[Post moved to other blog.]
This is my first post written for "Information to Pharmacists", an interesting Industry Newsletter with a typically idiosyncratic Aussie approach: they welcome authors of any viewpoint and profession, as long as they are respectful to others, not libellous and can write on medical/pharmaceutical issues. And "no dot points, please!" - a challenge for me, leaving behind my favourite organising technique.
Summary:
"Fist, do no Harm" not only embraces Systemic Quality, but better Economic outcomes and improved Efficiency and Effectiveness with reduced waste and Continuous Improvement. Learning and Process Improvement are common to both efforts as are monitoring outcomes: costs, clinical results and "process deviations", a.k.a. "errors".
Computing/I.T. and Medicine share a Fiduciary Duty to their clients, with the Amplifier effects of I.T. now the most cost-effective means of improving Patient Safety, Quality of Care and Treatment Effectiveness.
The enemy of Quality Improvement isn't only "Change Resistance" but faddism, like a cargo-cult adopting the outward signs whilst ignoring the underlying causes and principles.
This, not technical problems, will be the major obstacle to realising the benefits of e-Health initiatives here and overseas. Successful practice transformations have stemmed from Quality Improvement programs with electronic system assisting, not from the blind adoption of automation.
Showing posts with label improvement. Show all posts
Showing posts with label improvement. Show all posts
Saturday, July 21, 2012
Monday, July 9, 2012
Your money and your life: What the AMA and Friends of Science in Medicine won't tell you.
[Post moved to other blog.]
This piece in Business Spectator has a bunch of 'interesting' facts that both Friends of Science in Medicine and the Medical Industry body, the AMA, ignore.
Why is this??
I'd have thought it was in the Medical Profession's interest to run their operations as efficiently as possible in order to maximise their result and the benefit to individuals and to the community. That is, if that's what their Prime Mission is.
As Don Berwick formulated in 1996 with his Central Law of Improvement:
Just what is the current system designed to achieve, if its not Patient Safety, Quality of Care or Efficient, Effective use of Public Monies?
A superficial, simplistic analysis can't tell us...
But we do know that incumbents must benefit from the system: How?
This piece in Business Spectator has a bunch of 'interesting' facts that both Friends of Science in Medicine and the Medical Industry body, the AMA, ignore.
Why is this??
I'd have thought it was in the Medical Profession's interest to run their operations as efficiently as possible in order to maximise their result and the benefit to individuals and to the community. That is, if that's what their Prime Mission is.
As Don Berwick formulated in 1996 with his Central Law of Improvement:
Every system is perfectly designed to achieve the results it achieves.So, if Medical Healthcare and Hospitals aren't run efficiently and 'accidentally' kill far too many people, Why is this so?
Just what is the current system designed to achieve, if its not Patient Safety, Quality of Care or Efficient, Effective use of Public Monies?
A superficial, simplistic analysis can't tell us...
But we do know that incumbents must benefit from the system: How?
Wednesday, May 16, 2012
Egoless Practice: Becoming the Best in your Field
Jerry Weinberg coined the term, "egoless programming" in his 1971 book "Psychology of Computer Programming". Jerry describes the practice and mindset, and in 1977 co-wrote with Friedman, the definitive manual for practitioners: "Handbook of Walkthroughs, Inspections, and Technical Reviews: Evaluating Programs, Projects, and Products".
Is there a precise definition of "egoless programming" that could be expanded to a generic Professional Behaviour of "egoless practice"?
Johana Rothman is quoted by Jeff Atwood, presumably from a book, as saying:
The field of Reliability Engineering is aimed at creating near-Perfect (i.e. highly reliable) operation from imperfect parts and sub-systems. This approach can work very well, even when maintenance and fixes can't be done: the NASA Mars Rovers, Spirit and Opportunity, exceeded their 90-day design life by around 15 times, working from 2004-2010.
A working definition (unfortunately, of many parts):
Psych Effects: We see what we expect to see, and cannot see things outside our 'range'.
