Unintended consequences

There are a number of traps in this category called unintended consequences. These refer to well-intentioned, but misguided, efforts at cost reduction and other forms of operations improvement. An example is flavor of the month initiatives. For example, when total quality management (TQM) was topical, training programs and TQM teams flomished. Some organizations used the number of teams in action as the measure of TQM effectiveness. 

The consequence is higher cost in many forms. Table 24.2 lists examples of unintended consequences. They show how both buying and selling companies are affected. 

Increased purchasing overhead Added complexity to systems and procedures, unnecessary transactions Difficulty in isolating problems UnwiUingness to make capital investments. Reduced customer service Lower priority in production planning 

The principal effect on the buying company is added administration for every dollar purchased. This is incurred in the belief that it reduces the cost of material itself. On the other side, the selling company will hesitate to make the commitments needed for long-term market success. We don t think that sole source is the right path for every material requirement. But companies should have some method to make the trade-offs necessary to find the right mix. 

Another unintended consequence is illustrated by Alpha s choice of investment projects. Alpha, by virtue of its project selection process, is likely to pick project A. That project shows a good return on investment, has a strong advocacy, and represents the path of least resistance for management. But it has the risk of providing only minor improvement — in spite of all the safeguards put in place to protect the corporate pocketbook. 

One area where unintended consequences proliferate is in purchasing. We discussed the purchasing mentality in a previous section on partnerships. This paradigm looks to price as the cornerstone of supplier selection. It is difficult to argue, at least on the surface, with using price to make decisions on suppliers. 

However, having to compete and share business with others, paradoxically, adds uncertainty and reduces incentives to work hard at lowering cost. So one has to balance the need for lowest price against the need for lowest cost. The difference is that lowest price, as bid against others, may not result in the lowest cost. This is because the low bid comes with unseen costs such as quality and delivery problems — and an unwillingness to work to lower overall costs. 

The principal effect on the buying company is added administration for every dollar purchased. This is incurred in the belief that it reduces 

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Because disturbances in fluid balance are routinely encountered in clinical medicine, it is essential to have a thorough understanding of body fluid compartments and the therapeutic use of fluids. Similarly, disturbances in serum sodium, potassium, calcium, phosphorus, and magnesium are ubiquitous and must be mastered by all clinicians. Dysregulation of fluid and/or electrolyte status has serious implications regarding the concepts of drug absorption, volumes of distribution, and toxicity. Similarly, many medications can disrupt fluid and/or electrolyte balance as an unintended consequence. 

SD Horn, PD Sharkey, DM Tracy, CE Horn, B James, F Goodwin. Intended and unintended consequences of HMO cost-containment strategies results from the managed care outcomes project. Am J Managed Care 2 253-264, 1996. 

Finally, a particularly interesting ongoing challenge will be to understand the potential for do-it-yourself immune stimulation to have unintended consequences. There are now many herbal supplements, functional foods and other over-the-counter products that promise to boost the immune response and most are considered to be safe for use by the general public. Although there is limited published evidence of adverse immune system effects of these materials, some have been associated with autoimmunity [95,96], See chapter 11 for a detailed discussion of the beneficial and potential adverse effects of nutraceuticals and functional foods. 

Osborn R.N., Jackson D.H., 1988. Leaders, Riverboat Gamblers, or Purposeful Unintended Consequences in the management of complex dangerous technologies, Academy of Management Journal Vol. 31 (4), pp. 924-947. 

Evidence from the tobacco industry documents, from research studies that measure free-base directly in tobacco smoke particulate, and from examination of smokeless tobacco products, all show that the level of free-base nicotine as delivered to the tobacco user is a critical variable in the acceptance of tobacco products and their continued use. The physiological impact of the rapid delivery of nicotine in the free-base form is a critical determinant of continued nicotine-seeking behavior, with the unintended consequences of exposure to the other toxic components of tobacco smoke and smokeless tobacco. Evaluating total delivered nicotine alone is not sufficient to characterize product differences. To fully understand the influence nicotine has on the allure of these products, both total and free-nicotine levels must be measured. A comprehensive understanding of nicotine delivery is needed to help find effective means for breaking its addictive nature and, ultimately, in reducing the morbidity and mortality associated with tobacco use. The levels of free-base nicotine must be included as part of any effort to achieve a better understanding of how tobacco products themselves influence their continued use. 

Biocompatibility is an important consideration. Again, many unintended consequences are often found, unfortunately after the fact. In the areas of synthetic hip and knee replacement, use of alloys is often called for, yet some patients are found to have long-term allergies to certain metals present in minute amounts that eventually require replacement of the joint material. Thus, extensive testing is required before a new suture becomes commercially available. 

Unintended Consequences Pro-Handgun Experts Prove That Handguns... 

Filipecki, M. and Malepszy, S. (2006). Unintended consequences of plant transformation a molecular insight. J. Appl. Genet. 47(4) 277-286. 

Change Control This process focuses on managing change to prevent unintended consequences. 

Politicians, like all citizens, welcome the improvements in the physical world that have come from science, and they also worry about unintended consequences that accompany some scientific advances. In their quest to improve society, politicians have embraced science and increased government funding for research. Use of the public largesse is accompanied by political judgment and even direction about which kinds of science should be pursued and which discouraged or ignored. 

The essays in this book, written by scientists who have participated in or witnessed firsthand political-scientific interactions, provide descriptions of political manipulations of science and of political considerations. The essays describe excessive politicization—the misapplication or outright manipulation of the scientific record to advance policy agendas. Ultimately, actions such as those described have unintended consequences, the brunt of which are borne by everyday citizens, not those who politicize at the expense of objectivity. 

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