Eng. Hamzeh Al-Lahham

I am confident that many of these initial meetings will blossom into long term mutually valuable business relationships.

But life and living is about more than a job. During our trip, I had hoped to toss in a bit more fun than we were able to – I was really hoping to get a football game going in the desert or something like that. Maybe next time! Khalid and Majid talked a lot about diving …hmmm… During our visit, we made some new friends, ate some interesting food – yes, Camel was on the menu. However, by dinner time, most of the team was quite tired and jet lagged and could barely stay awake.

I am very pleased and proud of our accomplishments in Saudi. We exceeded our expectations and set the foundation for a significant expansion of TBS into the Middle East. The team worked hard, was very productive and I believe enjoyed themselves in the process - this is my definition of success.

To take TBS to the next level - we must be faster, more efficient and more focused – and also more fun and more passionate about the value we are contributing to humanity.

And of equal, if not greater, importance to the productivity and fun - are the intercultural aspects of our adventure. In these troubled times of terrorism and environment time-bombs, it is refreshing to see a mixed group of Christians and Muslims and even a Heretical American sharing meals, thoughts, jokes, and yes, work. There is too much ignorance in this small world - which of course, leads to dangerous prejudice. It is sad to see the ignorance of racial and cultural prejudice. 200,000 years ago – we humans started out in East Africa. I guess we are all “Originally African”. I am proud of the productivity of our team of “Originally African” TBS team members in KSA. And later this month – TBS team members will be in India with our Hindu brothers and sisters …. And soon China with our Buddhist relatives.

I look forward to sharing future adventures with many of you. --- Be Brave ---

Brian de Francesca

May 1st & 2nd 2010 - Leaving Saudi Arabia

And the final day has come! Tomorrow morning I'll check-out from the hotel, attend the eHealth conference, go to the AHCSC offices to say goodbye to our partners and friends and take my flight back to Europe.

I have already described how good this working trip has been for me and for TBS; we met a lot of interesting people, learned a lot about the healthcare technology issues in KSA, better focused on our business opportunities in the Kingdom and in general gained a better understanding of this Country.

Before my internet account expires (the hotel has very good wideband connection, but you have to pay for it on hourly or daily bases) I really want to thank all the people that made this experience possible and effective. First of all my company, TBS Group, that thruogh its expansion plans makes my job much more interesting and exciting than I would have expected. Then my colleagues that shared with me the intense week of meeetings around Riyadh and Jeddah: Brian, Roberto and Youssef. And then the colleagues and friends of our local partner AHCSC-OLAYAN: Hosam, Essam, Khalid, Ahmed, Mohammed and all their co-workes we met and that supported us throughout the week.

I leave a special mention for my new friend Majid; we worked hard together to prepare the scheduling and the logistics for our visit and he has been a great guide for us during the days we spent in Riyadh visiting all the hospitals around the city. But most of all I want to thank him for his generous friendship, opening the doors of his house and spending so much time with me talking of our business perspectives, of our home towns, of our culture and religion: I really thank you and hope to meet you soon again, inshallah.

April 30th 2010 - Our Muslim brothers

Being far from my family since 8 days today (and two more to come) makes me a bit homesick, so I’m writing this post with an eye to the Skype icon waiting for my wife to connect so I can say hallo to her and the kids at home.

Today is holiday in the middle east, so I don’t have hospital visits or other business related news to tell, but the day was interesting anyhow. Do you remember the polenta I taught Majid to cook yesterday night? Well, today we grilled it with meat, chicken and salmon in the backyard of Majid’s house! It has been a lovely day with his family and friends of AHCSC; in fact Hosam, the AHCSC general manager, picked me up at the hotel and we spent a pleasant day together. To continue my cultural mission from Friuli (the north east region of Italy I live in), I also prepared the “frico”, that is the most typical dish of the region, very simple (just boiled potatoes and cheese cooked in a frying pan until it gests crispy outside and soft inside) but really delicious, and my Arabian friends appreciated a lot!



AHCSC top management making the grill - note the toasting polenta

Me proudly cooking the "frico" in Saudi Arabia

All together in Majid's living room

During the day I discuss with Majid and Hosam of the cultural and religious peculiarities of their Country, and they give me more insights into the culture of the Muslim world and of their religion in particular. I can summarize just a few of the most remarkable teachings they explained me as inherently present in their religion, and I feel very fortunate to have had a first-hand non-stereotypal view of this world that seems so well known (from the distorting reports of the media most of all) but has a richness I would not have expected before coming here:

- Treating the other people as you would be treated yourself (as an example Majid told me of when in his previous company he made change all the cars of the employees with new models equipped with air conditioning, just after he had experienced on himself how painful it was driving in those conditions – a 1M$ non required expense indeed)

- Brotherhood of all people (one of the side effects of praying together five times a day with all colleagues in the company is the experience of equal dignity and respect between all of them; moreover, interrupting your business activities because it’s time to pray, reminds you of what really matters in life and where all our fortunes come from)

