conversation matters

Guidelines for Leveraging Collective Knowledge and Insight

Knowledge workers in any organization have a wealth of insights that are available to their organization to address the difficult issues the organization is facing. Drawing out those insights requires bringing knowledge workers together in meetings that are expressly designed to take advantage of collective knowledge. Over the years, as I have designed such meetings, I have come to rely on seven principles that work together to make the most of collective knowledge in conference settings as well as in-house meetings. The principles have been assembled from the work of many researchers and thought leaders. Where possible I have identified the sources.

1. Connection before content
Knowledge workers attending a meeting or conference need to get connected to each other before they try to construct new ideas together (Peter Block). In order to work effectively with others, they need to know:
a. who is in the room
b. what knowledge others have
c. how others think about the issue of the meeting, and
d. the group’s strengths and weaknesses

In a business context, connecting is best accomplished by engaging knowledge workers in small group conversations about strategic organizational issues. To build connections, those conversations have to be structured in a way that allows knowledge workers to frame themselves in a positive light, relative to their experience and successes. Icebreaker type exercises are less useful when the intent is to leverage collective knowledge because they do not provide adequate understanding of others’ knowledge and experience.

When a group has come together many times, the period of connecting can be brief, but not neglected altogether. Just as two friends typically engage in “small talk” for a few minutes each time they meet, any group that comes together regularly also needs a brief period of re-connecting before turning to content. In both situations the “small talk” affirms the relationship and the readiness to engage the topic.

2. Circles connect
Circles represent unity. They help individuals in the group view themselves as part of the whole. For example, the UN meeting hall is designed in concentric circles to provide a visual representation of what the UN stands for – unity among nations.

I was reminded of the benefits of seeing oneself, and being seen, as a part of a whole, when I conducted an exit interview with Lieutenant General Maples, then Director of the Defense Intelligence Agency. He told me that one of his first actions as Director had been to remove the large rectangular conference table in his office and have it replaced with a round table. He very clearly understood the difference a circle would make to the many, very difficult conversations he would have in the coming years.

It is a useful symbolism to begin and end meetings with chairs in a circle. It can be a big circle of 30+ or many small circles of 5. Ideally it is a circle of just chairs, without a table. Knowledge workers have a profoundly different experience when they converse in a group, absent a table.

3. Learn in small groups – integrate knowledge in large groups
We learn and create new ideas through our conversation with others in small groups. A small group is 3-5 members. This is the size that produces the richest and most in-depth thinking. It is large enough to contain diverse views yet small enough for members to engage each other.

Engaging each other means asking questions to clarify the meaning another has expressed and it means challenging as well as building on others’ ideas. The give and take of the small group serves to exchange existing knowledge as well as generate new knowledge.

In meetings designed to draw on the organization’s collective knowledge, after small groups have been in conversation, their ideas are brought together in a large group setting to integrate their insights into the thinking of the whole. In a lengthy meeting, small and large group discussions regularly alternate.

4. Diverge then converge
Any meeting that is focused on collective knowledge must first diverge in order to draw new ideas out and to stimulate thinking. “Knowledge diversity facilitates the innovative process by enabling the individual to make novel associations and linkages” (Cohen and Levinthal). Meeting leaders who want to leverage collective knowledge, intentionally invite people from other disciplines, stakeholder groups, and outside experts to introduce that diversity.

Without time for divergence the many differences within a group are not expressed and without their expression they cannot be made use of by the group. It is in the critical space that lies between divergent ideas that innovation often emerges (Scott Page).

Knowledge workers are reluctant to turn their thinking to what they have in common until they have had an opportunity to give voice to their differences (Marvin Weisbord). The way the human brain works is to first recognize differences and only after those are clarified to focus on similarities.

The first part of a meeting, whether it is half a day or 3 days, is dedicated to divergence. The second part of a meeting converges to put those divergent ideas to work in terms of a complex issue that needs to be addressed.

5. Outside experts inform the thinking of others, not provide them answers
Bringing outside experts into a meeting can provide much needed cognitive diversity, but experts cannot provide solutions. It is the knowledge workers of an organization, who function within its context and who together understand the complexity of its issues, who are uniquely capable of developing workable solutions.

