As we enter the new year, it’s a great time to reflect back on 2012 – what worked and what didn’t work… what do we plan to do differently in 2013? Those are some of the core questions found on a “strategy A3” as often used in the Lean methodology.
Individuals and organizations often try to find one major improvement – a “home run,” if you will. Someone might say, “I want to lose 50 pounds” or “we need to develop a new product that doubles revenue.” Goals like that might be scary… and for good reason, as described in the new book by Robert Maurer, PhD: “The Spirit of Kaizen: Creating Lasting Excellence One Small Step at a Time.”
There’s one action that can lead to lots of little improvements (and, eventually, to innovation) – the adoption of the “kaizen” mindset.
Robert Maurer is a faculty member in behavioral sciences at UCLA and the University of Washington. I previously reviewed his earlier book “One Small Step Can Change Your Life: The Kaizen Way” and did a podcast interview with him about that book, which primarily focused on the application of “kaizen” (Japanese for “good change”) style improvement approaches to his patients and their personal lives.
He wrote about how “small steps” in the style of kaizen (as practiced in the industrial world) could help individuals lose weight and change other personal behaviors. Instead of telling an overweight patient to start exercising an hour a day (which would cause the “fight or flight” instinct to kick in because it’s a scary request), Dr. Maurer would ask a person to start exercising by just walking in place for the length of 30 seconds. This wasn’t as scary, so people would try that small step, building enthusiasm and confidence that would allow them to build up to an hour a day. The success rate from starting small was much higher.
In his latest book, Maurer brings these ideas back to the workplace, with stories about how this same kaizen mindset can be applied to improve quality, boost morale, reduce costs, reduce healthcare expenses, and more. The book is focused more on businesses, hospitals, and organizations, rather than individuals – but the understanding of how change happens is based on our own personal brain chemistry and evolution. Maurer calls kaizen “a doable path to innovation” because we’re more likely to have big changes occur when we start small. I wrote about similar thoughts from a Japanese hospital CEO back in November.
Maurer describes how the “reptile brain” (the amygdala) in the more complex human brain can help us, as when it’s kicking in the powerful “fight or flight” response that’s necessary when we are in real danger. The problem with the reptile brain is that the fight or flight response kicks in even when we merely imagine a dangerous situation or something threatening (such as losing one’s job)… and this reptile brain shuts down higher level thought processes and capabilities. So, instead of saying that people shouldn’t be afraid of change, we should recognize that large changes (or “radical changes,” as he calls them) are scary… it’s in our DNA… and we need to work to make changes smaller and, therefore, less scary.
In Chapter 1, Maurer writes of a doctor’s office that he taught to use Kaizen. They were, initially, asking for innovation. But Maurer suggested that each person think about “the smallest step possible” that would improve the office. He had two rules:
- The step couldn’t cost anything (resources were tight in the struggling office)
- The idea had to benefit the customer (the patient)
Maurer cites the American approach of “Training Within Industry” and the teachings of an American, W. Edwards Deming, in laying out the principles that allowed the clinic to dramatically reduce patient no show rates and improve patient satisfaction – lots of little improvements led to a successful practice. These aren’t just Japanese practices. They are human practices that work around the world.
The clinic was hesitant to use kaizen, as are many, because the improvements seem trivial and insignificant. Kaizen and continuous improvement approaches aren’t sexy or exciting… but they work. Maurer writes:
“These steps are so small that they may seem useless, but that’s why they work. If the amygdala is like an alarm system, small steps are like cat burglars…. Your alarm never goes off…. You retain access to your rational, creative thoughts.”
“The Spirit of Kaizen” is a short book (I read it on my flight back from Japan and it didn’t take the whole trip), but it’s full of examples that reinforce the core kaizen principles and our understanding of how people can embrace and initiate change for the betterment of customers (patients), themselves, and their organizations. The main themes are a bit repetitive, but they’re solid and they work: start small (the smallest step possible), expect to stumble along the way, and continue striving to get better.
If there’s one new habit to embrace in 2013, let it be kaizen! What’s the smallest possible step you can take toward the goal of having a kaizen mindset or a kaizen culture?
I’ll share more about the book in future posts. If you’re interested in kaizen, also check out my latest book, “Healthcare Kaizen.”
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 VP of Innovation and Improvement Services for KaiNexus.