Productivity is driven by incentive and impeded by lack of control over decision making.
Leadership given and appropriate goal setting cannot be excluded from the list nor can continuing education and the proper tools, equipment and facilities. These familiar factors of productivity immediately come to mind, but there is an insidious factor which has been described as the most significant public health problem in the United States today. We are a sleep deprived nation. The investigation of the Challenger explosion revealed that sleep deprivation played a major role in the events and decisions that led to our most devastating space tragedy. In the Exxon Valdez oil spill, Captain Hazelwood was certainly remiss, however, the 3rd mate who was dead asleep directly below the blaring warning siren as the result of severe sleep deprivation could have averted the disastrous event.