Recently in Current Affairs Category
Earlier this year, America was stunned to hear of the terrible treatment of veterans at the famed Walter Reed medical center. Whatever any of us think of the wars in Iraq and Afghanistan, there is consensus that injured veterans should receive the best possible care.
On the heels of the scandal, President Bush convened a panel of experts, led by Bob Dole and Donna Shalala, to investigate the matter. Their report, released earlier this week, revealed an unexpected surprise. To get inside the problem, the commissioners took an unconventional approach: they assumed the perspective of the patient.
The President made note of this fact at his press conference:
They took a very interesting approach. They took the perspective from the patient, as the patient had to work his way through the hospitals and bureaucracies. "WhiteHouse.gov":http://www.whitehouse.gov/news/releases/2007/07/20070725.html
Charged with investigating a crisis spanning some of the largest bureaucracies in the world, Dole and Shalala led one of the most important pieces of user research done in recent years.
To quote from their final report (PDF):
Our recommendations are few, but they are actionable. They are based on the priorities of patients and families. Essentially, our recommendations hope to accomplish three goals: To serve those injured in the line of duty while defending their nation, to support their recovery and successful rehabilitation and to simplify the sometimes overly complex systems that frustrate some injured service members and their families and impede efficient care.
To see immersive user research succeeding at this level is truly inspiring. Looking closely at its components, it clearly offers a case study for designers of all variety embarking on large projects in unwieldy organizations.
Reinterpret your mission
The objectives of the project were defined by the White House in an official "Charge to the Commission." Like many project charters, the goals were defined in the language of the client. The White House uses words like "effectiveness" and "coordination." They want to know how they can provide "high-quality" service.
But what do all of these buzzwords mean? What can you do to really dig into the problem if your starting point is this kind of lingo?
You reinterpret your objective.
It is almost cliche\xC3\xC5 now to find examples of a wounded Marine having initially been treated by a Navy Corpsman, find himself medevac\x82\xC4\xF4ed by an Army helicopter to undergo emergency surgery at an Air Force Theater Hospital. Air Force LtCol Andrew E. Moore
To put it another way, the individual soldier, sailor, or marine doesn't care what uniform the doctor struggling to save his or her life happens to be wearing.
Beginning with this premise, the Commissioners turned their charge on its head. Their mission wasn't to assess the organizations and their "effectiveness," it was to assess the whole experience of soldiers as they interact with a number of sprawling organizations.
Choose your research methods carefully
In a few short months, the nine members of the Commission visited a variety of treatment facilities, met with service members and their families, and distributed a nation-wide survey that received a thirty-percent response rate. In addition to employing their own methods and relying on the unique strengths of their team, they also evaluated the findings of earlier commissions.
When pressed for time, it is essential to use carefully targeted techniques to gather new information, while also looking to old assessments for additional information. Just because the last set of research findings were left in a storage room doesn't mean they can't offer solutions to current problems.
Redefine the problem
With the experience of wounded soldiers as their starting point, the Commissioners identified and defined where the system was failing and where it was succeeding.
A significant finding was that the first touch-point of a wounded service member's experience was very successful. Individual patients were impressed by the battlefield medicine they received. The military was also pleased by the success rate of battlefield medicine, and how the speed of evacuation increased the survival numbers of service members with serious injuries.
In the Vietnam era, five out of every eight seriously injured service members survived; today, seven out of eight survive, many with injuries that in previous wars would have been fatal. This is a remarkable record.
So with all this success, where does the problem come from?
From their own experiences with the different stages of a veteran's experience and the direct discussions with patients, the Commissioners concluded that the problem was located where the tectonic plates of bureaucracies collide.
Despite accomplishments in clinical care, problems do occur\x82\xC4\xEEparticularly in handoffs between inpatient and outpatient care and between the two separate DoD and VA health care and disability systems.
By breaking down the individual experiences of wounded service members, the Commissioners were able to separate the good from the bad in the current system. This is often the hardest part of evaluating any system. When the end result is failure, it is easy to call for wholesale change.
We designers are very good at wanting to do a complete redesign, or to make an entirely new product. Instead, the right answer is often to tweak what's wrong with the current structure or product. Incremental change, though less dramatic, is often more effective. The other side of the conservative lesson is that if you are going to call for wholesale change, make sure that you understand every step of the problem and what about each piece is broken.