Human Minds are "editing machines" par excellence, we all have very efficient perceptual filters, part of our competitive advantage over other species. We've learnt to leverage by many times the compute capacity we have by ignoring the unimportant, predicting what we expect to see and quickly generically classifying actions, words and behaviours.
Our brains silently select, delete, add and change what we sense in real-time and also from our memories.
It a necessary outcome of the processing problem: Our brains don't have the compute capacity to process (receive, recognise, analyse, classify, predict, react) the full input streams from our senses.
To reduce the load, we increase our focus and ignore everything else, even shutting down irrelevant senses and heightening those that are useful. This shows most clearly in extreme circumstances like accidents ("everything slowed down") or in a "killing zone" (those who can see, experience 'tunnel vision' of the danger, or their hearing is much heightened).
Our brains "edit" what our senses provide to avoid being overwhelmed and being able to react in real-time. Our brains develop models of the world, the objects and actors in it and of ourselves, then
Hence the immutable law of Quality: You cannot check your own work, you'll only see what you expect to see, not what's 'there'.
This is more than just "proof-readning".
Virginia Satir pointed out that the two most important faculties for perfect communication were denied us:
Is there a precise definition of "egoless programming" that could be expanded to a generic Professional Behaviour of "egoless practice"?
Johana Rothman is quoted by Jeff Atwood, presumably from a book, as saying:
Egoless programming occurs when a technical peer group uses frequent and often peer reviews to find defects in software under development. The objective is for everyone to find defects, including the author, not to prove the work product has no defects. [my italics]When asked for a modern definition, Jerry pointed at Jeff's Ten Commandments of Egoless Programming.
The field of Reliability Engineering is aimed at creating near-Perfect (i.e. highly reliable) operation from imperfect parts and sub-systems. This approach can work very well, even when maintenance and fixes can't be done: the NASA Mars Rovers, Spirit and Opportunity, exceeded their 90-day design life by around 15 times, working from 2004-2010.
A working definition (unfortunately, of many parts):
- Egoless Practice is
- a Professional Behaviour
- designed to
- routinely and reliably achieve
- as Perfect as Possible outcomes
- for the Client or Service Recipient
- by knowledgable and skilful
- Practitioners
- supported by systems, processes and procedures
- that actively monitor, examine and report performances,
- for both failures and successes,
- to systematically and without-backsliding improve
- Quality, Performance and Process
- of Individuals, Teams and Organisations.
To Err is Human isn't a syllogism, it is an Iron-Clad Law.
It's the basis of the unending, relentless Professional Challenge:
- we're not machines,
- we cannot ever exactly repeat a process, not even twice, let alone the many times every day needed in Professional Practice, and
- our Minds and Bodies are always letting us down or tricking us in some way.
Simply stated: We are constantly making mistakes, inadvertently or not.
As people become older and wiser, they routinely report the veracity of "The more you Know, the more you understand how little you Know".
All Quality and Performance Improvement is predicated on engagement and care-and-concern for the people affected and the outcomes.
In the Quality Improvement approach, led by Dr Deming, the Fundamental Attribution Error, that Mistakes are due to people who have been inattentive, incompetent or negligent (or worse), is taught as a leading to The Blame Cycle, not corrective action.
Deming's Quality Improvement methodology/process is based on the tenet:
People, even the most competent and with the best will in the world, will make mistakes. The system is responsible for preventing or catching these incipient Errors before they turn into an Error, Defect or Accident.Dunning-Kruger effect: "unskilled and unaware of it" - doesn't go far enough. American Idol demonstrates, infinite self-belief without objective base: "I'm The Greatest, the Judges don't know anything!".
Psych Effects: We see what we expect to see, and cannot see things outside our 'range'.
Human Minds are "editing machines" par excellence, we all have very efficient perceptual filters, part of our competitive advantage over other species. We've learnt to leverage by many times the compute capacity we have by ignoring the unimportant, predicting what we expect to see and quickly generically classifying actions, words and behaviours.
