Lean Lessons for Healthcare from a Boeing 737 Factory Video
Her most recent video features video from her visit to Boeing and their 737 assembly factory. In the brief visit, we can see a few Lean practices in action, or at least alluded to.
In the video, Cali alludes to the slowly moving assembly line. This is often associated with Lean factories and there’s a lot of debate about whether this is inherently a Lean manufacturing practice. Toyota builds cars on moving lines (but so did every other not-yet-Lean automaker back in the day). Autoliv is a great Lean manufacturing company, and their airbags and other auto safety products are built in U-shaped cells without conveyor belts. Hospitals provide “Lean patient care” without putting the patient on a conveyor belt, of course!
Cali shows us, earlier in the video, examples of andon lights (without calling them that). A yellow light starts blinking when there’s a problem and there’s 20 minutes to get the problem resolved before a purple light would go off and the line would stop. This shows the Lean principle of “stopping the line” to fix problems rather than scrambling and letting problems get by to be fixed later.
Read this classic tale from 2007 about the mindset differences at Toyota (you must stop the line) versus Ford (don’t you dare shut down the line and stop production). I’m guessing that, at Boeing, it’s OK to stop the line because they value root cause problem solving and the prevention of other problems. This is a Lean principle used at Virgina Mason Medical Center (also in Seattle). They use the principle in their “patient safety alerts” which emphasizes calling out problems (or risks) when you see them and getting the problem resolved for future prevention (this goes well beyond normal “fire fighting”). See related blog posts about this concept at VMMC.
Cali also talks about the practice of “kitting” parts, creating kits that are delivered to the electricians working on the planes. Before kitting, Cali explains, the workers would have to walk back and forth chasing their own parts down. That old condition at Boeing sounds like the current condition at many hospitals and primary care clinics — nurses and doctors and other highly skilled professionals. Lean hospitals, including VMMC and ThedaCare, place a major focus on improving the system so caregivers don’t have to walk back and forth so much. That walking, that hunting and gathering is waste! Reducing that waste (by storing supplies closer to where they are needed and having better delivery processes from the materials management department) frees up time for patient care, as Virginia Mason and other hospitals have done.
Seattle Children’s Hospital and Virginia Mason Medical Center, among others, have learned Lean from Boeing, The University of Michigan Health System and others around Detroit have learned Lean from General Motors (yes, seriously – GM had/has a lot of very experienced Lean manufacturing people).
There are a lot of opportunities for us to learn across industry boundaries. And this doesn’t mean copying every practice – like the assembly line.