The solution is in the system
In their report, the Commissioners made a number of recommendations ranging in scope. Among their recommendations is a radical shift in the structure of the disability and compensation system.
Only from the perspective of the patient would you see this single piece as the key to unlocking the crisis.
After their survival is assured, injured service members undergo a process to assess whether they can return to military service. If they must be discharged of their duties, military doctors assign them a rating to determine what level of benefits they receive.
Now a veteran, the patient must choose whether to receive their benefit from Veterans Affairs or from the Department of Defense. With little or no information, they are asked to immediately evaluate which package is better and make a choice.
It is this choice the Commissioners want to eliminate. This single bureaucratic hurdle is where too many veterans trip. At no fault of their own, they often choose poorly and are blocked from the best care possible for the rest of their lives.
Explain how your solution impacts the bottom line
To sell this radical solution, Shalala argued in the language of the bottom line. By rethinking the system, the government would eliminate a large portion of its overhead. The improvement in user experience could also result in dramatic cost savings that could then be reinvested elsewhere.
Other recommendations, such as early treatment of brain injuries, could also be funded by this restructuring.
Learning from this process
Whether the report's recommendations will be implemented is still an open question. Some have criticized the report for not investigating the role the Bush administration played in setting the stage for this crisis.
Regardless, there is much to learn from the process that Dole and Shalala used to complete the Commission's work. They reinterpreted their mission by assuming the perspective of the user instead of the organization. Focussed research enabled them to then clearly define the nature and source of the problem. The recommended solutions emerged from this clear understanding of the entire system and how changes to key pieces could make the most difference.
This process mirrors the ideal strategy and research phase of the design process, and we designers can learn a valuable lesson: If focussing on user experience can uncover solutions to the most intractable problems of large government bureaucracies, surely it is the right approach for our clients.
I am, without a doubt, no fan of Condoleeza Rice. Her bizarre pronouncements on subjects ranging from foreign policy (her duties) and fundametalist Christianity (her personal life) disturb me. She makes me want to throw things when I see her, like Janus, earnestly defening the double-speak of this administration. I am, on the other hand, quite a fan of The New York Times, the gray lady, the last bastion of "liberal" reporting.
A story on the front page of NYTimes.com today about Ms. Rice seemed to go a little to far in liberally deciding what news is fit to print.
Dance of Diplomacy Is Grist for the Gossip Mill documents the chatter surrounding Ms. Rice's professional associations. Condoleeza, you see, is notoriously single. Some people, including me at times, have delighted in rumors of her pining for the President himself. But such indulgences do not befit a newspaper of such stature.
The particular subject that prompts today's article is the news that Canada's strapping young foreign minister, newly single after his MP-ladyfriend traded him in for the other party, might be of interest to our Secretary.
He has a tan and the build of someone who spends his time on the rugby field, not holed up reading G-8 communiqu?\xA9s. Sure, at 40 years old, he is younger than Ms. Rice, who is 51, but that did not stop gossips from engaging in baseless speculating.... O.K., there needs to be a disclaimer right here. Foreign ministers rarely have a lot of alone time together. There is no evidence whatsoever to suggest that Ms. Rice and Mr. MacKay are linked by anything more than their shared status as singletons.
No it didn't stop the gossips and there is no evidence to warrant evening mentioning these rumors. The lack of foundation didn't stop this very article in fact, from chronicling it with all the saccharin relish of the Daily News.
So what about the juicy details? After twelve paragraphs of foreplay we get to the meat of the rumors: they had dinner and shared an airplane. Sure Javier Solana got a lift too but "he looks like, well, a diplomat."
Yeah, like, who would be interested in him.... what a dork? Right, Condi?
Whatever her quirks, Ms. Rice is the Secretary of State and while she lacks the expertise needed for such a position, being an expert on the Soviet Union and all, she still deserves the same basic human respect granted to other kooks like Donald Rumsfeld or the President. Yes I titter when Bush and Angela Merkel share an ackward moment but the story there is that the President is genuinly behaving innapropriately. Today's news chooses to focus not on anything that Rice has done apart from her job.
