There was something odd about the building that we moved into last month. It looks like something that doesnt quite go with the Art Deco or Spanish Architecture that is so prominent in Beverly Hills.


Today, I find out that its because I live in a Paul Williams Building. So I ask who is Paul Williams and I get this look of surprise from anyone I ask .. since he is such a household name in Los Angeles.

Here's something to enlighten myself and my reader.

Paley Residence, bel air, 1934 Paul R. Williams

Encouraged by his family, Williams held firm, and upon graduation from high school enrolled in an L.A. workshop of New York’s Beaux Arts Institute of Design, eventually winning the Institute’s medal of excellence. His first job in an architect’s office came by consulting the Yellow Pages and visiting the offices in geographical sequence. His weekly salary was $3.

At age 20,Williams won first prize in a city planning competition in Pasadena, California, and did well in two other design competitions before enrolling as an architectural engineering student at the University of Southern California.

Upon graduation he attended three arts schools before joining the offices of residential architect Reginald D. Johnson where he given the assignment to design a $150,000 home. "Before I embarked on my architectural career, I had never been in a home that cost more than $10,000," he later wrote. "When my employer gave me the assignment for a $150,000 home, I was dumbfounded. I couldn’t imagine how you could spend so much on a home. My employer sent me to look at some homes in Santa Barbara and I soon found out." He later joined the commercially-oriented offices of John C. Austin, where he helped prepare construction drawings of the Shrine Auditorium and the First Methodist Church, among others. In 1917 he married Della Mae Givens whom he met at the First AME Church (the marriage produced two daughters).

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Thanks Ankur, this is indeed an interesting way to communicate. I did some of it when I visit india but mostly I am amazed that this is such a universal language in all of India!

I wonder if I speak this tongue. I do use a lot of these terms but never in the way that in the table below.

Consultantese is a term coined by both consultancies and consulting clients that describes the jargon, cliches, and phrases that professional management consultants use regularly in their professional dialect. These terms are created to make consultants look impressive to their clients, colleagues, senior managers and managing partners.

• 1 Common Consultantese Phrases
• 2 Consultantese in Deliverables
  • 2.1 Chevrons
  • 2.2 Matrices
  • 2.3 Swim-lanes
• 3 Consultantese Institutions
• 4 References

From my CTOs blog:

For the last few months, I’ve been accumulating some simple examples of Consultantese from our own workplace and putting them into a file on my desktop for further study.  I’m sharing a few with you today in the hope that you will contribute others in return and help me in my collecting efforts.

Consultantese	English
Share	Say
Reach out	Call, email
Socialize	Persuade, justify, rationalize
Circle back	Confirm, respond
Project plan	PowerPoint slide
Touch base	Discuss
Challenge	Problem
Serious challenge	Disaster
Opportunity	Aftermath of serious challenge
Resource	Human being
Deep dive	Any meeting with non-trivial content
Analyze	Skim
Pushback	Disagreement
Strong pushback	Violent disagreement
Best practice	Whatever the consultant says at a particular point in time
Directionally correct	Essentially wrong, but consultant grants you some points for trying
It has been shared	You must take this as fact but the knowledge of who said so is above your pay grade
Low-hanging fruit	Work that is already done or nearly done and can easily be relabeled to create the illusion of progress
Leverage	Harvesting of low-hanging fruit (vide supra)
Straw man	Hopelessly inadequate presentation or document that is circulated only for the purpose of meeting a deadline
Optimization	The stuff we really bought the system for, but won’t get done before go-live
Value proposition	Business case based on theoretical benefit that’s impossible to measure while the consultant is still here and thus cannot be disproved

Since Catalina got cancelled this weekend, we decided to go to Lake Arrowhead which is just off 605 east of LA about a 2 hour drive and right by San Bernandino.

We drove through some very dry area and were frankly not expecting this place to be very beautiful. It was a shock when suddenly this outdoor mall appeared right by this beautiful lake that transported us back to Washington.

"The Lake Arrowhead Communities are located within the San Bernardino National Forest. For almost 100 years, Lake Arrowhead has been the premier mountain resort in Southern California. Nestled at an altitude of 5108’ in a magnificent forest of pines and cedars is Lake Arrowhead, a 782 acre alpine lake some describe as the “jewel of Southern California”. Located just 90 miles east of downtown Los Angeles, Lake Arrowhead is within a 2 hour drive of a population of 15 million people. The fresh mountain air and four-season climate is unmatched in Southern California."



