I'm happy to announce that I will be speaking at a few events and forums this fall. The firm I work for will also be doing some events in Boston (September) and Dallas (November), so I hope to be able to share some details here.
This looks to be an outstanding event, I'm hoping to attend the whole week (which would be great for networking with Lean Blog readers in attendance). My talk is titled, "Hospitals Heal Thyself: Using Lean Methods to Improve Patient Care."
This session will look at the application of Lean tools in the healthcare setting. From years of working in hospitals, Mark explains the benefits for patients and hospital staff from the implementation of Value Stream Mapping, error proofing, layout and process design, problem solving and more. Mark outlines the lessons learned from implementation – what works, what didn’t and lessons learned along the way. The presentation will also discuss the importance of focusing on people, not just tools, as part of the lean effort.
Other speakers include Steve Spear, Mike Rona, and Dean Bliss (a good friend of the blog).
I will be presenting here on "Lean Methods, Lean Culture, and Error Prevention." Other presenters include Dr. John Toussaint (From ThedaCare), C. Martin Hinckley (his podcast is here), Cindy Jimmerson, and a VP from Danaher.
This is not a strictly healthcare focused event, but there will be some great healthcare content and general Lean lessons that are transferable across industries.
We all struggle with taking continuous improvement from a department or process level to an enterprise level. But what would it mean to take it to a national level? What would that look like? I saw a taste of this that impressed me a great deal.
Most of you that partake in international business know that perhaps the #1 threat to business in developing areas is dealing with corruption. During a recent trip to Malaysia, the newspaper had a pretty extensive report on their own efforts to improve this. Every year a survey and study is done by Transparency International that ranks countries by corruption. You can view the study here.
What does it take to practice continuous improvement on a national scale? Fundamentally, the same thing as in organizations, except with one major difference. On the national scale, you must encourage people to do it for themselves, at all levels and all socioeconomic levels. It begins with helping people understand current reality. In the interview about Malaysia's effort, it started here: "We decided to develop an integrity survey that covers what Malaysians think about themselves." It also must be done with the right attitude. They continued: "This is the health-check that we should have had a long time ago, so that we know where we are, what we need to do to improve things." Whether it is true health checks or some other kind of assessment, how many organizations such as this go through such an effort. How do we really know where we are? Without some purposeful, explicit effort, we essentially tell a story to ourselves.
Everyone wants to see progress, but how we frame that progress is vitally important. Malaysia ranked 43rd on the study by Transparency International. That can't be too good, but that is based on external perception. There is no doubt that external perceptions will be based on past experiences and is someone is making progress in either direction, perception will lag reality. So it is important to review the internal progress based on what people see who are closest to it every day. Hence, the start of an annual survey of Malaysia by Malaysians. They state: "The only real comparison we can make is when [the following year's] results come out. Then we can see whether it is getting better or worse; and we can then move from there."
I think the healthiest comment I found was this: "We must not always compare ourselves with those who are below us." This is something that we all must remind ourselves of. Malaysia, as far as Asian nations go, is doing pretty well at 4th. Only Singapore, Japan, and Taiwan are ahead. But so are any other countries, and Singapore which it neighbors is tied for 4th in the world. The United States generally feels pretty comfortable that it has a low level of corruption, which is indeed true. Is it better to be comfortable in our own success, or focus instead on the fact that there are 19 countries that rank better that we. This is common for even lean managers inside companies. You learn, apply and become further ahead on the lean journey that just about everyone around you. Do you become focus on the gap between yourself and everyone else, or your own gap between where you are and where you could be?
I have no doubt that through the attitude and tactics taken that Malaysia will improve. I don't expect them to rank in the top 5 next year, but their efforts at transparency, reflection, and continuous improvement can only lead to positive results.
Very exciting day, I have my first copies of my book, Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction, in hand!!!
In other book news, my good friend Kevin at the Evolving Excellence blog has hosted a Q&A session with me about the book and Lean healthcare, in general. Here is the link.