As a woman in a male dominated profession she deserves the basic dignity afforded the men in her position: a thorough analysis of the substance of her statements not rumor that she is trying to get in someone's pants.
Joe Lieberman, please don't run as an independent. You lost today's primary fair and square. Sure, you can point to the fact that your web site was down today to twist today's results into a claim that the true will of the voters was routed. But we all know the real reason you will run as an independent: You are an egomaniac.
Please Joe, please don't do it.
If you live in Connecticut I strongly encourage you to vote for Ned Lamont this fall. If you know someone in Connecticut, give them a call and encourage them to get out and vote for Lamont and the Democratic take-over in the Senate this fall.
Joe Lieberman represents everything that is wrong and out-of-date about the Democratic Party. Ned Lamont represents the present and the future. He is an entrepreneur, a liberal, and stands with most Americans in his opposition to President Bush's failed Republican policies at home and abroad.
And if you don't live in Connecticut, send money to that important race but also get out and help your state party win like it never has before. Howard Dean's brilliant fifty state strategy depends on each of us to do our part. Look how far the passionate people of Connecticut took the Lamont campaign and imagine how far it still has yet to go. Now think of the races in your state that were long ago written off as impossible. You can make a difference there.
May no Republican or Democrat-in-name-only run unopposed ever again!
In nearly every American city immigrants from the far reaches of the globe are joining in solidarity to demand their rights. They demand only what they have justly earned by the hardships endured on extended sea voyages in shipping crates from Hong Kong, deadly desert crossings from Mexico, and the many other myriad ways that immigrants make there way to our border.
These immigrants have earned the respect and dignity they demand through years of toil. Whether picking crops that supply our overstocked grocery stores or locked in a WALMART through the night expected to clean for little pay they have suffered as our government turns an official blind eye.
They have had enough. Their safety is being threatened by jingoistic Republicans desperate to garner votes in the fall elections by inflaming the latent racism and desperation of the white working class. These machinations will fail and through solidarity and public protest the deep believers in the promise of America who take to the street today will have their voices heard.
Immigrant communities, it is reported by the press, are divided over whether a strike is the best course of action. One need only look at the direct cause and effect of a few short weeks ago. The House of Representatives had passed reprehensible legislation that would have made the millions of undocumented workers who clean our offices and stores, pick our vegetables, and construct the edifices of our opulence into felons. In Los Angeles and elsewhere, students and workers took to the streets demanding justice.
Congress responded. The protests worked. The Senate reached a better compromise. The new position is not good enough, but those who took to the streets learned that they could stay the hand of intolerance through mass action.
Today is another opportunity and as I drove to work this morning I was excited to see the shops in the immigrant neighborhoods closed. I was glad to see traffic a little lighter than usual and imagined that all of those people would be joining the marches.
I'm at work today and not at the mid-day march. I will join the afternoon march for those who did not take off work. I am the descendant of immigrants, we all are. We all must turn out and show solidarity.
In last weeks debate, George Bush harangued John Kerry about his failure to include Poland when describing our glorious "coalition of the willing." Although Poland had agreed to support the invasion, there were no Polish boots on the ground in the first wave.
Although this picture doesn't do them justice, these cops outside the Metro are armed to the teeth.
Standing with pistols strapped to their legs they appear to be carrying H&K sub-machine guns. These weapons are traditionally used by special forces units and paramilitary SWAT teams in urban combat environments.
These police officers stand there in an apparent effort to ensure security and are used only as tour guides. The crowd swirls past going down into the subway and the cops stand chatting to each other answering the questions of passersby.
When I see this display of power, men dressed like soldiers guarding my coming and going, I cannot help but question the effectiveness of this approach. After the latest terror threat, the pictures in the paper and the images on television highlighted the arsenal of our police forces.
Standing in public with big machine guns might make some people feel better but it reminds me of how misguided many of our attempts to grapple with the threat of terror still seem to be. We fail to ensure the security of containers coming into our ports and relax the security requirements at out airports. Instead we have these men stand outside my metro station and have other men walk large dogs through the station that bark at commuters waiting for their trains.