We ate some very authentic mexican food and shopped around the outlet mall. Also managed to catch a wink on a bench right by the water before we headed back to LA. It was nice to see a lot of boats on the water, if it wasnt so hot - I think we would have taken a boat ride around the lake.

I've been terrible at blogging this month, its been a whole week and I havent posted my Yosemite experience.

The day before we left for Yosemite, we moved to Beverly Hills from West Hollywood, suffice to say we were up till late, tired and exhausted with the movie and very excited to sleep before we hit the road. After maybe 4-5 hours of sleep our friends joined us to start this supposedly 6 hour drive to Yosemite. Luckily we were early and it was the 3rd so we didn't hit much traffic. I was sufficiently drugged up on caffeine and we had Micheal Jackson music on the whole time as a tribute. I believe it was the Essential Michael Jackson collection that was on one of our iPODs that kept us awake.
RIP!

After a few rest stops we got to Fresno and stopped at a Mexican restaurant. That filled me up so much, I decided to take the back seat and a nice long nap. Somehow after a few miles the GPS ditched us and we ended up on 15 from 99, going through apple orchards near Bakersfield. Eventually after some roadside cherries and some directions we made it back to 99.

Our lodge was only reachable through the Yosemite entrance on 41 through the exit on 120 to get to Evergreen road, so thats how we got our first glimpse of the most beautiful bridal veil falls and half dome which one day I want to go near and maybe climb it.

The Ahwahneechee tribe believed that Bridalveil Fall was home to a vengeful spirit named Pohono which guarded the entrance to the valley, and that those leaving the valley must not look directly into the waterfall lest they be cursed. They also believed that inhaling the mist of Bridalveil Fall would improve one's chances of marriage.

Half Dome is a granite dome in Yosemite National Park, located in northeastern Mariposa County, California, at the eastern end of Yosemite Valley — possibly Yosemite's most familiar sight. The granite crest rises more than 4,737 ft (1,444 m) above the valley floor.



From there we drove around El Capitan -El Capitan is a 3,000-foot (910 m) vertical rock formation in Yosemite National Park, located on the north side of Yosemite Valley, near its western end. The granite monolith is one of the world's favorite challenges for rock climbers.



From there we exited the park on the western side and took the evergreen rd to get to the place we were staying both the nights: Evergreen Lodge. After check in Brad and I played ping pong for what seemed like hours, then planned out the next two days at the activity center and decided to relax before smores.

We had a log cabin with a big outdoor patio facing nothing but forests and wilderness.


That night after smores and sunset, we had dinner at the on site restaurant and retired early. We had a long day ahead of us.

First thing we did the next day was leave early for Touloumne Meadows. It was about a 2 hour drive on a very beautiful road which is normally closed between nov to may. After all the pine trees getting to a meadow which was so unexpectedly beautiful changed the whole scenery. We stopped by the visitor center and grabbed some food at the grill before we started on our 5 mile hike up to Lembert Dome. It was a moderate hike with a steep free climbing at the end but our end destination was way worth the sweat and tears, we saw snow capped peaks as wells as the wonderful stream through the beautiful meadows.

"Lembert Dome is a granite dome in Yosemite National Park in the U.S. state of California The dome soars 800 feet (240 m) above Tuolumne Meadows and the Tuolumne River and can be hiked starting at the Tioga Road in the heart of Tuolumne Meadows, 8 miles (13 km) west of the Tioga Pass Entrance to Yosemite National Park.

Lembert Dome was named for John Baptist Lembert who took up a homesteader in a section of Tuolumne Meadows in 1865.^[2][3]

Rock climbers can scale the face from the parking lot just off the Tioga Road, but hikers can simply walk up the back side or take the challenging steeper trek up the face starting from just east of the parking lot."

After a relaxing dinner of veggie chili, hot dogs and burgers at the grill we drove back to evergreen to take a nap before our second destination: Rainbow Pools.

"Rainbow Pools are natural swimming holes along the south fork of the Tuolumne river where one can dip their feet, take a plunge or just watch courageous kids jump the rock lined ledges into the largest of the inviting pools."

While the water was cold, it was still a lot of fun once you took the cliff dive from a ledge - climbing which required significant courage!