I've gotten a number of questions about Amazon.com showing late August as a shipping date now. It seems that the fastest / earliest way to get a copy will be to order directly through the publisher. The books are in the Productivity Press warehouse and they should start shipping this week (check in here with a comment or email me when you get your copy).
The good news is that Lean Blog readers can use a discount code. The code is 906GW and it’s good for a 15% off discount through the Productivity Press website until August 31. The direct link to purchase my book is here. You will have to input the code upon check out in their shopping chart to receive the discount. Regular ground shipping is free.
I still don't have a copy myself, if that makes anyone feel any better. I should be getting my first copy today... I'll post some celebration photos later maybe.
Thanks for your patience. Again, you can download the first chapter for free by registering here.
For those not in healthcare, the Joint Commission is a non-profit hospital accreditation organization. You might remember that Paul Levy and Beth Israel Deaconess Hospital posted their full Joint Commission report online last year. They conduct assessments and make recommendations that are supposed to help improve safety and quality. They are also pretty universally complained about in response to their sometimes heavy-handed mandates that are forced on hospitals and caregivers.
From the articles:
The Joint Commission is studying how to implement quality processes such as Lean and Six Sigma into its business functions as a way to improve internal operations.
Throughout the rest of the year, the commission will explore training opportunities and start to develop programs that embed processes into daily routine, said Mark Chassin, physician president of the accrediting body. Changes will be implemented across the organization, including Joint Commission Resources and Joint Commission International. An ongoing challenge is to ensure that standards are effective, Chassin said. The commission’s obligation is to maintain the “highest confidence” that its standards effect change, and applying processes that have been successful in other industries to its own practices will advance that goal, he said. “When you improve on our measures, health outcomes will improve directly as a result.”
In addition, the commission will determine if its next generation of standards might also include an assessment of how well healthcare facilities are using similar quality processes, said Chassin, who gave a keynote speech to open a Joint Commission International standards practicum in Chicago today. About 100 people from around the world are studying the commission’s international standards during the practicum, which is continuing all week.
That's all well and good that they want to use Lean internally. Lean methods can apply to any process, including internal office processes for an organization. I won't begrudge them that.
But waste in health care is vividly apparent, and its potential reduction is actionable at various levels. Opportunity areas include systems redesign in health care organizations, such as through adoption of the Toyota Lean methodology; implementation of electronic health records; placing evidence-based limitations on the deployment and use of new technologies; and payment system reform. Virtually all of these opportunities create corresponding new opportunities to improve patient safety and health care quality.
The page reeks of them forming a committee to study the issue... they'll get back to us. But those in the know realize that Lean *does* work and requires more action than study at this point.
To my healthcare readers -- what are your impressions about the Joint Commission and Lean? Could they do more to help promote Lean methods?
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple iTunes.
You can use the player (use the VCR-type controls) below to listen to a "streaming" version of the podcast (or click here for the streaming audio and RSS subscription). The streaming link is faster for one-time listening (hardly any delay to start listening). Or you can use the download link to put it on your iPod or other MP3 player.
If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com or you can call and leave a voicemail by calling the "Lean Line" at (817) 776-LEAN (817-776-5326) or contact me via Skype id "mgraban". Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.
Updated 7/28: The book now shows as "In Stock" at www.productivitypress.com and amazon.com says it will be "in stock on August 16." Thanks for your patience. I've been just as antsy as anybody, since I don't even have a copy in hand yet, myself.
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Original Post 7/21:
Thanks to those of you who have pre-ordered my book. Some of you have asked since Amazon lists the release date as today, July 21. Amazon also still shows the book as on "pre-order."
I do know, from the publisher, that the books have been printed. I haven't been able to hold a copy in hand yet and I'm not exactly sure when they are going to start shipping. Hopefully this week. If I get any official confirmation, I'll post it here. Thanks for your patience.