Experts can stimulate the thinking of knowledge workers by talking about what others have done in similar situations. But any practice from another organization or team always has to be adapted, not adopted. Even the best of examples have to be modified to fit a new context.

Fifteen minutes is adequate time for an expert to stimulate a group’s thinking. A presentation by an expert needs to be immediately followed by a period of time dedicated to participants connecting what the expert has said to their own knowledge and to thinking with others about how that knowledge can be used. Without committed time for processing, an expert’s ideas are forgotten within a couple of hours. Unfortunately, the ubiquitous Q&A does not provide the needed processing time; rather what is needed is time for colleagues to talk with each other in small groups.

6. Connect new ideas to what knowledge workers already know
Processing is about moving new ideas from short term to long-term memory by connecting the new ideas to knowledge worker’s existing knowledge. The term, absorptive capacity (Cohen and Levinthal), references the ability of knowledge workers to recognize the value of new, external information, assimilate it, and apply it to their organization’s issues. An individual’s or an organization’s absorptive capacity, is a function of their prior knowledge. That means that without related knowledge to connect new ideas to, new knowledge will not be absorbed.

In meetings designed to exploit collective knowledge, a more robust environment for knowledge linkages to be made is provided when knowledge workers from varying disciplines are present. A knowledge worker from engineering, for example, will have different prior knowledge than one from R&D, and different yet from a knowledge worker from legal. The greater the cognitive diversity of prior knowledge in the room the more likely that new knowledge, from outside or internally, will be connected to prior knowledge which will spur insight. To process new knowledge, group discussion, made up diverse participants, is most effective. If the group is small (3-5 participants) each knowledge worker has enough airtime to put their ideas into words – which leads to the last principle.

7. We learn when we talk
This principle is central to leveraging the collective knowledge of a group. Listening provides us new ideas but as long as those ideas are just swimming around in our heads, they are neither fully formed nor implementable. It is only when a knowledge worker puts an idea together in a way that allows him or her to explain the idea to others, that the idea takes shape for the knowledge worker, as well as for the person the knowledge worker is talking with.

Johnson and Johnson, researchers at the University of Minnesota, have shown that we organize information in a different way when we are preparing to explain our thinking to others. The information not only becomes more logically organized, but new connections are made, often in the act of speaking. It is fair to say, “We don’t learn when we listen, we learn when we speak,” or write, or even create a visual representation of our understanding. Giving knowledge workers the time needed to put their thinking into words, not only shares the organization’s knowledge, but creates it.

Implementing these seven principles requires considerable change in how we design meetings and conferences - but then the idea of leveraging collective knowledge itself requires considerable change. More expansive thinking about who within the organization has valuable knowledge with which to address organizational issues, necessitates new approaches to how we meet and work together. These seven principles, tested through research and practice, provide a way to design those new approaches.

How to Make Use of Your Organization’s Collective Knowledge – Accessing the Knowledge of the Whole Organization - Part I

Collective knowledge is the next step beyond knowledge sharing for organizations. More than just making use of the existing knowledge employees have, collective knowledge makes use of the sensemaking capabilities of employees.

Sensemaking is the very human act of creating meaning out of the incredible amount of data and input that continuously surrounds everyone within an organization. Sensemaking is a creative act, not an act of discovering or uncovering what is already there. The meaning created through sensemaking did not exist before the conversation that created it. In conversation the meaning that is created alters as new data and new patterns in the data emerge. The understanding that results from sensemaking is not a definitive answer, rather it is an understanding that is adequate for the organization to plan and take its next action.

The need for leveraging collective knowledge arises when organizations face difficult, complex issues – the kind of situations that are marked by disagreement on what the problem even is and certainly disagreement on what would constitute an acceptable solution. I have written a number of blog posts about organizations that have faced such issues, e.g. the US Army facing the issue of changing how doctrine is produced, the World Health Organization’s eradication of smallpox, the cancelation of NASA’s Constellation program.