Our brains silently select, delete, add and change what we sense in real-time and also from our memories.
It a necessary outcome of the processing problem: Our brains don't have the compute capacity to process (receive, recognise, analyse, classify, predict, react) the full input streams from our senses.
To reduce the load, we increase our focus and ignore everything else, even shutting down irrelevant senses and heightening those that are useful. This shows most clearly in extreme circumstances like accidents ("everything slowed down") or in a "killing zone" (those who can see, experience 'tunnel vision' of the danger, or their hearing is much heightened).
Our brains "edit" what our senses provide to avoid being overwhelmed and being able to react in real-time. Our brains develop models of the world, the objects and actors in it and of ourselves, then
Hence the immutable law of Quality: You cannot check your own work, you'll only see what you expect to see, not what's 'there'.
This is more than just "proof-readning".
Virginia Satir pointed out that the two most important faculties for perfect communication were denied us:
- We cannot 'see' inside anothers' head. We can't know what they are thinking and feeling, only infer it, and
- We can't see/experience ourselves as others see/experience us. (Which is why teaching communications skills with video/playback is a radical advance in the last 50 years.)
Sunday, March 25, 2012
Unsolicited advice for the new Queensland Government
Last night in Queensland, the Liberal National Party (it could only happen in QLD), won in a landslide, led by Campbell "Can Do" Newman, son of Federal Politicians and with 13 years distinguished service as an Engineer in the Army.
One of the candidates I graduated with from school, 40 years ago has a very successful legal practice, I'm an underemployed I.T. consultant.
I sent him this unsolicited advice.
Not very original of me I know, but I hope it gives a useful insight to them.
First, from my profession of I.T.
A piece of ~1,000wds on the cost to Govt. of essential infrastructure (IT) not fulfilling its promise (slanted more to CBR than QLD):
"The Triple Whammy - the true cost of I.T. Waste"
And a way out of the hole (600wds):
"Controlling Waste in Government I.T. - An Immodest Proposal"
Summary:
And establishing an Independent Authority with real teeth... One of the first actions has to be "start collecting performance and outcome data", like the 15yr old CHAOS report that reports on I.T. project outcomes in the USA.
If people and firms are assessed as incompetent or worse then, like in Aviation, the Govt has the right to de-licence them, only they aren't licenced. But they can be put on a public "not to be employed by Govt." register , which others will know if it is lawful currently or not.
Most importantly the "Authority" has to focus on Change and Improvement, not disciplining and "handing out consequences" (which is part of its remit) or it becomes counter-productive. (900 wds)
"The Accountability Paradox: Personal Consequences and Blame"
It comes down to a basic proposition:
In Aviation, not repeating mistakes is taken very seriously, but not in I.T. nor seemingly in the medical world.
In any Engineering profession, a professional who fails in this way, causing fatalities or allowing preventable economic failure, not only loses their license to practice, but is open to criminal, not just civil, charges.
Secondly, on Public Health and Hospitals.
Urgent reform is needed within Queensland Health, at many levels, but what's been tried over the last 20 years hasn't worked. A radical approach is needed, and one that is known to work.
This is not my area of Professional expertise and I wouldn't know where to start...
But I know who does and how to do it:
"An NTSB for Healthcare, Learning from Innovation: Debate and Innovate or Capitulate",
What they don't say is that Systemic Quality (my term) isn't just free, but because it embraces active, intentional learning and improvement, it is better than free:
2. Dr James' work is reflected in a major report by the US Institute of Medicine:
"To Err is Human: Building A Safer Health System" (1999).
3. Donald Berwick and the "Institute for Healthcare Improvement".
Here is a landmark article by Berwick from 1996:
"A primer on leading the improvement of systems"
BMJ VOLUME 312 9 MARCH 1996
Institute for Healthcare Improvement, Boston, MA 02215,USA
Donald M Berwick, president and Chief Executive Officer.
I'm sure you've read the 500 page QPHCI report and possibly Margaret Cunneen SC's "The Patel Case – Implications for the Medical Profession" (which as a layperson I found astounding).