- Particular care of the poor and unfortunate (would you imagine that here they have no gorvernmental taxation for individuals, but according to their religion – Zakat or alms giving - they have to willingly give to the poor and needy 2,5% of their yearly excess savings; in general taxes are only levied on excess wealth and not on income)

- Consciousness of the unavoidable arrival of death (Hosam told me that they have a very effective expression for this, that says that death is not chasing you, so that you may be tempted to try and escape, but we’ll encounter it coming towards us in the middle of the way)

- Respect for all life forms (we were talking of domestic pets and the responsibility they bring to take care of them, and Majid told me how in a famous story, a woman was doomed to Hell after she kept a cat till it starved to death)

- Consciousness of the common roots of the three monotheistic religions and respect for the Prophets (Jesus Christ being one of the most important Prophets for the Muslims)

Majid tells me that he’s so sorry that many Muslims themselves don’t know, understand or apply the principles he explained me, and they just mechanically apply the exterior forms of the religious practice; this leds to many problems and misunderstandings between our cultures and religions, and makes lots of people subject to easy manipulation, as we can easily see.

I love my religion and I’m proud to be Christian (my religion having inside all of the above principles, and the universal message of loving each other that Jesus brought to the mankind); however, from these days on I take with me a better understanding and an unbiased respect for our brothers under the unique God that created and rules all of us.

April 29th 2010 - 6sigma and Saudi polenta

Todays it's half holiday in KSA (as for our saturday), but the program at AHCSC offices is intense and exciting. They are waiting for the visit of the Singapore six-sigma consultant that is supporting the company in the deployment of their six-sigma system, that has started with the training of some employees and is continuing with the optimization of a series of internal processes.

The whole morning is spent in preparation for the visit: Majid is leading one of the projects that is to be reviewed today, so we work on filling the typical six-sigma documents. I have double interest in attending these meetings: on the one hand I have learned of lean six-sigma from books and publications but never had the occasion of a first hand experience with the metodologies involved into its deployment. On the other hand, I get to know that the process we are working on today is about the optimization of the delivery of products from the AHCSC international suppliers to the customers in Saudi Arabia; one of the main issues that we have learned as a critical one during the visit in KSA is the difficult delivery of spare parts to fix equipment in the Kingdom (mainly due to the specific custom clearance regulations in this Country), so I take advantage of the situation and ask a lot of questions to get more insights into this issue.

We have Burger King lunch in the meeting room while we continue discussing of Voice of the Customer, DMAIC, Pareto charts, ... At 2.30pm the Singapore consultant arrives. He's an elegant man with experience with the Motorola six-sigma system; in the specific terminology they use he's a black belt and his knowledge and focus capability is impressive. During a break of the meeting (due to one of the 5 prayer moments of the day) I intrduce myself and the TBS activities to him and we discuss of how lean six sigma in manufacturing is different from its applications in service companies. The subject may be boring for the vast majority of the people, but I find it fascinating and effective.

At the end of the day at AHCSC I go shopping with Majid; he's got to buy things for his home and we decide that I have to show him some specialities of the italian cooking. I select two representative dishes: the "frico" and the "polenta". We buy potatoes and cheese for the frico, and we also find the corn flour to make a perfect polenta. The frico will be the guest star for the barbecue he's organizing for tomorrow (friday is the holiday here as sunday is for us), but the polenta will be immediately prepared! We go to his home where I meet his wife and one of his cute kids, and I teach him how to prepare the polenta. They are lovely people and I take advantage of the time we spend together to ask them about the way people live in Saudi Arabia, their religion, their culture and the way they compare to the lifestyle in other countries: I feel fortunate to have met people like them, they're really deep and avaliable to discuss. You rarely find this and I feel thankful and enriched.

Majid preparing the polenta!

Amazing polenta in Riyadh!

I'm sure that other people from Friuli have been in Riyadh in the past, but I don't think that many of them may have prepared a real polenta here ...

April 28th 2010 late night - Back in Riyadh

Back at the Holiday Inn in Riyadh I'm going to sleep 'cause it's so much late, but before that I briefly post continuing from where we had arrived in the previous episode ...

After the fried chicken experience at Al baik, we take Brian to the Airport (he's continuing the journey to the Emirates) and the rest of us goes to the Jeddah AHCSC offices with Khaild; his office is beautiful, with a large wood desk, a leather sofa and, most of all, a Nespresso coffee machine. We can’t resist and take a good espresso (and least me and Roberto, while Youssef prefers a turkish coffee) and then we take a picture with some of the AHCSC-OLAYAN team in Jeddah.



We then go to the last appointment of this intense 5 days of hospital visits, and meet the Deputy Director of the Dr. Bakhsh Hospitals Group; Rania Bakhsh, the doughter of the founder, pays great attention to our presentation and the conversation with her and the Chief of Medical Staff is very positive.

The trip is almost over; on our way to the airport Youssef drives the rented car to the rental shop and has some difficulties with the automatic gear (and also because the car is so huge you almost need and interphono to talk to the guys in the last row) and then Khalid, who’s driving an amazing white Lexus, takes us to see some typical shops in the old city of Jeddah and we take a last couple of pictures. In the last picture there’s only one of the guys still wearing tie and jacket: guess who’s going home and who’s to stay some more days in KSA?







