Archive for July, 2010

SixSigmaIQ Podcast with Sami Bahri, the Lean Dentist

Here is a link to a podcast with our friend, Sami Bahri, D.D.S, dubbed the “World’s First Lean Dentist.”

SixSigmaIQ – Lean Dentist

Also, check out my previous blog posts and podcasts with and about Dr.   Bahri.

Lean Healthcare at Denver Health is Front-Page News

Lean Healthcare at Denver Health is Front-Page News

It’s nice to see examples of Lean Healthcare success in the news, this time on the front page of the Denver Post — “Denver Health saves millions using Toyota efficiency principles.”

As the city health system, they are both an example of Lean Healthcare and Lean Government, saving the taxpayers money and providing better care, to the tune of cost savings of $54 million over the past five years. I was a guest faculty member on Wednesday for an IHI workshop called “$10 Million in Savings – Reducing Hospital Operating Expenses While Improving Quality.” $10 million — congrats, Denver Health — times five.

Audio Parody: “Lean Spice” Commercial

Audio Parody: “Lean Spice” Commercial

Hello, readers. How are you? Fantastic.

The recent series of Old Spice commercials starring Isaiah Mustafa have been a pop culture hit, especially on YouTube and Twitter. Some of us have talked about the need to better market Lean, something I first experimented with in my iPad commercial parody. My friend Jay Parkinson, MD asked me, back in June, “How do you make Lean sexy?” Yeah, seriously.

Well, this might not be how, but I’ve recorded a parody of the Old Spice ads — this will make a lot of sense if you haven’t seen this commercial or this one. OK, so my parody still might not make sense, but take a listen, below…

I don’t have the skills to do a fake video (calling for a talented reader to help, click here) and I could barely photoshop these images together into a

Hospital Advertises 3-Second Savings – Will the Public Care?

Hospital Advertises 3-Second Savings – Will the Public Care?

Hat tip to Helen Z. for finding this full-page print ad in the New York Times. The full ad appears below in this post, but the primary element of the ad is what you see at left – it says prominently:  “3 {seconds matter}”. It’s an ad for NYU Langone Medical Center, a hospital that does have a Lean program, it appears from a Google search that turns up this blog post from our friends at the Lean Insider blog.

As you’ll see, the ad depicts an operating room and says:

“That’s why at NYU Langone Medical Center, surgical instruments are hung on the wall, instead of kept in a drawer. This is one of the many ways we enhance performance and efficiency and, ultimately, deliver a higher quality of care.”

So will the public buy it? Will this practice enhance their reputation amongst anyone other than “lean geeks?”

Standardized Working Toward Zero Infections and Getting There

First off, there’s nothing about “Lean” per se in this linked article from Quality Digest: “New York Pediatric ICU Ward Off Central-Line Infections for Entire Year“. That said, there are elements that are very similar to both Lean and the checklists methodology.

Standardized work has led to so many documented improvements in healthcare. There are still some (who might be lurking and reading this) who scream loudly about Lean turning people into unthinking robots, leading to poor quality. Lean standardized work and checklists aren’t about shutting off your brain – it’s about shifting from a current state where it can be true that “everybody does it different” to a middle ground where there’s a standard method BUT people have the professional judgment to deviate from that when necessary.

The Steven and Alexandra Cohen Children’s Medical Center of New York has reached a real milestone due to these sorts of methods…

The Red Bead Game Applied to Medical Errors

The Red Bead Game Applied to Medical Errors

A blog reader sent me a link to this UK news article — really, it’s a lesson in statistical literacy, so thanks to the BBC for that. In the web piece, “Can chance make you a killer?“, Dr. Deming’s famous lessons from the “Red Bead Game” are illustrated in the context of deciding, based on data, which hospitals or doctors have patient death rates so high that negligence would be implied.

Are you fluent in the terminology and concepts of “common cause” and “special cause” variation? The BBC provides a great primer.