In the meantime, I hope you've downloaded Chapter 1. There is already one reader question that came in, I posted a bit of clarification on my message board, in the section for Chapter 1. Feel free to post any other comments or questions there or in the comments here, our "virtual book club" of sorts.
This is a Lean-meets-EPA powerpoint. Download the original here. Click the little window emblem in the upper-right corner of the embedded image to see it full-screen.
It's been a while since I had the chance to post anything about Lean and Green on this blog, but when an email came across my desk at the EPA yesterday with the powerpoint above attached, I knew I had to stop making excuses for not posting and share it with Lean Blog's readers.
Most of my posts are more abstract, but here's a concrete example of how Lean can be applied to Green. In this case, EPA's Lean effort is directed inward, at our own programs and those we require our state partners to do. In particular, my colleagues in EPA Region 4 as well as in the Iowa state government used Lean to make some dramatic improvements in the process by which they issue permits for the Clean Water Act. These are the permits we issue to sewage treatment plants, power plants, large construction sites, chemical factories, and anyone else who might significantly impact water quality by dumping waste water or contaminating storm water hat goes into a river, stream, or lake.
In most states, the federal government has given the authority to issue these permits to the state environmental department (DEQ, DEP, DES, etc. in the powerpoint). In some states, EPA continues to issue these permits, often in conjunction with the state. The result is that we have 50 different ways to issue what is essentially the same permit. In some places, this permitting process can be especially onerous. One of my first jobs at EPA as an intern was to call dozens of companies that had applied for permits but had never received them to see if they were still in business or still needed the permit. Management was (and still is) trying to resolve a nightmarish permit backlog that left many permitted entities hanging in a kind of legal limbo.
Permits are supposed to be reissued every five years, ideally with stricter and stricter limits so that less and less pollution reaches the water. Companies spend a great deal of time and money applying for permits, and the conditions spelled out in their permits can have an enormous financial impact on these facilities, so we owe them a relatively fast response. But some permits are very complicated, and others involve lots of negotiation between lawyers on both sides. Those permits tend to slow down the easier, less complicated permits. Coupled with layers of bureaucracy and poor systems design, and you have a recipe for general unhappiness.
That's where many permit processes are today. Everyone is frustrated. The permit-writers are unhappy because they want to put out good permits that protect the environment but feel stymied by the bureaucracy and system. Their managers are under great pressure to speed things up, but don't want to put out sloppy permits that allow environmental harm. The facilities that apply for the permits want a resolution quickly so they can get back to work. And the public at large, usually represented by watchdog groups, is often upset because the process is complicated, hard to follow, not always fully transparent, and doesn't always produce the environmental improvements some people advocate for. Sounds like a perfect application for Lean, doesn't it?
At the same time, in another division of the EPA, we have Lean practitioners going out and preaching the gospel of Lean to manufacturing firms because of the waste reduction and commensurate environmental benefits of Lean. Unfortunately, the managers in charge of Lean and the managers in charge of Permits might not even know each other in such a large organization, so we haven't had the full buy-in we need internally to spread the message. In my own office, there are only 2 of us out of about 700 who really know much at all about Lean, and we are working hard to persuade the higher-ups to try it out internally. But getting that kind of buy-in has been difficult. That's why I was so happy to see this powerpoint come by.
Take a look at some of the results from Iowa (slides 20 and 21, with before and after value-stream maps preceding). After the kaizen event and the value-stream mapping were over, one permit process went from 51 steps to 18, from 13 decisions to 5, and from 8 loopbacks to 1. In another permit process, the time it takes to issue a permit dropped from 425 days to just 15. This is a real improvement, with a positive benefit for all of the stakeholders including the environmental groups who represent the planet at large.
There's nothing especially surprising here for experienced Lean practitioners--this is just Lean at work, with all of the usual barriers and successes. But it's Lean being applied to a particular part of the government that has a very big impact on the environment. Let's hope it catches on!