Berwick formulates this problem exactly with:
Changing Organisational Rules, and making them stick, can only come from above.
This is exactly why Dr Demings' "Quality Circles" (and his teachings) worked in Japan and failed in their country of origin, the USA. Deming was hired by the heads of Japanese industry and they were able to mandate the changes.
Some things to kick off reform of QLD Health are:
One of the candidates I graduated with from school, 40 years ago has a very successful legal practice, I'm an underemployed I.T. consultant.
I sent him this unsolicited advice.
Not very original of me I know, but I hope it gives a useful insight to them.
First, from my profession of I.T.
A piece of ~1,000wds on the cost to Govt. of essential infrastructure (IT) not fulfilling its promise (slanted more to CBR than QLD):
"The Triple Whammy - the true cost of I.T. Waste"
And a way out of the hole (600wds):
"Controlling Waste in Government I.T. - An Immodest Proposal"
Summary:
Create two bodies like Aviation has, ATSB/CAA. One to investigate, identify root-causes and write detailed recommendations for remediation, and another to implement and enforce those recommendations...It means making the Audit Office do more than check for fraud/broken regulations and develop real, on-going expertise in essential disciplines, starting with I.T.
And establishing an Independent Authority with real teeth... One of the first actions has to be "start collecting performance and outcome data", like the 15yr old CHAOS report that reports on I.T. project outcomes in the USA.
If people and firms are assessed as incompetent or worse then, like in Aviation, the Govt has the right to de-licence them, only they aren't licenced. But they can be put on a public "not to be employed by Govt." register , which others will know if it is lawful currently or not.
Most importantly the "Authority" has to focus on Change and Improvement, not disciplining and "handing out consequences" (which is part of its remit) or it becomes counter-productive. (900 wds)
"The Accountability Paradox: Personal Consequences and Blame"
It comes down to a basic proposition:
Is it ever acceptable for a Professional to repeat, or allow, a Known Error, Fault or Failure?I'd argue that a number of professions owe a Fiduciary Duty to their clients/patients and professional failures in this way should result in the most serious penalties.
In Aviation, not repeating mistakes is taken very seriously, but not in I.T. nor seemingly in the medical world.
In any Engineering profession, a professional who fails in this way, causing fatalities or allowing preventable economic failure, not only loses their license to practice, but is open to criminal, not just civil, charges.
Secondly, on Public Health and Hospitals.
Urgent reform is needed within Queensland Health, at many levels, but what's been tried over the last 20 years hasn't worked. A radical approach is needed, and one that is known to work.
This is not my area of Professional expertise and I wouldn't know where to start...
But I know who does and how to do it:
Adopt the Aviation model of Systemic Quality and Deliberate Change Implementation.A recent article in the Journal of Patient Safety proposes exactly this:
"An NTSB for Healthcare, Learning from Innovation: Debate and Innovate or Capitulate",
What they don't say is that Systemic Quality (my term) isn't just free, but because it embraces active, intentional learning and improvement, it is better than free:
20% cheaper is well documented.1. Dr Brent James of Intermountain Healthcare. You can read his 2001 ABC interview "Minimising Harm to Patients in Hospital" and his "its 20% cheaper" data.
2. Dr James' work is reflected in a major report by the US Institute of Medicine:
"To Err is Human: Building A Safer Health System" (1999).
3. Donald Berwick and the "Institute for Healthcare Improvement".
Here is a landmark article by Berwick from 1996:
"A primer on leading the improvement of systems"
BMJ VOLUME 312 9 MARCH 1996
Institute for Healthcare Improvement, Boston, MA 02215,USA
Donald M Berwick, president and Chief Executive Officer.
I'm sure you've read the 500 page QPHCI report and possibly Margaret Cunneen SC's "The Patel Case – Implications for the Medical Profession" (which as a layperson I found astounding).