Understandably most leaders see it as their responsibility to come up with answers for the complex issues their organizations face, ascribing to the manager-as-problem-solver model of leadership. That has certainly been the predominant model for thirty years - taught by most (but not all) business schools, management development programs and propounded by best-selling management books. However, over the last few years a new way of thinking about leadership has been gradually emerging. The leaders of the organizations I have written about in this blog are people who have come to understand that no one person has the sensemaking capacity needed to deal with truly complex issues, no matter how highly placed the leader is. These leaders have redefined their role from problem solver to conversational architect, designing ways to leverage the knowledge of the whole organization when faced with complex issues.

Collective Knowledge can be accessed at different levels within an organization, that is, the whole organization, divisions, teams/groups, or even between two individuals. Here I am focusing on accessing the knowledge of the whole organization.

I told the first story about a leader recognizing that he needed the sensemaking capability of the whole organization in a book I published in 1994, The Organizational Learning Cycle. It was the story of Ralph Stayer, the CEO of Johnsonville Foods. Johnsonville Foods was faced with a complex issue in the form of an opportunity. It was a small, family owned sausage company known in Minnesota for its quality. The issue the company faced was whether to “accept an offer from a food-processing company to buy large quantities of product on a regular basis. It was a complex issue because Johnsonville did not have the capacity to handle the job so accepting it would mean everything would have to change.

Stayer called a meeting of the whole organization, giving them all of the information he had and asking them to work in teams to answer three questions: What will it take to make it work? Is it possible to reduce the downside? Do we want to do it? The teams struggled with the questions for almost two weeks, wrestling with the risks, which were considerable, and figuring out how they would have to operate to accomplish that much increase in production. In the end the teams almost unanimously recommended taking on the new business. Reflecting on the process, Stayer said, ‘If you issue orders you’re telling people, don’t think; just do. But if you’ve got 1000 people, you’ve got a 1000 minds. And if you issue orders from the top, you’re using only 3 of them, or 2, or one. That’s stupid.’”

The second story is one that Ron Heifetz wrote about in Leadership Without Easy Answers. I’ve summarized it here but the full story is woven throughout his book and he uses it to build the case for leaders moving from the role of problem solver to convener of the conversation.

William Ruckelshaus was the head of the US Environmental Protection Agency (EPA) in 1983 when he dealt with a case involving a copper plant near Tacoma Washington. The Asarco plant was the only one in the nation to use copper ore with a high content of arsenic. Ruckelshaus was expected to decide what to do about the plant; in particular, he was expected to determine what constituted an "ample margin of safety" in the plant's operation to protect public health.

The plant had spent 40 million dollars on equipment to reduce emissions even before the EPA got involved. They were ready to install new converters at a cost of four million dollars that would reduce deaths from cancer from four persons a year to one. But there was no technology available to reduce the emissions further.

If Asarco were to close the plant it would be a devastating economic blow to the region. The former mayor of near-by Ruston, told reporters, "I've worked in the plant all my life. So have my brothers, and so have my neighbors. We're not sick. This town was built around that plant. People came here looking for fire and smoke in the 1900's to find work. Now the government's complaining about that same smoke and trying to take our children's livelihood away."

Ruckelshaus refused publicly to decide on his own. He said, "For me to sit here in Washington and tell the people of Tacoma what is an acceptable risk would be at best arrogant and at worst inexcusable." He wanted to solicit the views of those that would be most affected by the EPA ruling. He decided the usual public hearings would be preceded by public workshops. The three public workshops held that August were controversial and packed with people, including a large number of smelter workers, union representatives, local citizen organizations, and environmental groups. After a formal presentation by EPA, the audience was divided into small groups to discuss the issues while the EPA staff circulated to answer questions.

The workshops and hearings surprised the EPA staff. As Ruckelshaus put it, local citizens had shown that they were "capable of understanding [the problem of the smelter] in its complexities and dealing with it and coming back to us with rather sensible suggestions." After the three EPA sponsored workshops, local groups began holding their own workshops.

It was not easy for Ruckelhaus to take such a radical position. Throughout the months of discussion Ruckelhaus was frequently vilified in the press. He was likened to Caesar who was asking the crowd to signal thumbs up or down on whether a defeated gladiator should die. The Sierra Club said it was the EPA’s job to protect the public health not to ask them how many people should die from cancer.

