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Video of a Daily Huddle at Everett Clinic

by Mark Graban on August 9, 2010 · 17 comments

A key cultural aspect of Lean is the “daily huddle.” Sure, this practice isn’t exclusive to Lean, but it fits with the core concepts of continuous improvement and “respect for people.”

In this post, we can view a video about the daily huddle at the Snohomish location of The Everett Clinic. I’m curious to hear your thoughts – what did you see that you liked? What would you do differently? How does this compare to huddles you might do in your workplace – healthcare or otherwise? In this post, I also veer into a discussion of statistical process measures…

There are different approaches to doing huddles, but here are some key points that I’ve emphasized in my work with healthcare organizations:

  • It’s a stand up meeting
  • Have everyone there (unless you absolutely can’t shut down the process)
  • Start with a brief focus on safety
  • Have a 5-minute time limit
  • It’s a meeting for short two-way communication snippets
  • It’s a time to review recent performance
  • It’s a time to raise issues and surface ideas, not a time for in-depth problem-solving
  • It should be led by a senior team member (not a manager)
  • Do the meeting in the gemba, not a conference room
  • Everyone checks their title at the door

In the video, there’s clear evidence that Everett Clinic happens to follow some of these guidelines. For others, we can’t tell. Try to check them off as you watch, perhaps.


One thing that stood out to me from the video: Isn’t it amazing that a major detail like “which doctors are here today?” wasn’t communicated clearly before their daily huddle? That seems like a good thing for people to know, huddle or not, and that wasn’t happening?

What’s your reaction to that video?

Come back tomorrow – there’s one detail from the video that I’m going to elaborate on in a separate post.

Oh, also, on the topic of standup meetings, this is something that Bob Sutton covers a bit in his upcoming book Good Boss, Bad Boss: How to Be the Best… and Learn from the Worst. I’m going to be recording a podcast interview with Bob later tonight. If you have any questions for him, email me using the Contact menu up top.


Mark Graban 2011 Smaller Video of a Daily Huddle at Everett Clinic leanAbout LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the VP of Innovation and Improvement Services for KaiNexus.


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{ 10 comments… read them below or add one }

1 Simon Cunnane August 9, 2010 at 8:07 am

Great video and always good to see how other organisations approach this.
Constructive criticism? The main thing I noticed was that the area they’ve held the meetings in doesn’t seem conducive to really good communication. People seemed to be standing around the corner from others and walls seemed to be literally blocking communication such as eye contact and body language. Obviously, not being in the building, I can’t comment 100% on why this is happening. Perhaps this is the best place as it’s where everyone walks by on a regular basis? I’m just comparing it to the morning meetings they have at Fastcap as it’s the only other one Ive seen online (http://www.youtube.com/v/nY8nec2wmCg&hl=en&fs=1).

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2 Karen Wilhelm August 9, 2010 at 8:12 am

Simple, short. Would it have been useful to also look at more detail about the range of time-to-answer and abandon rate (by hour, for example) instead of just the average? Or would that be more appropriate for a separate kaizen or RCA project?
Karen Wilhelm recently posted..Massively collaborative projectsMy Profile

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3 Mark Graban
Twitter:
August 9, 2010 at 8:18 am

@Karen, a preview of my next post… I’m going to blog about that statement that the abandon rate was better than the goal of 10%. There’s a better way of looking at that data…

@Simon, thanks for sharing the video. As an aside, it’s a shame that so many organizations block employee access to YouTube…

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4 Stacy Williams August 9, 2010 at 12:16 pm

This huddle is very similar to those I’ve seen on construction sites. They quickly cover where everyone is working, what to watch for, preview what’s coming, etc. Simple, but effective.

I’ve only worked for one firm that had anything close. We had a brief weekly huddle. It was surprisingly useful. That was my first job and, since then, none have been willing to try. I think they are missing a valuable opportunity.