If you have any experiences with the government using Lean to improve processes, please post them in the comments.
Not long ago, I purchased a universal airplane/auto adapter. There was a packaging insert that exhorted me, the user, to NOT insert the plug the wrong way. There was even a "helpful" green line to help me line up the proper orientation (pictured at left, click for a larger view).
The problem was.... well, the plug was properly error-proofed. It was impossible to insert the wrong way. Great design.
So why the packaging insert? Why the green line? Seems like the "waste of overprocessing" to me. Extra helpful or unnecessary? How would you vote if it were your company? Do you do this to protect yourself from customer complaints, those who *do* try to force it together the wrong way?
The much-maligned software salespeople telling the truth? It was bound to happen. Mark Kuta, a former software salesperson, is peddling a book. In an online interview about the book:
Describe one of your case studies you used in the book.
The beginning of the book describes a case where I felt like that guy in “Catch Me If You Can,” you know, the guy that pretends to be a doctor, or an airline pilot, etc. I was pretending to be a lean manufacturing consultant when I was actually a software salesperson. While not understanding anything about brake presses, kanban’s or TAKT time, I used the methods I outlined to close the deal with a bunch of Ivy League MBA’s.
Wow, as a "not pretend" lean manufacturing consultant, that paragraph REALLY rubs me the wrong way. OK, I shouldn't disparage all technology salespeople. But here you have a guy sort of admitting he was pulling a fast one on his customers ("C-level" executives who bought $94 million worth of software from him). Does this speak more poorly about the salesman or the buyer?
Pulling a fast one on fancy MBA's.... way to go. I'm sure the MBA's might not have known anything about kanban or takt time either (so shame on them). If they believe the "siren song," then shame on the buyer, but you'd think sellers have some obligation to be ethical as well.
The phrase "caveat emptor" (buyer beware) is popular for a reason. If someone is selling you software, automation, or any technology that is positioned as a "silver bullet," don't believe it. There are no easy answers in life. Don't expect Lean to be an easy answer either. Toyota's success comes from dedication to the boring stuff -- developing great processes and developing people. Toyota's not successful because they have better technology. I worked at a GM plant that had the SAME technology as a Toyota plant, yet productivity was HALF of Toyota's -- because we hadn't yet shifted to a Lean management system.
Kuta's book, aimed at salespeople those building their "personal brands" (I hope he gives credit to Tom Peters in his book), says you should "think like a CEO." Does that include being tricked by technology salespeople into paying "more than list price," as his website points out. How dumb do you have to be to pay MORE than the listed software prices. Yes, that is unheard of. Until now.
The district hopes to reduce the figure to $983 million over the next five years by delaying completion or only partly completing some buildings, and by hiring a construction-management company that specializes in “lean” building techniques.
I hope they mean "our Lean" -- Lean, as in the Toyota Production System concepts. Does the construction company use Lean methods in construction (reducing delays and improving quality) or do they design so the hospital can be operated with Lean in mind (reducing travel distances for patients and staff, having properly sized and designed spaces)?
Hope they don't mean the colloquial "lean" -- meaning "less space they need."
Many hospitals *are* using Lean concepts in design or re-design. Some of those stories are covered in my book, particularly the case of LeBonheur Children's Hospital in Memphis and the design of their new emergency space...
Has your hospital used Lean methods for design or re-design? Click "comments" to share your experiences. Do the architects usually "get it" or are you having to re-educate them what a "Lean Hospital" would look like?
What's the purpose of thinking about work as a value stream? Is it just a buzzword? It helps us identify how our activities connect and flow together in order to deliver value to some customer. So let's look at the process of succession planning and development from that perspective. Succession planning as a value stream might be considered a subset of the much larger talent development value stream (see wikipedia on succession planning).