Through the EPA workshops and the community’s own workshops, local people began to see the situation in a new light. Rather than view it solely as a conflict between jobs and health, many people began to see a new possibility, the diversification of the local economy. That idea was obvious in retrospect, but at the time no one had seen it. By the time the plant closed in 1985, (due to falling copper prices) Ruckelhaus had still not made a decision, but Tacoma and Ruston had already begun the task of diversifying its economy. People had come to the early workshops displaying buttons labeled either "Jobs" or "Health." By the final workshops, people were sporting buttons that said "BOTH."

What a conversational architect does, as illustrated in these two stories, is to convene a conversation about the tough issues that the organization needs to face. The leader brings together those who are impacted by the issue and creates a setting in which he/she can draw on the collective knowledge to arrive at a workable solution.

In the post The Power of the Conversation Architect I discuss the critical tasks of the leader/convener in detail:
• Frame the conversation
• Identify who needs to be in the conversation
• Design highly interactive activities to fuel the conversation
• Use small groups as the unit of conversation
• Forge connections before discussing content
• Configure the physical space to serve the conversation

In Part II I will describe some of the conversational processes (e.g. Future Search, Appreciative Inquiry, Knowledge Café, etc.) that organizations have found useful in leveraging the collective knowledge of the whole system.

Leveraging Collective Knowledge: NASA’s Constellation Program

Every organization has the problem of how to save the knowledge it has created, but after the cancelation of the Constellation program (CxP), NASA has that problem in spades. NASA has been working on Constellation, the human space flight program that was to replace the Shuttle, for 5 years now, at a cost of 9 Billion dollars – so saving that knowledge is
critical. On February 1, 2010 the Obama administration announced the cancelation of Constellation. The administration’s intention is to pay private companies to shuttle astronauts to and from the Space Station, while NASA is suppose to turn its attention to developing advanced technologies and demonstrations, including heavy-lift propulsion research research.

In the 5 years NASA has been working on Constellation it has accrued an enormous amount of new knowledge, for example, new habitats for astronauts living on the moon or Mars, more sophisticated space suits, and of course many new vehicles including, Ares I and V, the
Orion crew capsule, and Altair Lunar Lander. With the ending of the Constellation program, the engineers and scientists who created all that knowledge will now disperse to other NASA projects, or in many cases leave NASA altogether to work for other organizations. Without some direct intervention the “know how” accumulated over 5 years will be lost.

NASA learned its lesson about losing knowledge early in 1990. They experienced the sad recognition that much of the knowledge about how to build the Saturn V rocket that took the astronauts to the moon, had retired along with the engineers who had been encouraged to take early retirement. David Delong wrote about NASA' loss in Lost Knowledge, Oxford Press 2004.

Dave Lengyel, who heads NASA’s Risk and Knowledge Management Program is committed to ensuring that Constellation’s knowledge will not be lost. But the task of saving it is an enormous one. The program is spread across NASA’s ten centers from the Kennedy Space Center in Florida to the Jet Propulsion Lab on the West coast, each working on a different aspect of the program.

What Lengyel needed in order to meet his commitment, was a knowledge capture strategy that would provide direction over the next year as the program shuts down. The capture strategy needed to include:
* how to identify the most critical knowledge to be retained
* effective methodologies for capturing knowledge
* how the captured knowledge should be formatted so it would be most useful to other parts of NASA or to the commercial companies that might eventually use it
* effective knowledge transfer techniques for a wide range of explicit and tacit knowledge
* an estimate of the potential cost of capturing and storing five years of work
* a way to prepare engineers with the skills to effectively capture and then transfer what they have learned

Lengyel chose to address that need by leveraging NASA’s collective knowledge to create a knowledge capture strategy. He invited 35 people who had worked on the Constellation program to a two day meeting in Huntsville Alabama for the purpose of jointly developing the knowledge capture strategy. Before arriving each had been asked to construct a knowledge map that identified and prioritized the knowledge in their part of the project. The group was given only minimal instruction in how to construct such a map, which resulted in a great variety of formats and content.