Podcast #95 – Norman Bodek “How to Do Kaizen”

Podcast #95 – Norman Bodek “How to Do Kaizen”

Also available as Video Podcast #11, Episode #95 of the LeanBlog Podcast  features  Norman Bodek talking about some of the ideas in his most recent book, How to do Kaizen: A new path to innovation – Empowering everyone to be a problem solver. Late in the podcast, Norman asks and answers an interesting question: what if an employee suggests “we should blow up the factory”??

This was recorded in March 2010, with Norman appearing from his office in Portland, OR.

Click to play:

MP3 File (run time 10:54)

norman-bodek

For earlier episodes, visit the  

Guest Post: The Hidden Gold on the Frontlines

Mark’s note: Today’s guest post comes to us from Ireland and a lean consultant and author named Andy Brophy. He has a new book called Innovative Lean, for which he interviewed me and some client team members from Children’s Medical Center Dallas to talk about some kaizen mechanisms we put in place there, one of many case studies in the book. Hope you enjoy the post…

So many employees aren’t accustomed to being even asked for their ideas. The average American worker submits one formal written idea every 8 years and of these less than 1/3 are implemented! Employees see problems and opportunities every day in their immediate work areas that their managers do not. When employees are not given the opportunity to be heard and the time to implement their ideas, they lose faith in management and are thus not fully engaged in their work.

How Many Hospitals Have Quit Lean Efforts?

How Many Hospitals Have Quit Lean Efforts?

I was asked a really good question today, a simple question that probably has a complex answer:

How many hospitals have gotten discouraged and quit their Lean efforts?

It’s a simple question that doesn’t have a simple answer. OK, maybe the answer is “17.” I don’t know.

The question is a corollary to the question of   How many hospitals are implementing Lean?

Answering either question requires to start with “Well, it depends what you mean by…”

A New Book That Says “Incrementalists Need Not Apply”

A New Book That Says “Incrementalists Need Not Apply”

I’m very interested in the interface between healthcare architecture, space design, and processes. I’ve seen so many cases where poor design (often done without the input of nurses, medical technologists, and other front-line staff) leads to systemic inefficiency. Classic bad examples would include not having enough local storage space in a department for equipment and supplies that are truly needed or not having the chemotherapy center close enough to the oncology clinics. A great example of Lean patient-centered design is the cancer center at Park Nicollet, where “care comes to the patient” (yes, it makes a great ad slogan too).

I recently discovered a book, a “manifesto” the author calls it, titled Efficient Healthcare – Overcoming Broken Paradigms. It’s not only the Lean people who get frustrated with the sorry state of typical layouts and space planning – it’s this architect and author, David Chambers from Rice University.

Seeking Submissions for “Patient Flow” Track – SHS 2011

Seeking Submissions for “Patient Flow” Track – SHS 2011

I’ve participated in the last two Society for Health Systems conferences, as a presenter, and I’m looking forward to attending the 2011 event in Orlando, FL next February (17 to 20). It’s an excellent event – both the content and the networking around healthcare quality improvement. Their logo looks like a hurricane – a hurricane of learning?

Report: CPOE Technology is Not a Silver Bullet (No Surprise?)

Report: CPOE Technology is Not a Silver Bullet (No Surprise?)

Lean thinkers and TPS advocates sometimes get a bad rap as being Luddites. That’s not true, I’d say it’s more that Lean thinkers have a healthy skepticism toward technology being a “silver bullet.” You typically need good process in addition to technology… and you need the right technology that serves your processes and your people (to quote The  Toyota Way-  Principle #8).

