L.A.M.E. — Thinking That Lean Hurts People

‘Lean Production’ May Also be a Lean Toward Injuries

People getting hurt would be a good indicator of Lean As Misguidedly Executed. The above link is from the American Psychology Association of all places, and they are talking about physical injuries AND mental stress, in an article from 1999.

Employers’ movement toward “lean production” may be increasing workers’ risk of injury, say experts.

Makes me wonder who the “experts” are?

Lean-production practices attempt to increase productivity through continuous improvement, improved inventory systems and elimination of wasted time and motion.

But new research suggests that lean production can backfire if not implemented carefully, warned researchers at the March “Work, stress and health conference.”

That’s true. If “Lean” is not implemented properly or non-Lean concepts are called “Lean,” people might get hurt. Every environment I’ve worked in that was implementing Lean focused on Safety. Look at the common Lean metrics: SQDCM (Safety, Quality, Delivery, Cost, Morale). It’s no accident that Safety comes first. Lean environments often start EVERY meeting with a safety related topic. That’s a good practice. Lean environments don’t attempt to work people to the point of injury, Lean doesn’t ask people to work in non-ergonomic or unsafe ways. That said, people DO get hurt at Toyota factories (a fact the UAW loves to trumpet), but I’ve seen non-Lean environments that cared far less about safety than the Lean ones.

In the above paragraph, I said “Lean doesn’t….” Lean is just a word, it’s a concept. People and leaders are the ones who drive the importance of safety. People are the ones that ignore safety. You can probably have an environment where the organization is implementing Lean tools (kanban, 5S, heijunka, etc.) but does NOT care about safety. This is wrong. Caring about safety is part of the Lean “respect for people” concept, a core pillar of the Toyota Production System.

“There’s a big debate between the people who think lean production will help people work smarter and people who think it will make workers miserable,” said Sharon K. Parker, PhD, of the University of Sheffield. “It’s a very polarized debate.”

Yes, that’s a very active debate. I don’t mind shedding light on the debate or engaging in that debate here.

Lean Should Help Employees Feel Better

The article continues:

The assembly-line workers reported increased stress and depression, reduced autonomy and decreased job satisfaction. Evidence also suggested that accidents had increased and product quality decreased. Most distressed of all were assembly-line workers who had to certify their procedures as the line moved inexorably past them.

By “reduced autonomy,” they might mean that workers have to be to work at given times and take break at certain Standard times. When workers are in isolated islands, working on batches, they are often disconnected and have the “freedom” to work fast and then take breaks. Lean doesn’t allow this, as employees and their work operations are more tightly connected. You’d hope that this loss of autonomy is explained in terms of the customer needs and what is good for the company. If employees don’t feel like they win when the company and customers win, that’s a very challenging culture and leadership problem.

You’d expect that employees would have great opportunities to contribute to continuous improvement and that their ideas would be listened to by management, as opposed to the old “check your brain at the door” mentality. You’d think this would be good for mental health and self-confidence. But, if companies are implementing Lean methods (synchronized assembly lines) without also implementing the “Respect for People” side (which often happens), then the “benefits” of Lean would be missing and it would be understandable how employees would hate Lean.

In contrast to the assembly-line workers, for example, workers in cells enjoyed some positive mental health outcomes that compensated for their decreased control over their jobs. In addition, assembly-line workers’ complaints about not being listened to suggest that opportunities to provide feedback could mitigate some of the line’s negative effects.

As I would expect.

Companies may also change their ways [away from lean] when they see data demonstrating declines in product quality, said Parker, adding that 65 percent of the workers felt quality was getting worse. Unfortunately, there will be a lag before those data become available.

As I’ve written about before, it’s mind boggling to me how a company can implement Lean and have quality get WORSE. If quality is declining, that would be another sign that only a subset of the Lean methods have been implemented. If the company put workers into new roles and didn’t properly train people (not properly implementing Standard Work), then quality MIGHT decline. I would blame this more on a misapplication of “Lean” instead of a problem with Lean itself.

Something Positive, At Least

There are some positive reports in the article, at least:

In a study of a Ford facility outside Detroit, Kaminski found that a strong union and cooperative managers can work together to create a system offering the profit-enhancing benefits of lean production without harming workers’ mental health.

The facility introduced work teams in 1990. The change was designed to push decision-making down the hierarchy and increase workers’ control over their work. In contrast to other companies where supervisors dominate teams, the Ford plant chose to create teams led by hourly employees elected by their peers.

This sounds more like Lean, what Ford was doing.

It Gets Worse: Their Description of “Lean” in a Hospital

The article then goes on to describe “lean” in healthcare:

The potential for harm is even greater in the health-care arena, where lean-production techniques are becoming increasingly common. For nurses, changes in work organization can be deadly.

That’s because nurses have borne the brunt of hospitals’ efforts to maintain profits by downsizing, said Susan Wilburn, MPH, of the American Nurses Association. The association analyzed nurses’ injury rates in a dozen Minneapolis/St. Paul hospitals from 1990 to 1994.

During that period, patients’ length of stay and hours of care per day increased, yet the number of nurses decreased by about 10 percent. In this fast-paced work environment, the number of reported injuries and illnesses jumped 50 percent for licensed practical nurses, 65 percent for registered nurses and 117 percent for unlicensed “assistive personnel.” Back injuries and needle “sticks” were the most common injuries.

Downsizing is not “Lean”!!!!!!!! There’s nothing to indicate that the period from 1990 to 1994 had anything to do with Lean at those hospitals. Given the time frame, I’d suggest it’s very UNLIKELY that this was a Lean implementation. This sounds exactly like traditional cost-cutting thinking and traditional management. It’s very unfair to lump this downsizing in with “Lean.” It’s as bad as the IBM Global Services “LEAN” effort that’s just a bunch of downsizing.

I did some Lean work in a hospital lab where, in previous years, they were attempting to cut costs through the traditional benchmarking analysis and downsizing route. The remaining employees were stressed out and the system was performing poorly. We came in with Lean and promised ZERO LAYOFFS as the result of Lean improvements. This was quite a nice success story where Lean was an attempt to reduce waste and make things easier for employees while also, obviously benefiting patients.

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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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