The first afternoon of the meeting, following the usual introductions and welcomes, the group did a walk-around their maps, each of which had been blown up to poster size. During their walk-around, which was formatted much like a poster session, they examined each other’s maps and gained ideas about how they might revise or add to their own. They learned different ways to prioritize the knowledge, ways to illustrate levels of
expertise, the need for more than one POC, etc. The knowledge map session ended with high-spirited voting for the most useful map. Each attendee was given three dots to distribute among the maps based on what each found to be most useful. The many discussions about the merits of the maps led to a number of insights about the elements a knowledge map needed to display in order to make it a valuable tool for knowledge capture.

A second activity that same afternoon was a panel discussion of KM thought leaders, myself among them, who were asked to talk about best practices in knowledge capture and transfer from other organizations. The panel got the NASA engineers thinking about what did and did not work in other organizations and generated a lively conversation about what had worked at NASA in the past.

The next day was a day-long knowledge café, complete with all the trappings including red and white checkered tablecloths and menus. The menus had nothing to do with food, rather
each menu was a list of questions to be discussed at that table. We called the table facilitators, Sous Chefs, and the Maître D’ was Dave Lengyel himself, wearing a chef’s apron. The idea behind a knowledge café is for participants to have a conversation that is as open and as fervent as they would have at a sidewalk table on the streets of Paris. And that is exactly the kind of conversation that happened in Huntsville. Each table addressed a different issue related to knowledge capture and transfer, with participants moving from table to table until they had engaged in all of the topics. Each facilitator stayed at his own table to help jump-start each new conversation and to take notes on what was being said.

At the end of a very busy day a number of the engineers commented on the experience:

“I got 6-8 new things to put in my plan.”

“It was huge dose of reality and grounded me in the difficulty in doing this. It needs to be carefully planned out.”

“Very powerful. There were experts from different disciples and I sure took away more than I gave. The networking was good.”

“I was blown away by the diversity of ideas on frameworks.”

By the following morning the table facilitators were ready to formulate a draft plan based on their table discussion. A sophisticated framework for the knowledge capture emerged as
well as detailed steps in the process. Even in this final step everyone in the room was able to comment and improve upon what the facilitators offered using Think Tank. The Think Tank software enabled each person to use their own laptop to project their reactions and comments for everyone to see during the facilitators’ summaries.

This meeting was an excellent example of leveraging collective knowledge and illustrates the three elements that need to be in place to make use of the knowledge that resides in the minds of those doing the work, 1) joint sensemaking, 2) cognitive diversity, and 3) organizational transparency.

1. Joint Sensemaking.
Dave Lengyel could certainly have sat at his desk at NASA headquarters and drawn up a knowledge capture strategy, but that plan would not have been able to take into account the unique aspects of each of the Center’s needs. It would not have been as rich nor as comprehensive as the plan the group was able to develop together. Moreover, had Lengyel constructed it on his own, he would then have had the job of selling the plan to those who would implement it – never an easy task with a plan conceived at headquarters! The Knowledge Café gave everyone the opportunity to fully express their thinking and needs and to understand the needs and thinking of their colleagues.

For joint sensemaking to occur the leader, in this case Dave Lengyel, has to take responsibility of convening the conversation – and that task itself requires a number of skills.

Framing the conversation: Before the meeting was held Lengyel had thought through what the issues were that were facing this group. Early on he provided the rationale for the meeting, then developed the topics to be addressed, and just before the meeting posed questions for the facilitators to ask.

Identifying who needs to be in the conversation. In more traditional meetings people are invited on the basis of who needs to be informed. For joint sensemaking the criteria is different, it is who can inform the conversation. Lengyel convened people who had been working on the project and would therefore know the most about what needed to be captured. He also invited engineers from the space shuttle program who had already been engaged in knowledge capture for shuttle. Others that would be tangentially impacted by the plan were invited, e.g. a CxP information systems representative, the head of CxP records management and the head of CxP security. The meeting was by invitation only - no one was required to attend - so of course Lengyel had more people wanting to come than he had room for.

