Comments on: Lean or ‘L.A.M.E.’ in a Hospital? http://www.leanblog.org/2008/03/lean-or-lame-in-hospital/ Mark Graban's leanblog.org - Lean Healthcare, Lean Thinking, Lean Manufacturing, Toyota Production System Thu, 09 Feb 2012 15:26:57 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Anonymous http://www.leanblog.org/2008/03/lean-or-lame-in-hospital/#comment-3645 Anonymous Mon, 09 Jun 2008 19:06:00 +0000 http://leanblog.bigbigdesign.net/2008/03/lean-or-l-a-m-e-in-a-hospital/#comment-3645 Obviously the focus should be on managing the process not the person. Often for complex variable demand processes a stop-watch is a good proxy measurement tool to evaluate process compliance. If a process takes longer than expected then what went wrong? Obviously the focus should be on managing the process not the person. Often for complex variable demand processes a stop-watch is a good proxy measurement tool to evaluate process compliance. If a process takes longer than expected then what went wrong?

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]]> By: Mark Graban http://www.leanblog.org/2008/03/lean-or-lame-in-hospital/#comment-3352 Mark Graban Sun, 30 Mar 2008 23:00:00 +0000 http://leanblog.bigbigdesign.net/2008/03/lean-or-l-a-m-e-in-a-hospital/#comment-3352 This was also covered on the "Pass the Buck" blog.<br/><br/><a HREF="http://passthebuck.wordpress.com/2008/03/20/disgruntled-employees-in-a-lean-hospital/" REL="nofollow">LINK</a><br/><br/>I agree with Brian's comments. You can't just write off people as "not buying into Lean." It's a leader's job to sell Lean, sell the need for change, and to help alleviate anxiety that comes with change.<br/><br/>That said, he's right, some people are always going to be unhappy with changes. This was also covered on the “Pass the Buck” blog.

LINK

I agree with Brian’s comments. You can’t just write off people as “not buying into Lean.” It’s a leader’s job to sell Lean, sell the need for change, and to help alleviate anxiety that comes with change.

That said, he’s right, some people are always going to be unhappy with changes.

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]]> By: Jason Yip http://www.leanblog.org/2008/03/lean-or-lame-in-hospital/#comment-3351 Jason Yip Sat, 29 Mar 2008 21:45:00 +0000 http://leanblog.bigbigdesign.net/2008/03/lean-or-l-a-m-e-in-a-hospital/#comment-3351 Given the tone of the comments, it smells like the core problem is not engaging the people doing the work, even before looking at gross wastes and such. Given the tone of the comments, it smells like the core problem is not engaging the people doing the work, even before looking at gross wastes and such.

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]]> By: Mark Graban http://www.leanblog.org/2008/03/lean-or-lame-in-hospital/#comment-3350 Mark Graban Sat, 29 Mar 2008 21:11:00 +0000 http://leanblog.bigbigdesign.net/2008/03/lean-or-l-a-m-e-in-a-hospital/#comment-3350 One other thing I meant to say about stopwatching... most of the waste I've seen in hospital processes (care-giving or administrative) has more to do with:<br/><br/>1) poor handoffs between roles or departments<br/>2) batching<br/>3) poor value stream design<br/><br/>These are types of "gross waste" that don't require stopwatches. At least early on, the use of a stopwatch to micromanage the specifics of "finding a faster way" to do something seems like overkill or it's possibly misguided (looking at a specific tree, not the forest).<br/><br/>Maybe VMMC is far enough along that they starting looking for waste at that level... I'm not there first hand, so I can only speculate.<br/><br/>I'd just hate for other hospitals to think that's a necessary starting point, hounding people with a stopwatch. One other thing I meant to say about stopwatching… most of the waste I’ve seen in hospital processes (care-giving or administrative) has more to do with:

1) poor handoffs between roles or departments
2) batching
3) poor value stream design

These are types of “gross waste” that don’t require stopwatches. At least early on, the use of a stopwatch to micromanage the specifics of “finding a faster way” to do something seems like overkill or it’s possibly misguided (looking at a specific tree, not the forest).

Maybe VMMC is far enough along that they starting looking for waste at that level… I’m not there first hand, so I can only speculate.

I’d just hate for other hospitals to think that’s a necessary starting point, hounding people with a stopwatch.

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