The inherent problem with Commissions of Inquiry is that they cannot oversee or enforce the implementations of their recommendations. The responsibility gets handed back to Govt. which delegates the Change and Improvement process to the organisation that has the problems.This fails a basic sanity test:
If the organisation could've changed itself, it would've.Continuing systemic problems are not the result of lack of knowledge or insight.
Berwick formulates this problem exactly with:
every system is perfectly designed to achieve the results it achieves.The Organisational Rules have to be changed to create more than cosmetic change because the incumbents have both an investment in keeping the status quo (its worked for them) and if they could've changed the system within the existing Rules, they would've.
Changing Organisational Rules, and making them stick, can only come from above.
This is exactly why Dr Demings' "Quality Circles" (and his teachings) worked in Japan and failed in their country of origin, the USA. Deming was hired by the heads of Japanese industry and they were able to mandate the changes.
Some things to kick off reform of QLD Health are:
- assess the degree of compliance with the QPHCI recommendations within 2 weeks.
- Any good bureaucratic will attempt to stall efforts like these for months or years. Think of the HSU Inquiry by Fair Work Australia as an outstanding example.
- look to new laws addressing Patel's deliberate action in harming patients.
- There is also a lesser offence of ' professional incompetence', proven by the statistical outcomes of a doctor. Individual victims cannot be identified, but that there are victims is proven by the stats.
Monday, September 21, 2009
Academic Freedom, Creativity and Intellectual Performance
Is there anything more important for Universities and Colleges than improving their performance in the 3 basic disciplines: Research, Teaching and Administration?
Don't they already spend huge slabs of time, effort and money on exactly this? Or more exactly, reporting this?
Publicly funded institutions are required to account for their grants.
Private Universities have to make a convincing case to students and benefactors - usually by way of "League Tables".
Academic Freedom is basic to Research, as is "The Scientific Method" to most fields of study. (Post modernists aside).
So who applies The Scientific Method to the work of Academics, Researchers or Scientists?
Who actively seeks to answer:
In the way that the Australian Institute of Sports (AIS) seeks to do with Sports. Improve the selection, training, health and nutrition of athletes, the technique & methods of coaches and study the science of sports, training, coaching and athlete management & performance: physiological, psychological, mental and emotional.
Would you be surprised to know that Rest and Recreation are critical success factors?
Over training leads to poorer results and even illness (Chronic Fatigue Syndrome).
Every University I know has some Centre for bringing the latest theories of education & instruction to their teaching academics and for training those new to teaching... But not the area I'm discussing.
In the courses I've come across in the last 5 years, there is huge variability in instructor knowledge and use of the tools provided. Providing training and support/help where needed to reduce the range is a simple, obvious step & relatively cheap - but not done. Universities I know of don't actively assess teaching delivery of all staff and work to improve performance and student outcomes.
Where do Academics find their Computing skills? Taught the basics, then left to their own devices is what I've observed. Shouldn't they be keen to learn new tools, techniques and processes to improve their performance in all fields? My direct experience is very few spend any effort in examining their use & performance with tools and technology. I've seen no institution do more than provide basic tools, and let individual schools & faculties create their own 'templates'.
My guess is they don't want to be dictated to. But how would you know unless it was formally researched?
Computing is a "Cognitive Amplifier" and a perfect fit for the work of Academics, the prototypical Knowledge Workers. (Should the field be called "Knowledge Engineering"?)
Proficiency in the "academic tools of trade" should be mandatory - like mechanics and plumbers being proficient with their tools. Especially new gadgets & techniques that radically increase productivity.
There is a systemic bias at work. What's the cause or reason?
I suspect Universities, organisationally and as individuals, confuse "Academic Freedom" with absolute freedom.
There is one academic that dared to ask & address what I think is the basic reflexive Academic Question... That his work is under valued & seldom applied is pretty much what I'd expect.
He started by asking the question:
Applying their own Methodology to their own work... What could be so hard about that?
Books by Mihaly Csikszentmihalyi in Amazon
2009 Good Mentoring: Fostering Excellent Practice in Higher Education
by Jeanne Nakamura, David J. Shernoff, Charles H. Hooker and M.C.