Designing high interaction activities: The meeting involved several different interactive processes; the walk-around and voting for the maps, the knowledge café that
generated content, and Think Tank to refine the plan. This was the first time Lengyel had used walk-arounds, but knowledge cafés were a process he had used several times before. Several of the participants had also been involved in other knowledge cafés.

Using small groups as the unit of conversation: Smaller groups create conversations with more depth, authenticity and rigor. The café groups in Huntsville ranged from 3-7 and were different each time the group moved from table to table, which greatly enhanced networking. One of the practices of joint sensemaking is to alternate between small group conversations, where the hard work of knowledge creation is accomplished, and large group meetings where the knowledge can be integrated. This alternation was practiced and effective at the Constellation meeting.

Forging connection before content: To work on difficult issue, participants need first to gain a sense of who others are, the skills they bring, the experience they represent, and the hopes they have. Round table introductions, as useful as they are, are never enough to build the kind of connections needed to do difficult work. The Constellation meeting started in the afternoon, with the panel and the knowledge maps, and then spent the first evening with a group dinner and drinks to that built the connections this group needed to do the hard work in the knowledge café the following day.

Configuring the physical space: One of the responsibilities of a convener is to make sure the space is conducive to the type of activity planned. As happens in many situations, the
meeting space in Huntsville turned out to be too small for the number of people who showed up. Lengyel quickly re-configured the physical space by rounding up enough patio tables so that several of the café sessions were held outside in true sidewalk café style.

2. Cognitive Diversity
Cognitive Diversity (as differentiated from identity diversity) increases the possibility that a group will generate new and more creative ideas. The inclusion of people from different disciplines provides a larger set of problem solving strategies and perspectives on an issue.

The Constellation group was naturally diverse coming, as they were, from many NASA Centers across the country. Even so their experience was limited to NASA’s culture and an engineering approach to issues. By bringing in KM thought leaders, myself and Larry Prusak, Lengyel provided the group with new ways of thinking about knowledge capture and transfer. Lengyel invited in several other sources of cognitive diversity:
• Ed Hoffman from NASA’s Project Management program, APPEL, who brought a social science perspective
• a representative from Lockheed (a likely recipient of Constellation knowledge)
• a Marshall Space Flight Center History Office representative
• a NASA Engineering and Safety Center representative
• John Adams from the Defense Acquisition University (DAU) who brought in-depth knowledge about how other government organizations have dealt with shut downs based the work DAU has been doing developing insight into smart shut downs. The cognitive diversity at the meeting made a difference. As one participant noted,

“It opened my mind. I had in my head what KM was and now I have a very different way of thinking about it.”

• Organizational Transparency
Organizational transparency is the willingness of an organization to be open both about its knowledge and its problems. It is, of course, not possible to leverage the collective knowledge of an organization unless the collective is fully apprised of the issues the organization is facing. Being a government agency funded by Congress, NASA had the advantage of all employees being fully apprised of the pending shut down of Constellation. So in this situation a certain level of transparency was built in.

In two additional ways the meeting in Huntsville demonstrated organizational transparency. First, as just described, the meeting made itself open to ideas from outside NASA. This meant that those of us from outside became privy to the problems and complaints voiced by the participants, but more importantly allowing us to offer a new way of thinking about many of the issues participants raised.

Secondly, organizational transparency was demonstrated by Lengyel himself who was willing to say to NASA seniors as well as to participants at the meeting, “I need to draw on the collective knowledge of the organization to address this issue.” The acknowledgement by leadership that “I don’t have all the answers” is the pre-requisite and the first step in leveraging collective knowledge.

Collective Intelligence: The Eradication of Smallpox

All of the recent talk about collective intelligence has reminded me of one of the best examples of making use of collective intelligence – an example which occurred without benefit of social media or even the internet. I wrote about the World Health Organization’s (WHO) eradication of smallpox in The Organizational Learning Cycle, presenting it as one of four exemplary organizations. There has probably never been a better illustration of an organization learning from it’s experience; of workers freely sharing their knowledge with each other; and of drawing on the ingenuity and knowledge of frontline workers.

