Archive for March, 2011
I was in L.A. on Tuesday and I had a little extra time on my way to the Burbank airport, which meant a rare treat…. lunch at the famed In-N-Out. I don’t mean to be that guy who tweets what he eats, but my lunch is pictured at left (click for a larger drool-inducing view if you are a meat eater).
The main picture I wanted to share is a simple example of perfect mistake proofing (a.k.a. error proofing or “poka yoke“). There is a possible customer error that could be made in many fast-food or deli restaurants – that error is throwing their reusable tray into the trash bin.
Ineffective organizations post signs, warning, and exhortations. Smart organizations error proof.
In discussions of “kaizen” (the Japanese word that is translated to “continuous improvement” or “change for the better”), I often hear of organizations talk about getting goals and targets for the number of kaizen ideas that employees come up with in a year?
Long story short, the question for debate today: Does getting a goal or target violate the spirit of kaizen?
I snapped this pic while visiting a hospital earlier this year. This was out in the cafeteria as part of a series of signs that featured real people talking about their real role in quality.
Lean is not a “command and control” leadership and management model. The old command-and-control dynamic leads to so much poor quality and misery in all sorts of industries and organizations – including factories and hospitals.
In a command and control environment, directives flow down from senior leaders (“thou shalt do this”) and bad information tends to not flow upward, due to fear and the threat of punishment for not hitting said goals and targets.
A haunting NPR blog post tells the story about how the Soviet space agency and political leaders sent a Cosmonaut to a certain death in 1967…
Fans of Bob Dylan and Mike Rother’s book Toyota Kata will appreciate this song especially:
Today, I am recording a podcast interview with Prof. Samuel Culbert from the UCLA Anderson School of Management. He is author of the recent NY Times piece “Why Your Boss Is Wrong About You” and the book Get Rid of the Performance Review!: How Companies Can Stop Intimidating, Start Managing–and Focus on What Really Matters.
Today, I’m sharing a brilliant Slate.com interview : “Risky Business: James Bagianâ€”NASA astronaut turned patient safety expertâ€”on Being Wrong.” He’s actually also an engineer and an anesthesiologist. An impressive background and impressive thinking.
I will share a few highlights and some core themes, encouraging you to go and read the whole article (with comments and discussion welcome back here on this post).
MP3 File (run time 24:31)
Episode #116 is a chat with Jim Womack, founder and former Chairman of the Lean Enterprise Institue, now their Senior Advisor and author of the new book “Gemba Walks,” available in paperback, Kindle format, iBooks, and other formats.
Here, we talk about the new book, how a gemba walk differs from “management by walking around,” some of his most memorable walks, progress in lean healthcare, and other topics.
For a link to episode, refer people to www.leanblog.org/116.
We recorded two podcasts in the same sitting. Part two is Episode #118,
Let me give a big ole’ Texas-sized hat tip to Bob Emiliani for sending me this sad article with the headline“General Motors lays off workers at NY plant.” This is an addition to earlier Shreveport layoffs.
The media will let GM off the hook as the parts shortages are the result of the tragic Japan earthquake, as the media again piles on to blame “Just-In-Time” supply chain practices (or more broadly, criticizing Lean in some cases).
Ironically, GM appears to be following the “Just In Time” practices often associated with Lean without also following what Toyota calls the “respect for people” principle. A truly Lean thinking company, like Toyota, would NOT lay off those workers. GM did. GM chose to.
I am working on finishing up the revised and updated edition of my first book Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction. I’m adding new case studies and examples, refining the book in general, and adding some new topics like strategy deployment and A3’s.
I’ve shared the first chapter of the book for those who signed up on my book’s site. Now as I’m making revisions, I’d like to get your input and ideas around the final chapter – “A Vision for a Lean Hospital.” I think the chapter has some good ideas, but given my audience here, I’m not going to pretend I have all the answers for hospitals. So I’d like to hear what you think in the comments for this post, or email me. What’s missing? What’s confusing? What’s wrong?
