Chapter 23: Gratified to Serve the Institution's Growth
In this segment, Mr. Daigneau looks back on his years at MD Anderson and then talks about his plans for retirement. He expresses his satisfaction that he was able to be personally involved in all aspects of organizing and planning the institution's growth as well as planning for continued improvement. Mr. Daigneau explains how he always attempted to move MD Anderson beyond a standard approach to square feet in the institution. He uses the model of Facilities Management 101, 201, and 301 to explain how he pushed MD Anderson to shift from looking at square feet as simple space, to a set of perspectives about use held by a number of different users. This is needed to meet his goal: making 80% of patients happy. When he arrived, he says, everyone at MD Anderson was in 101. By the time he left he had moved everyone to seeing space in more complicated ways. Mr. Daigneau next reflects on some lost opportunities, on challenges that came with the growth of the Division, and the need to cultivate leadership among younger people in the Division. He explains how he attempted to do this by working with Human Resources to create an aptitude test that would identify possible managers, however budget issues made it necessary to suspend this project. Mr. Daigneau explains that with the growth of the institution, it is more important than ever that MD Anderson achieve economies of scale. He notes that Dr. John Mendelsohn was able to achieve growth of the institution's infrastructure for advanced research as well as the numbers of lives saved. The reality of modern research is possible because of growth, and MD Anderson states how pleased he is to have been part of that.
The University of Texas MD Anderson Cancer Center
The Interview Subject's Story - View on Career and Accomplishments; The Administrator; Career and Accomplishments; On the Nature of Institutions; Overview; Definitions, Explanations, Translations; Discovery and Success; Building/Transforming the Institution; Growth and/or Change; Obstacles, Challenges; Professional Practice; The Professional at Work; MD Anderson Culture; Patients; Patients, Treatment, Survivors; The Life and Dedication of Clinicians and Researchers; MD Anderson Snapshot; Understanding the Institution; Healing, Hope, and the Promise of Research; Giving Recognition; Institutional Mission and Values; MD Anderson Culture; The MD Anderson Brand, Reputation
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History of Science, Technology, and Medicine | Oncology | Oral History
(laughs) Uh-hunh (affirmative). Now when you look back at your eighteen years at MD Anderson, what are the initiatives that you set in place that you're most you're happiest with" most contented to have seen come to their completion?
William Daigneau, MBA:
Well, on two fronts, it was obviously" I mean" anybody can build buildings. An idiot can do that. Can you build something that is lasting and works well over the long term? I spent a good portion of my career going in and fixing problems that other people had created because of lack of foresight, lack of planning, et cetera. So I personally am involved on the" on all aspects of the organization and the development of the planning side of things. That covers campus master planning, site and building planning, space planning. Once you have the space, what do you do with it? First of all, you should try to be utilizing ninety percent of it all of the time. You say, Well, why not 100%?" Well, because ten percent of it ought to be probably be upgraded" modernized" whatever. So just like a hospital, you don't want to be at 100% occupancy in a hospital all the time, because you don't have an even flow of patients. All the sudden, you get an influx of patients. What do you do with them? I have no place to put them. So you have to have some vacancy just to be able to handle the highs and lows of volume all the time. Same with space. CLIP A: Overview A: Definitions, Explanations, Translations B: MD Anderson Snapshot C: Understanding the Institution C: The Professional at Work Sophisticated Facilities Management at MD Anderson: A Square Foot of Space is About Different Users and Patient Satisfaction
William Daigneau, MBA:
+ You always have to have something in reserve" something held back to handle unexpected needs, unexpected growth, or to deal with modernization and maintenance and renovation. If you're 100% full, you can never deal with those things. Who do I move out to renovate their space?" Impossible to do. So you always hold that space. Space management is very important key to that" not let yourself get into a situation of, Oh, shoot. I didn't think of that." (laughs) Well, now you're affecting people. I used to give a course on" as I said, Facilities Management 101, 201, and 301. Facilities Management 101 looks basically at square foot" how to maintain that square foot, how do I create it" square foot. Just like in finance, it's the" the denomination is the dollar; in Facilities Management, the denomination is the square foot. When you graduate from 101 to 201, you realize that" what a minute. What's the square foot there for? Well, it's for some use. It's a hospital room. It's an office. It's something" it's used by something. Well, now you say, One square foot is not the same as another square foot." Now we're talking about different square feet. It has a different use, a different purpose. That's why you created it. Is it being used well for that purpose? Every square foot has been built for a different purpose, not just to create square feet. A lot of facilities managers say, Oh, that's just square foot." Well, now the realization comes, Wait a minute. I have an array of different square feet." It's like the cards in a deck. Every card has a different value. Do I want to" is my trump card an ace? (laughs) Is it a three? Different outcome! (laughs) So that's 201. When you finally graduate" when you finally get to the ultimate in your knowledge of facilities management, you realize that that different square foot is occupied by a person" a different person everywhere along the line. With people come perceptions and expectations more complex than the difference of the use now. The surgeon has a different expectation for that OR. In two different ORs, there are two different surgeons, and each of them will have different expectations. Now the complexity of that square foot just has been escalated by the variety of human beings in the world: Background, education, whatever. So is your organization looking at square foot, types of square foot, or people? I try to push Anderson" our organization towards look at the people. The only way you can deal" you can't" if you have a standard approach per square foot" for type of square foot, you're still going to get a lot of problems, because the expectation is of the people using that space. So can we make every patient 100% satisfied? No, but our goal ought to be" Pareto's Law" probably eighty percent of them are really happy with us. We'll have to try to satisfy the other twenty percent, but probably not going to make them happy, but we definitely" our goal is eighty percent of those patients say, This is the best thing that I've ever seen" my best experience ever." That should be our goal all of the time. Twenty percent of the value is in eighty percent of the items and eighty percent of the value is in twenty percent of the items. I figure that's our goal. The patients are here not because of the facilities. Why do they come to Anderson? There's a doctor that knows how to treat their cancer. So physicians" I don't care what pain in the neck they might be; if we don't give them absolutely what they need, then they're not going to be able to give the best they can to the patient. So we threaten the mission of Anderson. Researchers" why did Anderson hire them? Because they believe that maybe they can unlock the secrets of this thing. So if the researcher is worrying about their fume hood or if they're safely able to use certain radioactive materials or anything related to that" why did we bring them here? Because they can't contribute" so right along the line when you start looking at people, it unlocks the secret of all facilities, and while your purpose there and what you're attempting to do and all that. So I try to teach people to look at 301. Deal with 301. When I got there, we were looking at 101. Every square foot is the same. Get in there. Wash it down. (laughs) Then 301 says, When should I? Why should I? How do I do it?" That minimizes and maximizes" minimizes the impact on people and maximizes their contribution. So that was the whole goal all along the way" is to achieve that state.