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5 April Zepeda August 9, 2010 at 12:25 pm

It’s great to see this video as part of the discussion on Lean. Constructive criticism is always welcome as we have much to learn from each other.
I work for The Everett Clinic and produced this video. Actually “which doctors are here today” was communicated, but in the interest of keeping the video short (it’s three minutes and the huddle is five minutes) it was edited out.
We put this video together to allow our internal audience to see what was coming. Our Snohomish location piloted the huddle with great success and we were getting ready to roll out the process clinic-wide. (We have 16 facilities and roughly 80 departments.) Hence the video was edited to convey a general understanding, but not necessarily a step by step guide.
We have found the use of video to be a valuable tool in sharing Lean concepts and I would encourage other organizations (budget permitting) to explore it. Love the blog, and thanks for the discussion – it’s always great to hear the ideas, suggestions and reactions of others on the Lean journey.

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6 Mark Graban
Twitter:
August 9, 2010 at 12:34 pm

Hi April – thanks for posting and sharing a little more about the process.

My comment was sort of directed at the period before the daily huddles started, when staff members might have not known who was working on a given day. That seems like such a basic piece of information… that’s good that it’s covered in the huddle.

Video is indeed a useful tool. We use it to share within the Healthcare Value Leaders Network – each organization has a flip video camera and we had someone post a video they shot with their iPhone of a staff member sharing about her participation in some lean improvements. Video conveys so much more and it really should be a cost issue for anyone anymore (you can get a $100 flip video camera).

Thanks for being open to the discussion and constructive feedback. I’ll share more tomorrow, I think.

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7 Stacy Williams August 9, 2010 at 3:12 pm

Just to clarify my incomplete comment from earlier…both construction and architecture industries talk about embracing Lean. It seems to me that beginning with a “huddle” shows a willingness and interest in considering how processes flow most efficiently. This may not be a fair comparison, but I see construction and architecture as being similar to clinical healthcare and healthcare administration.

The video is a nice reminder of a good habit to get into, regardless of industry. Thanks.

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8 jenny kowalczuk August 9, 2010 at 4:47 pm

Nice, simple, inclusive, informative and easy! My only thought – not a criticism as this is a great move for primary care teams – was that there wasn’t much interaction – it felt like the huddle was missing ‘this is what it was like for me yesterday’ or ‘this is my concern about today’ or ‘could we try doing x today instead of y’ from any member of staff.

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9 Tim McMahon August 10, 2010 at 8:35 am

Mark, in my world we call the huddle “fast response”. Same concept. The agenda is standard starting with safety, then quality, productivity related topics, and then any final plant communications (customer visits, special meetings, etc.) The one thing I noticed missing is the interaction. In the format we have everyone talks about their functional area or value stream. In the video it appears like they are just reading off the boards with no dialgoue. Maybe it is just the way the video was editted. I believe this type of meeting should be more than just a status update but also a forum for action. Issues that are raised do need to be supported with a resolution.
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10 Mark Greenhouse August 12, 2010 at 12:04 pm

Great to see that some organisations are willing to share these experiences, it certainly helps to have access to examples when talking to organisations or members of staff, uncertain about lean.

So onto how I saw the huddle or “Daily Shout” as we sometimes call it over here (UK), not that the title really matters.

Location – having done these with staff half way up open plan stairs because of a lack of space I can sympathise with what looked like a poor layout, you do the best with what you have, making sure though there are no places to hide.

Performance – I can only assume that the historical targets were well covered. I can’t really communicate on the validity of the targets i.e. is “call abandonment rate” (communicated) more or less important than “issue resolved within call” (not covered)?
One thing that did strike me is that a number of the doctors seemed at or near 100% capacity at the start of the day – there was no discussion shown, it may have been edited out, on how to deal with this and if the doctors are at 100% today what is their availability for the next few days? did the clinic need to address this and how by staff resolution or management?

As I said, great to see this and thanks for sharing! and to Simon for highlighting the FastCap one as well.

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