When hospital people say they don’t want to be a factory or “we don’t want assembly-line medicine,” the statement often goes unchallenged. What is the statement or the anxiety behind such a statement? I sometimes challenge in a friendly way and ask who in a healthcare audience has ever been a factory. The answer, usually, is not many.
People fear or assume that a factory is a cold, heartless, mindless, monotonous, repetitive, dirty, unsafe place where robots dominate and stupid people are treated shabbily. This perception may have been true in the past and pop culture references reinforce that factories are generally nasty places to work, including:
- the Lucy and Ethel chocolate factory
- Charlie Chaplin’s film “Modern Times”
- Family Guy episodes where Peter Griffin is miserable at a toy factory
- the movie “Gung Ho”
- the thoughtless GM TV ad with the suicidal robot
And we had this WIRED Magazine factory bashing (they didn’t print my letter to the editor after initially asking for my contact info).
In my talk, I set the stage that, of course, not all factories are terrible workplaces. I share examples like Toyota, Alcoa, FastCap, VIBCO, and Autoliv (the last two being factories where I’ve toured with healthcare leaders who learned a lot of great lessons about a quality and improvement culture).
Paul Akers, from FastCap, shared a video he shot with a visiting physician. I might not have time to share the whole video during my talk, but take a look:
A second video with reflections from a doctor who visited FastCap:
I’m glad that a growing number of hospitals are open to learning from manufacturing, aviation, and other industries. This mindset change is still very much a work in progress and many healthcare organizations still say “only those with healthcare experience need apply.” There are, though, many job postings out there from hospitals that WANT to hire those with Lean manufacturing experience.
Factories are, from my experience, very people-driven places, even when there are robots. They are socio-technical environments, often with a heavy focus on the social and political. Great factories treat everybody with respect (see Toyota’s “Respect for People” principle). “The factory is not just a big machine,” as Paul says in the video with Dr. Wei.
So what are some of the Lean Mindsets (an earlier talk of mine) that can be learned and transferred from manufacturing to healthcare? Some of the aspects of a Lean factory that CAN benefit healthcare (without doing something silly like putting an operating room table on a moving line):
- Provide support systems that allow staff & clinicians to focus MORE time on the patient
- Minimize patient delay and movement
- Safety first. Seriously
- Lean factories, including Alcoa, focus strong on employee safety
- Make developing people a top priority
- Use kaizen for people development, not just ROI, as Toyota is doing during the tsunami parts shortages, unlike GM which lays off workers.
- Engage everyone in improvement every day
- A theme of my upcoming second book on daily kaizen for healthcare (title still needs updated)
- Be a “gemba leader”
- Get out of your office and engage with everyone as a leader and coach
I’m not trying to say all factories are great (I worked in some bad ones) and I’m not saying healthcare should blindly copy from factories. But the reality in many cases is that factories can be more customer-focused (John Toussaint says that the Ariens snowblower factory treated their products better than the hospital treated patients) and factories can be great workplaces where the employee engagement and empowerment is often far higher than hospitals.
We can change the culture and approach in healthcare – combining newly developing operational excellence with the strong tradition of clinical and technical excellence. Lean helps hospitals EXCEL at what they want to be - caring environments that provide the best patient care.
What are your thoughts and reactions, as a manufacturing reader or a healthcare reader? I can post more notes and thoughts after the talk too.
About 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 Chief Improvement Officer for the technology company KaiNexus.