Before getting on board again, I tell Khalid of bananas, nuns and other strange train characters (see posts before …) and then the team finally divides: I get to the national flights terminal and say goodbye to Roberto and Youssef. We’re looking forward to possibly see Khalid in Italy, but I guess we’ll be back in Jeddah sooner than that. And now the adventure is due to continue in Riyadh … with the people you learnt to know (Majid and his colleagues) and some more to come!

PS: As I started the Internet connection I immediately went to corriere.it and see the result of the return match Barcellona-Inter. The more you're far from Italy, the more your national pride rises! Sorry for the friends at TBS ES ...

April 28th 2010 - Internet available!!

I was not sure to find an internet connection today, but here it is ... an open WiFi and we're surfing the net! I take advantage of this to post a few pictures we have taken today in Jeddah. Enjoy ... and get back in touch from Riyadh!

Surroundings of Jeddah: a nice villa

Boats "parked" in the middle of the desert

Surroundings of Jeddah: ship shaped mall

Surroundings of Jeddah: street lamps

Biomedical engineering department at King Abdul Aziz University Hospital

The TBS team with Khalid and the director of Biomedical engineering at KAAUH

The TBS team entering Dr. Soliman Fakeeh Hospital

With the head of Biomedical Department at Dr. Soliman Fakeeh Hospital

Entering the mythical Al Baik fried chicken Jeddah fast food

The team saves reimboursement of expenses money eating cheap!

April 28th 2010 tomorrow - Day 5 in KSA (last ... for some of us)

So, tomorrow is the last day in KSA for the main part of the TBS team visiting the Country. After our last scheduled meetings, Brian is leaving for the Emirates in the afternoon, while Roberto and Youssef will take the 00:20 flight for Paris and then home; more or less at the same time I'll take my internal flight and go back to Riyadh. Since we'll be leaving the hotel in the morning after breakfast, and will be around the city all day long until getting to the airport in the evening, I think I won't be able to post tomorrow, so here are a few notes at the end of our presence in Jeddah.

The city here is a lot more lively than Riyadh, especially at night. We went to a beautiful libanese restaurant with Marty and Jeff of RTKL and then left for a ride around the city with Khalid; the city is really beautiful, of a beauty I could not see during the hot day. It really changes its face, with the all-bright signs of the shops and restaurants, the nice front of the houses and some amazing monuments and attractions. The one that most impressed us was the King Fahd's Fountain, that is the highest fountain in the world, shooting water at an height of 312 meters!

So, I'm going to spend a couple of days in this Country without my TBS soulmates, but my new Saudi friends prepared a couple of interesting days for me while I'll be waiting for the eHealth conference next sunday, so I have to thank them and Majid in particular. With him I'll attend the 6-sigma survey at his company, we'll have a holyday with his friends (on friday, being thursday-friday the weekend for Saudi) and follow up with a couple of the hospitals we visited in the last days. He's a great guy, both nice, funny and deep.

I have learned a lot in these days in KSA both from the professional and the cultural point of view, and I'll post more about this side of the trip in the next posts, so stay tuned for the next posts from Riyadh, and for more flavour from the middle east!

April 27th 2010 - Day 4 in KSA: Stefano feeling sick, team around Jeddah

Waking up this morning was really hard: headache, nausea, ... I guess I was victim of withdrawal symptoms from the total lack of alchool since last friday (or may it have been the japanese sushi, or maybe too much blogging and to less sleeping ...). Anyway, I woke up, had a shower and reached Khalid at the lobby; Khalid will be our guide in Jeddah for the next two days and he prepared our schedule around the hospitals of the city. I'm definitely not at my best and decide that I won't join the team for the morning, so I have to rely on what they told me to update our followers with the latest news from Saudi.

The first stage is at the opening of the Saudi Critical Care Society conference; since the speakers speak arabian, the most remarkable element the team reported from the experience is the high quality of mango fruit juice.



After this the team has an interlocutory meeting at the King Fahad Military Hospital followed by two really good meetings: one at the local offices of the Ministry of Health, and one at the Saudi German Hospitals. When Brian, Roberto and Youssef get back to the hotel I'm feeling much better and can join them to discuss about these days in KSA and write a draft of the daily report with all notes and impressions from the hospitals we visited (the report is slightly different from what you can read in this blog: two complementary tales of the same working trip experience).

Tonight we'll meet again with the guys of RTKL and continue our discussions on technology assessment and planning, Ferrari, strange transplant interventions, etc.

I leave you with a sight of Jeddah at sunset taken from the 16th floor of the hotel (click on it to see it larger); I can't already say much about the city, but I feel this place is really different from what I used to know. Tonight Khalid is taking us around the city; I'm not sure I'll post again (if I don't take a long sleep tonight I fear tomorrow morning I'll be again out of order), but I promise I'll soon give you further insights into this city sitting on the Red Sea.