After I took the jump from the ledge and managed the logistics about getting my flip flop back by walking through the rugged road to get to them, we finally went back to the Lodge. This time we all took showers and got to the smores to find that the chocolates were all gone but the marshmellows were still there. Then dinner back at the lodge (the same veggie pasta for me!) and then we were so tired we pretty much collapsed the moment we hit the bed.

Next morning we tried to go the the redwood trees in Wawona before heading back to Los Angeles, but managed to capture just a glimpse of them from far since the parking lot was full and we were asked to turn around and take the bus, so our dream to go through the Redwood tree remained a wish ... but we did see some trees while we drove back out of the Yosemite National park.

The drive back was a straight shot and I drove back the entire time. We had to get back to LA early enough to get Brad's ranger from the dog hotel by 5.30 and Connie to take her quiz and midterm before 8.

All in all it was an awesome trip, short but well utilized. This is probably the most picture perfect state part I have been to in United States!

I want to end with a quote from John Muir who convinced FDR to make this a National Park and preserving this amazing piece of land so that future generations to rejoice in its beauty:

"We are now in the mountains and they are in us, kindling enthusiasm, making every nerve quiver, filling every pore and cell of us. Our flesh-and-bone tabernacle seems transparent as glass to the beauty about us, as if truly an inseparable part of it, thrilling with the air and trees, streams and rocks, in the waves of the sun,—a part of all nature, neither old nor young, sick nor well, but immortal." — from My First Summer in the Sierra (1911)

Great insight into the challenges they faces and are facing, here are some questions I especially liked:

By closely integrating care delivery, Kaiser Permanente delivers high-quality, cost-effective treatment. One of its senior executives outlines its approach.

Kaiser Permanente (KP), the largest nonprofit health plan in the United States, is renowned for the tight integration of its clinical services. KP closely coordinates primary, secondary, and hospital care; places a strong emphasis on prevention; and extensively uses care pathways and electronic medical records. By doing so, it provides its 8.7 million members and patients with high-quality, cost-effective care.

That KP can achieve such tight integration and strong results is especially remarkable in that it is not one organization but several cooperating entities (see sidebar, “Kaiser Permanente at a glance”). All these entities share a common vision: to deliver coordinated, comprehensive health care that keeps patients as healthy as possible.

The Quarterly: What are the benefits of integrated care?

Hal Wolf: KP carefully coordinates the work done by primary care physicians, specialists, hospitals, pharmacies, laboratories, and others. This approach offers several advantages. It improves care quality, makes care delivery more convenient for members, and increases communication among all the people providing care. It also enables us to find efficiencies that reduce costs, improve or maintain quality, and allow for innovation.

We believe strongly in evidence-based medicine, and we are always looking for innovative ways of delivering care. When we find an innovation that is working well, we want to propagate it as best practice throughout our organization.

The Quarterly: How do you provide integrated care?

Hal Wolf: We operate in nine states and the District of Columbia, and our operations are slightly different in each area. In all cases, however, we integrate care as closely as possible. In California, for example, we provide members with an end-to-end experience; we own and operate a large number of clinics, hospitals, laboratories, and pharmacies. At all our clinics, patients can receive primary and secondary care; at most, they can also undergo laboratory and imaging tests and get prescriptions filled. At some clinics, they can even undergo same-day outpatient surgery. This way, we take care of most of our patients’ health care needs in a single facility.

Our primary and secondary care services are closely intertwined in California. Our primary care services include everything from basic health checkups to disease-management programs. Those programs include appropriate specialist consultations when needed, but primary care physicians remain in charge of patients’ overall care. Even if patients need to be hospitalized, care delivery is seamless because all physicians and other health professionals have access to KP HealthConnect, our electronic medical record database.

In Colorado, our services are similar, but we don’t own our own hospitals. Nevertheless, we have extremely close relationships with our partner hospitals. For example, the physicians who take care of our patients at these hospitals are part of the Colorado Permanente Medical Group and have full access to KP HealthConnect. As a result, they are able to view a complete medical history for their patients, and we are able to compile a complete record of what happens to our patients while they are hospitalized. Because KP HealthConnect updates itself in real time, the records are never out of date. If a patient leaves a clinic and drives to a hospital, the physicians at the hospital can see the clinic records as soon as the patient arrives.

The Quarterly: How do you develop your care pathways? And how do you support their use?