When we don't think of succession planning as a value stream, we just think in terms of the end result. The end result is knowing who will replace a key position if that person leaves, is fired, or is otherwise not available. Most organizations skip to the final result: they name one person who best fits into that role. That answers the open question on the table, but it doesn't solve the real problem, which is how do I get someone to the point that they could replace someone.
GE is an example of someone doing this right. They have systems, evaluations, relationships, goals, and resources all designed on developing leaders to their full potential with the assumption that tomorrow's division presidents and CEOS are working somewhere in the company today. When Jack Welch was getting ready for his retirement, he had 3-4 individuals that he, the board, and the shareholders all would have been comfortable as a replacement. Warren Buffett is in a similar situation, with 2-3 "deemed worthy" successors sitting in the wings. On the other hand, no one can imagine or can see anyone being groomed and prepared to take over for Steve Jobs at Apple. The naming of a successor is not just an event, it is instead the end result of a thought out and managed value stream of leaders.
As with any value stream, we must consider its design and execution in the context of the changing environment in which it operates. As it relates to succession planning, a great example is found in the privately-held family business. The commonly-accepted flow was that "dad" (it's not always dad but the majority still is) would run the business until they were in their 50s or 60s at which point they would retire. The son, daughter, son-in-law, or other next-generation-representative would then take over in their 30s or 40s with some experience behind them but also plenty of time to make their own mark and take the business to a new level. How is the environment changing? Quite clearly, each generation is living longer, and working longer. This has a dramatic impact on the value stream. If dad is going to run the business until they are 75, son doesn't want to wait until they are 50 to take over. So instead they leave and find something else to do. Now there is no one "downstream" in the succession process to take over. Right now there are many privately-held business in that condition looking for a solution in ownership and leadership.
How do you look at succession planning as a value stream? Ask yourself these questions:
First, what is the value, what are customers willing to pay for? This is defined by having a clear leadership model. There is no right leadership model, you must develop that based on who you are, who you want to become, and where you want to be.
Second, what is the takt time, or customer demand rate? You will need to develop leaders at a certain pace, and that pace is probably constantly in flux depending on your current conditions. If you industry is headed for a certain level of decline, it might not be as attractive and you have to develop people at a faster pace to replace outgoing leaders. It's just as important to know if you have a slow need for new leadership.
Third, understand the activities that make up that value stream, from initial hiring to exit. Look at the flow. Very often, there is a great deal of batching of the development of leaders centered around late in the value stream. It is very helpful to spread more of that change upstream to earlier in a leader's career. Although it is spread across more "product" that may not make it, it is cheaper and those investments have longer to pay you back.
Lastly, measure it, manage it, and improve it. Measure you pace, your success rate, and your fallout in the succession planning value stream.
It's more a story of exchange rates (weak dollar) than Lean, but manufacturing isn't dead yet, especially in Wisconsin.
As someone who re-opened a closed factory says:
"America got tired of manufacturing," Mr. Martinez says. "But it remains a great way to make money."
Some handy stats on the U.S. manufacturing economy from the article:
Nationally, only about 10% of the U.S. work force is currently employed in manufacturing. That's down from a peak of about 42% in the early 1940s, and about 18% in the 1980s.
But while manufacturing now represents about 12% of gross domestic product, down from 15% a decade ago, exports have surged. Last year, the U.S. exported about $1 trillion worth of goods, up 39% from 2002, when the dollar started its decline. The National Association of Manufacturers, a trade group, estimates U.S. exports will hit $1.1 trillion this year. A weaker dollar makes U.S. goods more price-competitive in Europe and other lands with a strong currency.
Now let's hope the surviving and newly-opened factories are also applying Lean methods...
Do you know of similar stories from your part of the country? Factories being re-opened or mini-manufacturing booms?
I'm proud to report that I survived driving in the U.K. for the first time today, driving about an hour to Cambridge. I'm working in a town without a direct rail link (would have to go down to London and back up... wasted motion) and the bus takes about 3x longer than driving. So I sucked it up and rented a car. Got a small GM product called a Vauxhall Astra (pictured in blue, parked at the Cambridge American Cemetery and Memorial).