In recent years, we’ve all heard a lot about the promise of information technology from both sides of the political aisle (Obama and Gingrich). There’s been lots of hype, but will the technology like CPOE – Computerized Physician Order Entry – live up to their promise of preventing errors and preventing medical harm and death? A new study says it might not…

New Book: “Laugh, Sing, and Eat Like a Pig”

One of the people I’ve been fortunate to meet in the last year is Dave deBronkart, aka “e-Patient Dave.” I saw e-PD present at the HIMSS conference this year and we were able to spend some time together during some Lean training at Beth Israel Deaconess Medical Center in Boston. We’ve been able to talk a lot about the wonderful overlap between Lean and concepts of “patient-centered care.”

Dave has written a book based on his blog, the book is called Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer (And What Healthcare Can Learn from It). I just received my copy and I decided to do a parody “unboxing” video (partly because Dave comes from the hi-tech world). Dave and Paul Levy each did a good job setting context when they posted the video on their blogs. If you’ve ever seen a nerd carefully open an XBox 360 or some other gadget, you’ll recognize the style of badly made video, perhaps.

Podcast #94 – Bob Miller, Dr. Covey and the Shingo Prize

Podcast #94 – Bob Miller, Dr. Covey and the Shingo Prize

miller

Episode #94 of the LeanBlog Podcast is here and our guest is Robert Miller, Executive Director of the  Shingo Prize for Operational Excellence. Bob was previously a guest for Podcast #59, talking about changes to the Shingo Prize criteria. Here, we are talking as a follow up to my discussion with Dr. Stephen Covey in Podcast #91.

Click to play:

MP3 File (run time 24:13)

Bob tells me some of the background and history about how Dr. Covey became involved with the Shingo Prize and how he became a professor at the John M. Huntsman School of Business at Utah State University. Bob also talks about some of the future hopes and plans for Dr. Covey’s involvement with the Shingo Prize.

For earlier episodes, visit the  

@EricRies #LeanStartup Q&A Posted at Lean.org

If you are a fan of Eric Ries and the Lean Startup methodology, you might have seen and heard the webinar that Eric did for LEI a few months back. If you missed it, you can view the archive here.

After some delays and technical glitches, we’ve posted six follow up Q&A’s with Eric as streaming audio files that you can find at the LEI site by clicking here. We had originally recorded it as a Skype video chat, but I lost the files when my MacBook crashed the day after we recorded it. All I could recover was the audio (since I wasn’t using Time Machine every day).

The questions answered are:

Video Podcast #11 – Norman Bodek, “How to Do Kaizen” Part 1

Video #11 features  Norman Bodek talking about some of the ideas in his most recent book, How to do Kaizen: A new path to innovation – Empowering everyone to be a problem solver. Late in the podcast, Norman asks and answers an interesting question: what if an employee suggests “we should blow up the factory”??

This was recorded in March 2010, with Norman appearing from his office in Portland, OR.

A First-Person Lean Leadership Story from John Toussaint, MD

A First-Person Lean Leadership Story from John Toussaint, MD

I’ve had the pleasure to work with Dr. John Toussaint, CEO of the ThedaCare Center for Healthcare Value, over the past year.  John’s no “ivory tower” guy, he speaks from his practical and hard-fought experience as the CEO and Lean transformation leader at ThedaCare, the health system in Wisconsin.

John is also co-author of the new book, published by the Lean Enterprise Institute, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry. Below, I’m showing the video that John recorded to tell a story that is in the book. Watch the video and share your reactions and comments.

WSJ Wrongly Blames Apple Inventory Problems on “Lean Manufacturing”

OK, so I’ll admit I had a case of “rabbit ears” when I took the WSJ to task for calling the doomed BP Deepwater Horizon rig a “lean” operation. They were using the colloquial everyday use of “lean,” a term that can get in the way of understanding the real “lean manufacturing” principles and approaches based on the Toyota Production System.

The WSJ, though, has a track record of being horribly wrong about lean manufacturing, you almost wonder if it’s intentional or if it’s bad reporting (it’s multiple reporters who are guilty of this). Thursday’s article about Apple is another case of this –> (“Gadget Appetite Strains Suppliers“).