We may not know where we're going, but we're making good time.

The title is a quote from one of my favorites, Yogi Berra. When I think of this, I often think about the myriad of programs and projects that I have seen over the years that seemed to suffer from a staggering lack of cohesion, thought, or planning, or follow through. I have worked in health care for almost 40 years (I started when I was 16), so I have had plenty of opportunities, some of which will stay with me forever.
One hospital where I worked decided to adopt TQM (Total Quality Management). It is a system developed by a gent named Deming, and revolves around the concept of "Do it right the first time". The idea is that, if you can plan to be efficient and not have to re-do tasks, you can save money in a variety of ways (materials and labor). I took the class,along with throngs of other managers, was given a "Q" pin (which I never took out of the little plastic bag) and we were off. This was back in 1991 and, at that time, the hospital spent $3 million on the training. About a year and a half later, the entire program was quietly dropped. Why? There was no "champion" in leadership, no follow through, no real effort to organize the necessary effort. We basically learned that we couldn't do it right in the first place to save our lives.
Another program (at the same hospital) solicited ideas from employees on how to save money. Each idea was evaluated (you got a flashlight as a thank-you just for submitting an idea) and, if the idea was adopted, the employee who submitted the idea got a check for a percentage of the amount the hospital saved. The program was very popular with the employees, and hundreds of ideas were generated, some of them excellent. Many programs like this one, though, suffer from the Law of Diminishing Returns, where the longer you continue, the less effective it is. Programs such as this probably should have run over a defined period of time and then been discontinued. The hospital leadership, though, when the ideas petered out, decided to make submitting ideas a requirement for managers, and it was reflected on our annual evaluations and tied to any salary increase. Needless to say, my boss was not pleased when I pointed out that creativity is probably better when encouraged rather than mandated, and I learned an important lesson about shutting up.
A final example from this hospital was the famous Employee Satisfaction Survey. The administration decided to do a hospital-wide survey, and launched a huge campaign to communicate it and promote participation. They survey (allegedly anonymous) came to each employee in an individually addressed envelope. Each survey had a number on it (checking with others, I found the numbers were different on each survey, so the idea that it was anonymous began to be suspect). My suspicions were confirmed because, when I did not return the survey, I got an email from my boss right before the deadline reminding me to complete the survey. I realized I needed to return the survey to be politically correct, but I was not inclined to be helpful. Out of 100 questions, I answered 15 or 20, so they would got a returned survey from me, but not one that was statistically valid.
When the results were tallied, the administration withheld them because the feedback was so extremely negative, and they were totally unprepared to address the concerns in a meaningful way. Almost a year later, the results were released quietly, and managers were told to create action plans, few of which they had any authority to carry out. Overall, the survey was a huge flop. A lesson that administration hopefully learned was that, if you really don't want to know what's going on, and you don't intend to fix it, don't go there in the first place.
While not every idea is bad (I have been fortunate to have been involved in many good ones) there are some that should just be killed, but not all are. You have no doubt experienced many yourself from places you have worked, business you have patronized, screwball relatives, etc. The world is full of good judgement and bad and, while you want to escape the bad, sometimes it just isn't going to happen. Let's just hope the good outnumbers the bad. Some days, that's as good as it gets.