2008 Flow: The Psychology of Optimal Experience.
2007 Everyday Creativity and New Views of Human Nature: Psychological,
Social, and Spiritual Perspectives
by Ruth Richards and M.C.
2006 A Life Worth Living: Contributions to Positive Psychology
by M.C. and Isabella Selega Csikszentmihalyi
2006 Experience Sampling Method: Measuring the Quality of Everyday Life
by Joel M. Hektner, Jennifer A. Schmidt, and M.C.
2004 Good Business: Leadership, Flow, and the Making of Meaning
2003 Creativity and Development (Counterpoints)
by R. Keith Sawyer, Vera John-Steiner, Seana Moran, and Robert J. Sternberg
2002 Flow: The Classic Work on How to Achieve Happiness [1991 repub]
2002 Good Work: When Excellence and Ethics Meet
by Howard Gardner, M.C. and William Damon
2001 Becoming Adult: How Teenagers Prepare For The World Of Work
by M.C. and Barbara Schneider
2000 Beyond Boredom and Anxiety: Experiencing Flow in Work and Play
1999 Flow in Sports: The keys to optimal experiences and performances
by Susan Jackson and M.C.
1998 Finding Flow: The Psychology of Engagement with Everyday Life
1997 Living Well: The Psychology of Everyday Life
1996 Creativity: Flow and the Psychology of Discovery and Invention
1994 FLOW - Living at the Peak of Your Abilities
1994 Changing the World: A Framework for the Study of Creativity
by David Henry Feldman, M.C. and Howard Gardner
1993 The Evolving Self
1992 Flow: The Psychology of Happiness
1992 Optimal Experience: Psychological Studies of Flow in Consciousness
by M.C. and Isabella Selega Csikszentmihalyi
1991 The Art of Seeing: An Interpretation of the Aesthetic Encounter
by M.C. and Rick E. Robinson
1990 Flow: The Psychology of Optimal Experience
1990 Television and the Quality of Life:
How Viewing Shapes Everyday Experience
by Robert William Kubey and M.C.
1986 Being Adolescent: Conflict And Growth In The Teenage Years
by M.C. and Reed Larso
1981 The Meaning of Things: Domestic Symbols and the Self
by M.C. and Eugene Halton
1979 The value of leisure:
Towards a systematic analysis of leisure activities
(Research paper/Research Group on Leisure and
Cultural Development, University of Waterloo)
1976 The Creative Vision: Longitudinal Study of Problem Finding in Art
by Jacob W. Getzels and M.C.
1974 FLOW: Studies of enjoyment
Don't they already spend huge slabs of time, effort and money on exactly this? Or more exactly, reporting this?
Publicly funded institutions are required to account for their grants.
Private Universities have to make a convincing case to students and benefactors - usually by way of "League Tables".
Academic Freedom is basic to Research, as is "The Scientific Method" to most fields of study. (Post modernists aside).
So who applies The Scientific Method to the work of Academics, Researchers or Scientists?
Who actively seeks to answer:
What works in Academic Research & Creativity?What institutions actively seek to identify "Their Best" in each of the 3 basic disciplines and the techniques used? None that I've come across.
In the way that the Australian Institute of Sports (AIS) seeks to do with Sports. Improve the selection, training, health and nutrition of athletes, the technique & methods of coaches and study the science of sports, training, coaching and athlete management & performance: physiological, psychological, mental and emotional.
Would you be surprised to know that Rest and Recreation are critical success factors?
Over training leads to poorer results and even illness (Chronic Fatigue Syndrome).
Every University I know has some Centre for bringing the latest theories of education & instruction to their teaching academics and for training those new to teaching... But not the area I'm discussing.
In the courses I've come across in the last 5 years, there is huge variability in instructor knowledge and use of the tools provided. Providing training and support/help where needed to reduce the range is a simple, obvious step & relatively cheap - but not done. Universities I know of don't actively assess teaching delivery of all staff and work to improve performance and student outcomes.