It was my first time driving on the left side of the road. I have some experience with roundabouts from some time in the northeastern U.S., but they go clockwise here and there are A LOT of them everywhere. I'm happy to say I don't think I endangered anybody directly.
It's a challenge, requiring concentration, to shift driving habits after 18 years of driving in the U.S. I was sure to rent an automatic (not always easy to get here) since I didn't want my brain to explode thinking about driving a manual (which I am capable of, just not on that side and not while focusing on keeping left).
It got me thinking (on the way back, when my comfort level grew and I didn't have to focus 100% on "keep left, keep left... not too far left... keep left." I started thinking about Lean and how we often, with Lean improvements, change the way people's work is done. Think about going from working in batches to single piece flow. It feels weird at first. It's awkward for a while, then you start getting comfortable and it's OK.
I use an exercise with teams in training that doesn't EXACTLY correspond to my driving experience today, but I'll share it anyway. You can do this at home. Write (or type) a name like "George Washington" ten times and time how long it takes (my team here chose to write Winston Churchill, no joke).
Now, we're going to institute a somewhat nonsensical "efficiency improvement." Now type or write just every other letter of that name and time it.
Gog Wsigo
Gog Wsigo
Gog Wsigo
etc....
It's 50% fewer letters... should be half the time, right? NO! It's real awkward and requires a ton of thinking. Until you get a few down (and start copying your work instead of thinking so much), then it gets easier.
It's "better" but it's also "new," so there is a "learning curve" involved. The first few "Gog Wsigo"s take much longer than 1/10th of the previous time. But, then it gets much faster and the time to write 10 is much faster (although not 1/2 the previous time... because of the learning curve effect early on).
We use this example to emphasize an important idea in change management -- not giving up too early! If you give up on your new process when it's new and "it's difficult," you'll go back to old ways and lose out on your benefits that would have come from the improvement.
That said, you have to make sure you aren't just being stubborn if the new process truly is NOT better than the old one... the old PDCA cycle requires checking, not just waiting for things to automatically get better via the learning curve.
Do you have similar experiences from your work? Or your own driving over here?
p.s. It took me 55 seconds to write "George Washington" ten times (with pretty poor quality, I'll admit). The 2nd faster attempt took 35 seconds for ten. Not 1/2 the time. The first "Gog Wsigo" took about 8 seconds... slower, but then I got faster.
A returning guest (episodes #30 and #38), Bob Emiliani is again featured in episode #48 of the LeanBlog Podcast. Bob is the President of The Center for Lean Business Management, LLC. He is a leading authority on Lean management, who since 1995 has focused his efforts on de-mystifying the "black art" of Lean leadership. In this episode, we talk about his "Real Lean" series of books.
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple iTunes.
You can use the player (use the VCR-type controls) below to listen to a "streaming" version of the podcast (or click here for the streaming audio and RSS subscription). The streaming link is faster for one-time listening (hardly any delay to start listening). Or you can use the download link to put it on your iPod or other MP3 player.
If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com or you can call and leave a voicemail by calling the "Lean Line" at (817) 776-LEAN (817-776-5326) or contact me via Skype id "mgraban". Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.
It's always interesting to read about GE's shift from a Six Sigma company to a Lean Six Sigma company. Their CIO, Gary Reiner, is responsible for their Lean Six Sigma program, which is unique for a Chief Information Officer.
From the FORTUNE article:
You've been in charge of GE's Six Sigma initiative since it started, in 1996. Are you still getting value out of it?
We've been aggressively trying to migrate away from talking about tools and instead to talking about outcomes. Six Sigma is a tool. It is a wonderful tool, but it is a tool. What we're talking more about as a company is outcomes, and the two outcomes we really want are product reliability and customer responsiveness.
