By January 13, 2009 8 Comments Read More →

Experience vs. Outside Views (or Experience + Outside)

I’m getting some really interesting and constructive comments in my reader survey. Keep it coming. I’ll reflect, summarize, and respond to it here on the blog or personally via email. Thanks to those who have taken the time.

One comment I wanted to respond to (and it’s just part of a thoughtful comment, the lengthiest of what I received):

I am a bit more on use of an experienced person to study processes, interview employees, observe, than some people who believe all you need to do is empower the existing workforce. There are a lot of tools one needs to apply, experience in process improvement makes the whole effort accelerate and increase in impact, and frankly the results are better, It’s like saying no one knows one’s body better than one’s self therefore only you can really improve it so why go to medical people. Rather you know what doesn’t feel right (as do employees in a process) but without an MD you may not be able to suggest fixes.

Yes! I agree wholeheartedly that you need to do more than free up employee time to get real, meaningful, lasting improvements in an organization (whether it’s a hospital or a factory). I also love the MD analogy.

I probably do overplay the “get your employees involved” and “just go to the gemba and listen to your employees” cards a bit. As a consultant, maybe I’m a bit sensitive to not overplay the role of a trusted consultant (or, though I shudder a bit to use the term… a “sensei”). I don’t use the term “sensei” because I’m not Japanese, nor are my clients, but that’s a different discussion.

I do articulate in my book that organizations need a good consultant for a number of reasons (and I just became “that guy who quotes himself” — sorry! I hope this isn’t the moment I “Jump the Shark.“).

On page 31 of Lean Hospitals:

Continued coaching, training, and mentoring are required, whether coming from outside consultants, internal process improvement leaders, or the direct line management and administrators themselves.

On page 217:

Regardless of the exact makeup, the Lean team requires a project leader and coach, either an outside consultant or an internal Lean leader from a process improvement department. The coach should not be expected to come up with all of the answers, nor can he or she be expected to “make you Lean” without any effort of your own. In fact, many coaches will, after training the team in Lean concepts, insist on not giving answers. Instead, the sensei will guide the team by asking questions and having the team develop its own solutions.

The outsider alone doesn’t know enough (most likely) to come up with the answers. The staff, on their own, might not push hard enough or get outside of their usual comfort zone.

A good Lean consultant can teach concepts that the employees might not have considered before, such as “single piece flow” (reducing batches) and error proofing as a quality strategy.

The equation I use might go something like this (and maybe it’s really multiplicative, not additive):

Employee Time + Lean Concepts + Leadership = Kaizen

Just turning employees loose with some time to “fix things” might lead to a lot of meetings or just some small incremental change. At the least, you have to give the employees time *and* some training in Lean concepts. “Quick and Easy Kaizen” might get you so far — employees can give “obvious” suggestions like “get the machine fixed properly” and “get us better lighting.” But, I think you also need Lean principles and concepts to get to the big waste in the process. I could be wrong… but I wonder how many teams, left to the own, would come up with radical overhauls that can come with Lean thinking?

For example, when I work with hospital laboratories, the lab employees (as smart and hard-working as they are) probably wouldn’t come up with the “Lean” layouts that we do without Lean Concepts (knowledge) and Leadership (the guts to take a risk and try something new). You’re right — the results ARE better with a combination of internal and external knowledge.

I think adding good coaching / consulting to the mix will increase the results even more. Part of that coaching includes the direct line leaders of the organization, who play a important role in setting direction and vision, keeping those in line with organizational values.

If anything is missing from that above equation, you won’t reach your full potential. If you just have Lean principles (like a lot of training or reading) without leadership or time to act — you’ll probably get zero. If you have a great outside consultant with Lean knowledge, but no involvement from the staff, you won’t get much (or the change won’t last without buy in from the staff).

What’s your experience with the balance between internal process knowledge and outside influence?

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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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8 Comments on "Experience vs. Outside Views (or Experience + Outside)"

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  1. Rick Foreman says:

    Mark;
    Great thoughts as usual. Past and present experience in aerospace and telecom lean efforts showed both good and bad results when our company brought in outside consultants. It all depended on the delivery and execution. One consultant was connected to the customer and developed internal consultants, which kind of tied it all together from an ownership view and it worked well. Yet, in other situations, the consultant came in without a sustained long term plan of engagement and influence in establishing an inside force and it failed. Our current organization has tried lean several times but it never took until there was a full time leader. In addition, we’re following the exact formula you have listed with significant results after 2 yrs into the battle.