Where do Academics find their Computing skills? Taught the basics, then left to their own devices is what I've observed. Shouldn't they be keen to learn new tools, techniques and processes to improve their performance in all fields? My direct experience is very few spend any effort in examining their use & performance with tools and technology. I've seen no institution do more than provide basic tools, and let individual schools & faculties create their own 'templates'.
My guess is they don't want to be dictated to. But how would you know unless it was formally researched?
Computing is a "Cognitive Amplifier" and a perfect fit for the work of Academics, the prototypical Knowledge Workers. (Should the field be called "Knowledge Engineering"?)
Proficiency in the "academic tools of trade" should be mandatory - like mechanics and plumbers being proficient with their tools. Especially new gadgets & techniques that radically increase productivity.
There is a systemic bias at work. What's the cause or reason?
I suspect Universities, organisationally and as individuals, confuse "Academic Freedom" with absolute freedom.
There is one academic that dared to ask & address what I think is the basic reflexive Academic Question... That his work is under valued & seldom applied is pretty much what I'd expect.
He started by asking the question:
What do Nobel Prize winners do differently?So why isn't that a core discipline and activity of every University & College?
Applying their own Methodology to their own work... What could be so hard about that?
Books by Mihaly Csikszentmihalyi in Amazon
2009 Good Mentoring: Fostering Excellent Practice in Higher Education
by Jeanne Nakamura, David J. Shernoff, Charles H. Hooker and M.C.
2008 Flow: The Psychology of Optimal Experience.
2007 Everyday Creativity and New Views of Human Nature: Psychological,
Social, and Spiritual Perspectives
by Ruth Richards and M.C.
2006 A Life Worth Living: Contributions to Positive Psychology
by M.C. and Isabella Selega Csikszentmihalyi
2006 Experience Sampling Method: Measuring the Quality of Everyday Life
by Joel M. Hektner, Jennifer A. Schmidt, and M.C.
2004 Good Business: Leadership, Flow, and the Making of Meaning
2003 Creativity and Development (Counterpoints)
by R. Keith Sawyer, Vera John-Steiner, Seana Moran, and Robert J. Sternberg
2002 Flow: The Classic Work on How to Achieve Happiness [1991 repub]
2002 Good Work: When Excellence and Ethics Meet
by Howard Gardner, M.C. and William Damon
2001 Becoming Adult: How Teenagers Prepare For The World Of Work
by M.C. and Barbara Schneider
2000 Beyond Boredom and Anxiety: Experiencing Flow in Work and Play
1999 Flow in Sports: The keys to optimal experiences and performances
by Susan Jackson and M.C.
1998 Finding Flow: The Psychology of Engagement with Everyday Life
1997 Living Well: The Psychology of Everyday Life
1996 Creativity: Flow and the Psychology of Discovery and Invention
1994 FLOW - Living at the Peak of Your Abilities
1994 Changing the World: A Framework for the Study of Creativity
by David Henry Feldman, M.C. and Howard Gardner
1993 The Evolving Self
1992 Flow: The Psychology of Happiness
1992 Optimal Experience: Psychological Studies of Flow in Consciousness
by M.C. and Isabella Selega Csikszentmihalyi
1991 The Art of Seeing: An Interpretation of the Aesthetic Encounter
by M.C. and Rick E. Robinson
1990 Flow: The Psychology of Optimal Experience
1990 Television and the Quality of Life:
How Viewing Shapes Everyday Experience
by Robert William Kubey and M.C.
1986 Being Adolescent: Conflict And Growth In The Teenage Years
by M.C. and Reed Larso
1981 The Meaning of Things: Domestic Symbols and the Self
by M.C. and Eugene Halton
1979 The value of leisure:
Towards a systematic analysis of leisure activities
(Research paper/Research Group on Leisure and
Cultural Development, University of Waterloo)
1976 The Creative Vision: Longitudinal Study of Problem Finding in Art
by Jacob W. Getzels and M.C.
1974 FLOW: Studies of enjoyment
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