Here is a portion of that final chapter…
I’m going to use this blog post / page to collect published statistics about the impact the Lean management philosophy has had on healthcare quality and patient safety. I have a similar page on quality and patient safety statistics here.
If you have stats to submit, email me or comment on the post.
Updated the tense of the post for Saturday morning: I’ve had a ton of downtime again the last few weeks, so I migrated the blog to servers at a new hosting company Friday night (with the valued assistance of Big Big Design, my site designer and technical advisor).
Hi – As a reader of my blog, your input and thoughts are important to me.
I am currently co-authoring a new book with Joe Swartz (from the Franciscan Health System in Indiana) on a subset of Lean methods, focused on daily continuous improvement for front-line staff and supervisors, primarily. Much of the “lean healthcare” world has been focused on week-long events, as people have often lost sight of true “kaizen” – the daily, small, incremental improvement of processes and systems by front-line staff.
I don’t have a LeanBlog Podcast this week, but if you are listening for more to listen to, I’d invite you to checkout these other podcasts.
You can listen to streaming episodes on our main podcast site or there are other ways to listen:
I really had a great learning experience at last week’s LEI Lean Transformation Summit that was held here in Dallas. The event sold out six weeks in advance, so a lot of regular attendees got frozen out, unfortunately. All of the sessions were recorded and there will be a way to register to view them even if you weren’t an attendee. I’ll share details about that as I keep blogging about what I saw and heard from Rother, Pascal Dennis, and especially the Lean leaders from Starbucks and the great story they had to share.
I heard a profound idea from Mike Rother during his breakout session that expanded on some of the organizational concepts behind his book Toyota Kata: Managing People for Improvement, Adaptiveness and Superior Results. I could write many posts about the insights he shared, but let me just share one powerful notion today – thoughts on ROI, Return on Investment.
The question they posed (which is hard if not impossible to figure out, due to the design of the site) is this:
“What is the lean approach to capital expenditure? As Toyota announces a new plant in high-cost Japan, it also claims that the overall investment is 40% lower than an existing equivalent size plant. How is this possible? What is the impact of lean on the investment cycle?”
My response, in terms of healthcare, begins with:
Mark’s note: I’m happy to have a new guest blogger, Dr. Wiljeana Glover, from MIT, and a fellow member of the Society for Health Systems. The plan is that Wiljeana will be a regular guest blogger here.
Greetings to the leanblog.org community. My name is Dr. Wiljeana Glover and I am currently a Postdoctoral Research Associate at the MIT Lean Advancement Initiative. My current research interests include healthcare systems, improvement sustainability, and management innovation. I look forward to sharing some of my research topics with the community from time to time and getting your invaluable feedback. I’d like to especially thank Mark for giving me this fantastic opportunity to share with you.
With the increased use of lean work system practices in recent years, many organizations are using various improvement approaches, including Kaizen events, to rapidly introduce change and to create a culture of continual improvement (or kaizen). Unfortunately, as many of the readers of this blog know, improvement approaches are often used ad-hoc, as opposed to systematically.
Our thoughts and prayers are with our friends in Japan and everybody there dealing with the aftermath of the earthquake and whatever problems are yet to come. This article from Forbes gives some suggestions on how to donate and how to avoid online donation scams that often sadly follow natural disasters.
From the Forbes blog post:
The American Red Cross has already added “Japan Earthquake and Pacific Tsunami” as one of the choices for online donations at www.redcross.org. Gifts will support disaster relief efforts to help those affected by the earthquake in Japan and the tsunami throughout the Pacific. Alternatively, you can simply make a $10 donation by texting REDCROSS to 90999. The Japanese Red Cross has already mobilized eleven teams to heavily-damaged communities to provide assessments, first aid, and emotional support and relief.
The Salvation Army is also accepting text donations. Text the word Japan to 80888 to make a $10 donation to support its relief efforts. The Salvation Army says it is sending a team to Sendai, the most heavily damaged city, tonight and tomorrow will start providing basic necessities.