Smallpox is the only major human disease to have ever been eradicated. The goal was established by WHO in 1967 and ten years later the eradication of smallpox had been accomplished. But before its eradication in 1977, every year over 10 million people in Asia and Africa, where the disease was still endemic, were inflicted with smallpox and 20-40% died, with the rest left scarred and many blinded. Once smallpox is contracted, there is no treatment.

Support for a world-wide campaign to eliminate smallpox grew when it became evident that North America, Western Europe, and Japan had all been able to eradicate the disease. More recently the Philippines and much of Latin America were free of smallpox. The decision to take on this enormous task was also influenced by the US military’s recent invention of the jet injector that was capable of handling up to 1000 vaccinations an hour and could be used effectively by untrained workers. Deeming the time had now come, in 1967 the World Health Assembly began an intensive effort that would focus on Africa, Asia, the Indonesian archipelago and Brazil.

By 1967, the start of the campaign, past experience in epidemiology overwhelmingly indicated that the most successful strategy was surveillance and control – a strategy that relied on containment teams quickly moving into areas of outbreaks, insolating infected persons and rapidly vaccinating all those around them. Despite the epidemiological evidence, The WHO chose mass vaccination, a strategy that involved immunizing 80% of the population on the supposition that smallpox would then decline more or less automatically. The choice of mass vaccination over surveillance and control was influenced by a number of factors, 1) the success of a recent test of the jet injector for mass vaccination that was conducted in1963 on the island of Tonga, an isolated and remote location; 2) the push from the national governments of the cooperating counties who saw mass vaccination as a highly visible display of government action, and 3) the large investment that had been made in creating a vaccine infrastructure, including jobs and salaries. So the campaign began with a strategy of mass vaccination.

Donald Henderson led the WHO headquarters team dedicated to smallpox. He had only 150 staff to work with 150,000 fieldworkers, mostly volunteers, in 50 countries. Headquarters had no authority over the fieldworkers yet chose to deal with them as co-researchers. Headquarters treated requests for help from the field with absolute priority providing immediate responses. To diminish the gap between fieldworkers and headquarters, all headquarters staff and regional advisors were expected to spend at least one-third of their time in the field, visiting each country at least once and preferably twice a year.

Within a year of the start of the campaign an outbreak occurred in Nigeria, where 90% of the population had already been vaccinated. Fieldworkers did not have adequate supplies for mass vaccination so they quickly sent for more. But the supplies of vaccine were late in arriving. Working with the limited supplies they had, the fieldworkers sought out smallpox cases and then vaccinated those who were in the immediate geographical area surrounding each case – surveillance and containment. By the time the mass campaign supplies arrived there were no detectable cases in Nigeria – containment had worked where mass vaccination had not.

With the lessons from Nigeria, the WHO smallpox team’s strategy changed to surveillance and containment. In hindsight it was recognized that the Tonga context, an isolated island with a limited population, was very different than countries like Nigeria with contiguous areas and large populations. Even so, the decision to change the strategy was not easily taken given the factors that had influenced the original decision.

Experimenting with surveillance and containment (which fieldworkers called the Bank Robber Theory, as in "go where the money is") fieldworkers discovered they could contain an outbreak when as few as 50% of the population was vaccinated. The process involved discovering new outbreaks before the smallpox had time to spread, then vaccinating the victims families, neighbors, and then the village in an ever-widening circle until no more cases occurred.

The focus on the new strategy meant the need for new practices and policies. Considerable attention was turned to the practice of reporting, a critical element of surveillance and containment. In some countries a reward was offered to the first person in an area who reported an undiscovered outbreak to authorities. The rewards were large, sometimes equivalent to one month’s income for poor villagers. A network was established through radio connections to report outbreaks. A manual was produced detailing the philosophy of surveillance and outlining methods for improving case detection and notification. A major breakthrough in reporting occurred when each local unit began to be visited regularly by a mobile surveillance team that provided instruction and assistance. The fact that someone was actively and visibly concerned with receiving reports and then acted on those reports encouraged increased reporting.