Do they make me safer? Do they lower the risk of an attack? D.C. commuters hear the message announced over the loudspeaker warning us not to forget our bags to "prevent what happened in Madrid from happening here." I see how not leaving a bag behind accomplishes this task but do not see how these men help that mission. Are they there to deter something from happening?
As I watch them standing there, I notice that their sub-machine guns are in fact loaded. These guys mean business. Is there some threat that they know about and we don't? I think of myself as a fairly rational guy and yet I am scared seeing these men. I am scared of what they are trying to prevent.
I also find myself scared of what they represent. They remind me of photographs from Israeli newspapers of police in Tel Aviv or Jerusalem. Is that what this has come to for us?
Or is this instead a mere flexing of muscle to make me feel at once secure and afraid of what I am being secured from.
I see them there. I see their guns and I wonder if they really make things better for my safety. It reminds me of the situation where a gun in someone's home is put to bad use. The criminal who uses a gun against its owner. Do guns in crowd situations pose similar risks? Could some crazy person come along and try to grab one of the many guns carried by these policemen and harm me?
If this is supposed to make me feel safer then it isn't working! I feel more at risk than ever.
Following recent allegations that Iraqi Prime Minister Iyad Allawi personally executed as many as six prisoners with his pistol, Americans soldiers are telling reporters that they have been ordered to walk away when they encounter agents of the new Iraqi government torturing prisoners.
The Allawi accusations recently made the rounds in the Australian press (here, here, and here) but made no ripples in the mainstream American or European media. The story was covered somewhat in the blogosphere and looks to be approaching the tipping point.
A story on Saturday in The Oregonian reports that American national guardsmen saw men in plainclothes "beat blindfolded and bound prisoners in the enclosed grounds of the Iraqi Interior Ministry."
The soldiers intervened and "found dozens of Iraqi detainees who said they had been beaten, starved and deprived of water for three days." Exploring the compound, the soldiers "counted dozens more prisoners and what appeared to be torture devices -- metal rods, rubber hoses, electrical wires and bottles of chemicals. Many of the Iraqis, including one identified as a 14-year-old boy, had fresh welts and bruises across their back and legs."
After disarming the Iraqi torturers they radioed for orders and received a strange response. Lt. Col. Daniel Hendrickson of Albany, Ore., reports that his superior officers told him to return the prisoners to their abusers and immediately withdraw. It was June 29 -- Iraq's first official day as a sovereign country since the U.S.-led invasion.
Both stories allege sanctioned Iraqi torture and American soldiers and operatives being told to look away. Although we claim to have handed authority of Iraq "to Iraqis," the unavoidable perception remains that if something goes wrong we had a hand in it. Iyad Allawi is a former U.S. agent and to many Iraqi's that employment appears to be influencing his current decision making.
His recent effort to offer amnesty appeared at first to be a genuine attempt to resolve the situation. However, Allawi's American handlers quickly became nervous about the impact of this policy in America and made their demands. Allawi was told that if anyone who had killed an American was given amnesty then it would be difficult to justify to the American people. Allawi immediately issued a corollary to the amnesty decree declaring that all who killed Americans would not be welcome. To the Iraqi on the street it reinforced two dangerous ideas: that Allawi was a mere puppet and the Americans truly see the lives of their troops as far more valuable than the lives or ordinary Iraqis.
Recent fighting in Najaf reveals the continued presence and strength of both rebels and American troops and conditions only appear to be deteriorating. A puppet of American power is in no position to convince the Iraqi people that he can solve their problems. Infrastructure problems are ongoing and the security situation is collapsing. As Paul Krugman pointed out last week, American casualties continue mount with 42 American soldiers dead in Iraq in June and 54 in July. The war has not stopped on the ground, it has merely left the front page of the newspaper and been edited out of the six o'clock news.
In an odd twist, the Pentagon has apparently begun offering soldiers and their families free plastic surgery. This offer extends to breast alteration and liposuction.
Between 2000 and 2003, Army surgeons performed nearly 500 breast enlargements and more than 1,000 liposuctions on both soldiers and their families, according to Pentagon statistics cited by The New Yorker. So far this year, 60 soldiers or family members opted for breast enlargements while 231 people received liposuctions.
The purported rationale is to train military surgeons and give them on opportunity to practice. Sha, what ev!
Who is this guy?