  2. Matt Wrye says:

    I think you definitely have to balance an outsider’s view with the insider’s knowledge. A past mentor of mine use to tell me to become familiar with the process but not an expert, because experts end up having sympathy of the process. In other words, they say things like, “That is inherent to the process” and “nothing’s perfect.” Not allowing them to stretch the limits and really strive for perfection. The outsider’s view can help break that thinking and allow the expert to take the process to the next level.

  3. Michael Lombard says:

    In my organization, we definitely struggled with the “Lean Concepts” part of the equation. We had a gap in our equation, which reduced the sum of kaizen. I do think the equation is multiplicative, because having a small amount of “Lean Concepts” had a reducing effect on the other components of the equation.

    Take “Leadership” for example. Our leadership was on-board for the most part, but they didn’t know what they were on-board with exactly. They would nod their heads in support, but they didn’t understand what they needed to do to support the mission.

    “Employee time?” Employees were somewhat willing to devote their time and managers were somewhat willing to allow it. They were skeptical. They thought it was gonna be all about cleaning up and painting walls, and didn’t realize that they were gonna see a return on their invested time.

    Having an outside mentor/sensei/consultant/expert/whatever come in would have helped, I think. In the early stages, we needed to create a critical mass of leadership, lean concepts, and employee time. Having somebody come in and help catalyze the initiative would have enabled us to achieve that critical mass and begin producing kaizen. That success would have gotten fed back into the equation and we would now be improving exponentially!

    Maybe outside experts are best used as an awesome short-term tool until an organization achieves critical mass?

  4. Mark Graban says:

    Great comments, all.

    Mike – the “employee time” piece is often overlooked. Leaders might want improvement, but the org. is trapped in the cycle of:

    1) things are messed up
    2) we’re too busy to make things better
    3) things are now more messed up

    In the hospital projects I’m doing, we have the luxury of dedicated employee time to get things kick started. That, combined with some external help, can get things started until momentum builds.

  5. Andrew says:

    Mark,

    We’ve worked with a lot of hospitals and related organizations, and find that the balance depends on the organization, and where the resisters are in the “power structure”.

    A bit self-serving but highly relevant… we at ExperiencePoint (www.experiencepoint.com) just released a multimedia simulation focused on change management to sustain lean initiatives in a healthcare setting. It is called Lakeview and it has opened to rave reviews from healthcare professionals as a means to learn change management principles and some lean methodology. See: http://www.experiencepoint.com/sims/Lakeview.

    As a part of the launch of I can offer demonstrations, and if you contact me at andrew.webster@experiencepoint.com and reference this posting, I can extend a free trial of the simulation as I think it’s highly relevant to the coaching/consulting approach you’re discussing.

  6. Bryan says:

    Hi Mark,

    This may sound odd, but most people WANT to follow a leader. Unfortunately, leaders aren’t always present and this is an acute failure of management that is often overlooked. I believe that it is a common failure point, as evidenced by the numerous comments and posts here on this blog and many others, and the fact that after 100 years and millions of pages written on leadership, we are still wanting it!

  7. Rick Bohan says:

    Your commenter says:
    “some people ..believe all you need to do is empower the existing workforce.”

    In nearly three decades, I’ve never met such a person either in consulting, teaching, or managing ranks.

    Nor have I ever met anyone who believes that “Just turning employees loose with some time to ‘fix things’ ” is a good approach.

    I think most folks understand that education is a necessary antecedent to participation and good ongoing leadership is vital.

    We might be rebutting arguments here that no one actually makes.

  8. Dan Markovitz says:

    Mark,

    IMHO, the employee time element is most often overlooked. Even if time is made for a kaizen event, time for followup maintenance seldom appears because people are too busy with adminstrivia.

    It only makes sense that if people are adding continuous improvement to their daily responsibilities, they’re going to have to either work longer or take something out of their days. Matt May over at “Elegant Solutions” blog refers to Jim Collins’ “stop doing” list.

    But alas, the notion of taking something out of the day is anathema to most organizations.

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