So we start with that and work our way back to what tools are needed to make that happen. For product reliability, the Six Sigma tools are sensational. On the responsiveness side, it's often less about using Six Sigma and more about getting the right people in the room to map out how long it takes for us to do something in front of customers and, using mostly common sense, take out those things that get in the way of meeting our customer needs responsibly.
That's great that they are focusing on outcomes, not just tools. He's right about Six Sigma, but it would also be true to say that you shouldn't just focus on tools with Lean either. Are you doing the right things for the customers and for the business? That's the real point of any of it. What Reiner describes above sounds very much like a Value Stream Mapping exercise to identify waste and waiting time through the whole process, not just any one area.
For example?
In our GE Money business we offer private-label finance to retailers. We are the financing behind jewelry stores and pharmacies and the like. Sad to say, it was taking 63 days from when a retailer contacted us saying it wanted to consider using us as a private-label financier until it could conduct the first transaction with our financing. No one had calculated this before we went on this journey.
We did a number of what we call lean workouts, where we get everybody in the room to map out the process, and they got it down from 63 days to one day. The leader of that business was able to go out and have as his marketing campaign, "Enroll today. Transact tomorrow." When we did that, sales doubled. And there are 30 examples of that throughout the company.
That's a wonderful example of using the Lean approach to take non-value-added time out of a process. Look how they used Lean to drive sales and revenue, not just as a "cost cutting" exercise. Nice stuff.
For all the talk about companies increasing prices because costs are going up (ignoring, at their own peril, basic supply-and-demand economics), Tesco has it right, I think. Their CEO and Chairman, Sir Terry Leahy, says:
"It's impossible for us to manipulate our prices because in this market if you price up unilaterally, it's commercial suicide. Therefore the industry would have to do it collectively, but it can't because that would be collusive behaviour.
How many of the companies that are raising prices, using costs as an excuse, are committing "commercial suicide?" Time will tell.
Another thing in the article that reminded me of Toyota was Tesco's frugal and spartan headquarters, as described by The Independent:
It's not exactly how you would expect to find the boss of the world's third biggest retailer. After 20 minutes' train journey into the indeterminate hinterland just outside London you walk a few hundred yards to a rather seedy industrial estate. It announces itself with a garage offering MOT testing and repairs. Barely a hundred yards beyond the car bashers looms a low-slung concrete block. This is the global headquarters of Tesco: annual sales £51.8bn, yes, billion.
The single receptionist sits beneath a sign reading: "Every Little Helps". Two minutes later Sir Terry Leahy is in the reception to take me upstairs to a fittingly unpretentious office.
Frugality - a core Lean principle, don't you think? "Every Little Helps" -- that's kaizen at work.
No, it's not that I've had bad food. Far from it! I know this isn't a food blog, but I wanted to briefly discuss two blog-worthy experiences.
Conveyor Belt Sushi
First, I ate sushi off of a conveyor belt tonight. Well, not directly off the belt. But I ate at an outpost of the UK chain Yo! Sushi, where sushi and other dishes travel around a conveyor belt in covered dishes. You just reach forward and take what you want. The plates (and their prices) are color coded, a visual control of sorts. But it's often hard to see what's underneath the clear domes if it's a hot/warm dish, as steam fogs the clear bubble lid. At the end of the meal, they count up your plates and you pay. It was the tastiest conveyor belt I've ever been around.
One of the newspapers had a story about how some of the locations aren't as clean as they should be. I guess I was seduced by the automation! Hey, it's a trap that many factories and hospitals fall into, so why should I be immune, this one time? Should I have been concerned about cleanliness or food safety? Call me brave. I figured they would "clean up their act" after the news stories. I did wish there was a clearer visual indicator of how long the food had been on the conveyor belt.
"Pay What You Think The Meal is Worth"
I can't find a website for them, but I ate (a few weeks back) at a restaurant called "easyCurry" (it's probably a trademark infringement suit waiting to happen... calling easyJet, they are using the same font as you in their logo).