Tacey A. Rosolowski, Ph.D:
Is there something that you wish you could have set in place during your time there but for some reason was not able to?
William Daigneau, MBA:
Well, as I said earlier, there are obviously lost opportunities. Proton Facility" I wanted to move it close to the main academic" Patient Care instead of it out on the South Campus. Now in the end, it hasn't really hurt it a lot, but we have shuttle doctors back and forth and patients back and forth. There are things that obviously didn't work" to what I think would have been the maximum solution. Sequencing sometimes didn't work out. Redevelopment and Backfill is was very difficult, because it required us to vacate space temporarily to remodel it. As I said, where's the empty space to move people to, things like that. There were difficulties along the way, and there were always opportunities I thought, Gosh, I wish I had more option than what I had at the time." But I think" the only issue that I grew to become more concerned about, especially for the structure of Facilities Management, was this issue we just talked about" the growing size of the division and problems that was starting to create in terms of decision making and response time and cooperation. The other issue that I started to deal with but had to suspend during the budget cutbacks in '08 was my" I was looking at" when I looked around at our management ranks, a lot of the people were starting to look like me in terms of age, and I became increasingly concerned that as Baby Boomers started vacating management ranks, there'd be a vacuum, and that we need to start taking steps to bring people up, identify those with management ability and interest, start developing their skills. I created what was called the Facilities Management University, which was basically an attempt to" because you have somebody" like a housekeeper. How do you know that housekeeper has more potential than" other than just doing their daily job? They may be really good with people. They may be really good planners. How can you identify that? So I worked with HR, and we actually created an aptitude test that we could give people to see if they had some aptitude towards management/supervision type skills, as opposed to just being there a long time. Oh, I've been here eighteen years, so I ought to be a manager." That's the wrong way, you know? (laughs) You may be here eighteen years, but you have no aptitude at all" no interest in managing other people other than the money, and that's the wrong reason to come up. So I started to work on that. Unfortunately, because of the budget issues, we had to suspend that effort. I was getting closer to retirement, so I figured that was something really the next generation would pick up. So of all the things I look back on, other than some of the lost opportunities" because we didn't have enough options. Some of the" obviously you always look back and say, I could have been more mature and handled this delicate situation better." There's always those, but in general I'm pretty happy that we were able to meet the needs of MD Anderson. CLIP B: MD Anderson Snapshot B: Growth and/or Change C: Healing, Hope, and the Promise of Research C: Giving Recognition B: Institutional Mission and Values B: MD Anderson Culture B: The MD Anderson Brand, Reputation MD Anderson Makes the Necessary Investment in Modern Research Space
William Daigneau, MBA:
+ You can't understate the value of leadership. Dr. Mendelsohn had some strong feelings and a vision, and I was just happy to be part of that team that" to fill in. Is Anderson a lot bigger than it was? Yes. I think, though, size isn't important, especially going into economic. There are certain economy scales that you must achieve. Not everybody can afford a cyclotron, but you need a cyclotron for some types of research. Anderson has some of that infrastructure in place" animal research, cyclotrons, imaging equipment, specialized facilities that if somebody is going to be successful at trying to unlock some of these things, I don't think it's going to come out of a garage. I think this is so vastly complex that if you don't have certain abilities, we are not going to solve that problem. Anderson has many of those abilities now. So if anything's been achieved over Dr. Mendelsohn" that growth" besides all of the patients that were served that might not have been served, all the lives that have been saved that might not have been saved, because we were able to apply our doctors and our specialists special knowledge about these things and experience these things. It's the development of the infrastructure necessary to support very advanced research" very complex research. Anderson has that scale" ability to do that now. So I think" regardless of how you feel about the good old days or whatever, the reality of modern research is now achievable because of the growth that occurred at Anderson, and I was just happy to be able to help fulfill the physical form of that vision, but it was held by Dr. Mendelsohn.
Daigneau, William and Rosolowski, Tacey A. Ph.D., "Chapter 23: Gratified to Serve the Institution's Growth" (2013). Interview Chapters. 146.