Hal Wolf: The care pathways are developed by multidisciplinary teams using evidence-based medicine, and they are one of the fundamental ways in which we integrate care. Roles and accountabilities are clarified in the care pathways. For example, our physicians provide only part of patient care; the remainder is delivered by nurses, pharmacists, and other team members, following the pathways’ protocols. KP HealthConnect facilitates the care pathways because it includes documentation templates, alerts, reminders, and other clinical-decision support capabilities. That is the power of KP HealthConnect—the ability to bring evidence to the point of care.

The Quarterly: How do you monitor performance?

Hal Wolf: The IT system is critical; without it, we would not be able to gauge the performance of our clinics and physicians or identify differences among them. For example, our IT system allows us to identify when a clinic has made a change to a care pathway and what results the change produced. If it enabled the clinic to lower costs while maintaining care quality or to hold costs steady while improving outcomes, we want to know about it; we may well want our other clinics to implement the change. A good IT system can also help us determine whether a change that increased costs was justified by the improved outcomes achieved.

The IT system also enables us to track physician performance on a regular basis. The physicians sit down as a group to pick the targets they want to achieve and the metrics that will be monitored. We then collect the data and share the results with them—each of them can see his or her performance. We periodically repeat the process of target and metric selection to ensure that our treatment approaches remain up to date.

Of course, physician performance cannot be assessed in isolation. For example, our best physicians tend to get the most complicated cases, but this means that they tend to see fewer patients, on average, than other physicians do. Our performance-management system has to take this into account. Also, physicians provide only one part of patient care, especially for people with chronic disease; nurses, pharmacists, and other clinicians are also involved. Usually, a wide range of information must be considered to determine why a specific outcome occurred. In Colorado, for example, we use balanced scorecards to gauge the performance of each department. These scorecards look at the care delivered by each team member, not just physicians. They also gauge member satisfaction, access, service, and more. The scorecards are developed with input from physicians, the other clinicians engaged in patient care, and the health plan—the payor side ofour organization.

The Quarterly: What challenges is KP currently facing?

Hal Wolf: Like all health systems, KP faces a variety of challenges. One of our newestis how to cope with the vast amount of data we have collected about our members. Who should have access to this data? Who should be able to use it, and in what ways? As more and more information has been gathered, we’ve realized that the cost of maintaining the databases underlying KP HealthConnect has increased. We therefore have to prioritize which types of data access are most important. For example, it’s very expensive to make all data available in real time; perhaps some types of information can be archived and retrieved on an as-needed basis.

Like all health systems today, KP must focus on cost containment and efficiency improvements; we have constant discussions about the strategic needs of the organization and the investments required to support them. KP HealthConnect has enabled us to innovate in multiple areas of disease management. But we have to keep its costs under control.

The Quarterly: What advice do you have for other health systems that are thinking about creating more integrated care delivery models?

Hal Wolf: This is something we’ve been studying and talking to the National Health Service (NHS) about, and so I’ll offer a few suggestions.

First, the health system must establish an effective method for creating and implementing care pathways. As part of this effort, it must set up the right handoffs between the various providers and make certain that incentives are in place to support providers working together. The NHS, through its world-class commissioning program, is attempting to do just this.

Second, it is crucial that the health system think about how it collects and shares information. As it does this, the system must consider the needs of its constituents, such as its local providers, payor organizations, and national regulators. It must also make sure that its leaders are aligned on how and why information should be shared. We learned this lesson the hard way; developing a good IT system for a health system is a difficult task. Before we began using KP HealthConnect, we attempted to implement another approach to electronic medical records, and that implementation did not go well. We did not have focused leadership from the health plans or medical groups. That changed when George Halvorson became CEO of KP. The experience taught us that large-scale change can be achieved only if management is aligned on the same goals.

Third, the health system must determine whether its internal channels of communication are sufficiently open—and if they are not, open them. Communication is not necessarily a question of putting everyone involved in a patient’s care in the same building (although that certainly helps). Instead, it requires that everyone talk openly to each other and maintain the same patient-centric focus.

That last point may be the most important of all: the patient must always come first. We have found that the combination of a good data environment, strong end-to-end processes, clear communications, and a patient-centric focus creates integrated care. It also encourages everyone within the system to do their best.

I knew it.. some benefits from abstaining!!!