They have a unique concept. You pay £5 ($10 US) to get in, an "admission fee," they call it. Then you order one starter, one main, one veggie side, and rice or naan (and ice cream if you want it.... I have some willpower, I said no to that). You get charged normal prices for drinks, but then at the end you "pay what you think the meal is worth". Cash only.
I paid another £10 total at the end of the meal. I had one beer (£2.65). The £10 included my tip, but its unclear how they work that out with the staff (which is a big issue over here right now). The food was OK. I figured £15 wasn't outrageous for a full meal with a beer. I wonder if their average take is better than if they charged normal prices? How many people would feel shamed by walking out without paying more? This is a new restaurant... and maybe a risky strategy in a down economy. At least it isn't "all you can eat," for their sake.
Has anyone else heard of a restaurant (or any business) a pricing concept like this? I guess it's the clearest illustration of "value is defined by the customer" that I've seen in a long time.
There's so much in the news about "checklists" in the medical context... and I'm convinced that it's basically the Lean "standardized work" approach in a different name.
Checklists help prevent people from making mistakes of omission -- forgetting a step when following a routine or doing the same work day in and day out.Making mistakes like that doesn't mean you're "stupid" - it's a sign that we're human. That's why airline pilots use checklists and more surgeons and other health care providers are doing the same.
The other morning, I noticed a checklist being used at my hotel. It was a single sheet clearly labeled, "Morning Front Desk Activity Checklist." There were about a dozen items that needed to be done, with room for checking them off. I'll bet with the proper use (and oversight) of this checklist, there isn't a morning where someone forgets to post the accounts of those checking out.
Hopefully, checklists aren't viewed as insulting or demeaning. Checklists are common sense -- they work. They help ensure that people don't make mistakes or omissions... what's wrong with that?
Trust me, I'm not picking on the NHS. There's a lot of good things happening here with Lean and I'll blog about some of that soon.
This article from the Sunday Independent highlights some numbers on medical errors:
Medication blunders by NHS staff are killing patients at a rate of two a month and costing the health service £775m a year, a watchdog has revealed.
The National Patient Safety Agency (NPSA) has found that thousands of patients are being given the wrong drugs, too little or too much of their prescribed medication or miss doses altogether.
The study found 60,000 "medication incidents" were reported by hospitals, GPs, pharmacists and community health centres over 18 months up to June 2006. Thirty-eight patients died as a result of these mistakes and a further 54 were dangerously harmed.
Experts believe that fewer than one in 10 cases are reported, suggesting that there may have been as many as 708 deaths out of one million incidents.
When you look at patient safety or medical error problems across the United States, Canada, and the U.K., they're roughly the same on a per-capita basis. It's not like any country is an order of magnitude better or worse than others. The operational processes tend to be the same across countries, leading to similar results, regardless of the payer system involved.
The response to these errors? We need more "Lean thinking" than what's demonstrated in the following quote:
These findings come a week after the NPSA Rapid Response Report which urged "extra care" when administering powerful drugs such as morphine, amid concerns incorrect dosing had caused several deaths since 2005.
As I've blogged about before (and write about in my book), "being careful" is not enough. Being careful is a good start, but bad processes and bad systems can defeat even the most careful of individuals. Urging staff members to be more careful, in my view, is unlikely to do much long-term good. Firing employees after the fact of an error doesn't do anything to improve the underlying processes.
If a process was error-prone, someone else is likely to make that same error again. If you could proactively identify which employees or physicians are likely to not be careful, those who going to cause an error, then just proactively fire those people. Problem solved right? Not really. We don't have that ability, so we'd better focus on processes and systems... not just "being careful."
The Lean approach urges us to create "error proofed" processes. Toyota and Lexus don't have better quality because their people are "more careful." It's all about systems and processes.
. Gwendolyn established Quality Methods International (QMI) in 1991 as a consulting, training and research firm, specializing in the Visual Workplace.
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