Early on the WHO smallpox team recognized the need to constantly learn from fieldworkers’ experience and adapt and change based on that learning. Although policies were established centrally, control resided at the local level. Fieldworkers were able to alter their practices to fit local culture. For example, in some locations where tattooing was used to ward off witchcraft, the vaccination scar became a part of that custom; in others midwives were used to encourage vaccination, in yet others the radio was a major tool.

Fieldworkers thought of themselves as researchers as well as workers, systematically recording their practices and tracking data. They religiously made those practices and data available to other fieldworkers. Every 2-3 weeks a summary was made of new approaches and distributed to fieldworkers. The variation in practice and the emphasis on collecting and sharing findings allowed the WHO smallpox team to innovate and learn continuously.

One of the changes fieldworkers brought about by their collection of data was the method of vaccination. Initially the WHO used the newly developed jet injector. But over time fieldworkers realized that speed was not a factor when staff were going from house to house, or waiting at local watering holes. The jet injector proved to have maintenance problems, breaking down in the field with no way to repair it. Through the influence of fieldworkers, the bifurcated needle, a simple device that had two prongs with a wire between them on which a drop of vaccine could be suspended, replaced it. The bifurcated needle was inexpensive to make and could be flamed with a match over 200 times without dulling – so was more field-worthy.

Even longstanding techniques were questioned and changed. Headquarters learned from field reports that the time-honored technique of swabbing the vaccination site made no difference in bacterial infection – so supplies that were costly both to purchase and then transport could be eliminated. They learned, again from field reports, that adult women rarely contracted small pox, so the time consuming task of vaccinating them could be eliminated.

It would have advantaged the WHO to track the number of vaccinations given and the number of areas free of small pox. But they chose instead to track trends in the incidence of smallpox. Those data were frequently embarrassing both to the WHO and to the cooperating countries – yet it allowed the WHO smallpox team to learn in a way that could not have been possible from data that was more sensitive to public relations. Negative as well as positive results were widely publicized.

Looking back at the effort from 1999, Donald Henderson, who led the smallpox team, said, “… research initiatives were encouraged at every level. This occurred despite the opposition of senior WHO leadership who insisted that the tools were in hand and the epidemiology was sufficiently well understood and that better management was all that was necessary to eradicate smallpox. Research initiatives included the development of new vaccination devices to replace traditional lancets; field studies, which revealed the epidemiology of the disease to be different from that described in the textbooks and, in consequence, the need for modification of basic operations; the discovery that the duration of vaccine efficacy was far longer than that normally stated, making revaccination much less important; operational research, which facilitated more efficient vaccine delivery and case detection; and studies which demonstrated conclusively that there was no animal reservoir. The principle was to ask again and again, how could this programme be made to operate more efficiently, more effectively. And, indeed, without the fruits of these research efforts, it is highly unlikely that eradication would have succeeded.”1

The story of the WHO’s success is a story of learning from experience, both successes and failures. Among them:
• The initial strategy of the WHO smallpox team did not succeed and they were able to shift strategies in mid-stream
• The initial technology proved difficult, and although the jet injector was one of the reasons the project had originally seemed feasible, they switched to the simpler solution of the bi-furcated needle
• Field workers considered themselves co-researchers, creating testable hypotheses in the field and reporting the results
• Field workers had authority to experiment, adapting their practice to local situations
• Data collected in the field about both practices and results were systematically distributed
• Everything was open to question – even long standing practices like swabbing the vaccination site
• All headquarters staff spent one third of their time in the field to reduce the gap between themselves and fieldworkers
• Policies promoted the collection of accurate rather than politically correct data

We Need More Examples of Collective Intelligence
We need more examples like this story to really understand what collective intelligence means. I’d appreciate it if you would suggest organizations you know of that provide other good examples. Add them to the comments so we can all see them, and I’ll write about any here that I can dig out enough information on.

1. Henderson, D. “Eradication: Lessons from the past.”

2. Hopkins, J.W. (1998).The eradication of smallpox: organizational learning and innovation in international health administration. The Journal of Developing Areas 22, 321-322.

3. The World Health Organization Smallpox Eradication Programme

4. Smallpox: 30th Anniversary of Global Eradication, CDC