Your Lessons Learned about Daily Kaizen?

2013-06-25 14.32.29I’m driving all over the state of Ohio this week, teaching three different workshops on Kaizen and Lean Healthcare with my friends at TechSolve. I was in Findlay yesterday, am teaching in Columbus today, and will be in Akron Thursday (some seats still available). The picture, at left, is me facilitating an interactive simulation where we have fun putting Kaizen principles into action with our Visual Idea Boards  (and I also talk about KaiNexus  software as an option).

It’s really fun teaching people about Kaizen and daily continuous improvement (as Joe Swartz and I wrote about in  Healthcare Kaizen  and our upcoming  Executive Guide edition). I try to teach just enough to get people confident and inspired that they can go back and start a pilot Kaizen program when they get back to work the next day.

I think it’s better that we start now – better to start our Kaizen work a little bit of planning (and then learn and adjust as you go) rather than plan, plan, plan, plan, plan. A little bit of education for leaders and a little bit of expectation setting with staff members can go a long way (as we demonstrate in my two-day onsite “Kaizen Kickoff” workshops).

So as I’m teaching the next few days, I’ll ask you, the readers, to share (as a comment here) what lessons you’ve learned from practicing daily continuous improvement. What barriers have you faced and how have you addressed them? What advice do you have for people starting with Kaizen? How have you incorporated daily Kaizen with formal Kaizen Events or Rapid Improvement Events?


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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4 Comments on "Your Lessons Learned about Daily Kaizen?"

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  1. Great questions. As for what lessons I’ve learned in practicing continuous improvement, there are too many to list! Here is a small sampling of my lessons learned:

    1) The quicker I can test an idea for improvement, the more likely I am to move forward with additional cycles of improvement in a continuous improvement fashion. To be able to test quickly, the “batch size” of my improvements need to be small. A complete process redesign (big batch) may take months to plan, but a simple kaizen (small batch) can be done today, then another tomorrow, and on an on in a continuous fashion.

    2) However, if I’m too quick to test an idea for improvement, then I’m at risk for wasting time and effort on the wrong idea. This is not the worst thing in the world, since I will still learn from the test, but it’s not ideal either. The ideal would be to study the current condition just enough so that I can identify potential root causes of the problem, and then come up with ideas for improvement to test based on that knowledge.

    3) Helping people build a habit out of using the PDSA cycle to test their ideas for improvement is a huge challenge. The analogy I use is “it’s easy to teach somebody to do a push-up, but it’s hard to get somebody to make a habit of doing 50 push-ups every morning to improve their fitness.” It’s easy to teach PDSA, but it’s hard to make it an instant reflex. For that, we need to develop habits/”muscle” memory. This doesn’t come through training only. We need daily cues, routines, and rewards to form a habit. Establishing these three elements of a habit-building loop is difficult, but methodologies such as Toyota Kata help a lot.

    • Mark Graban
      Twitter:
      says:

      Thanks for adding some of your lessons, Michael.

      I think there’s an important need to balance, as you stated, the goals of 1) fast action / fast learning and 2) being rigorous in problem identification and root cause analysis.

      In the PDSA framework… I guess we need just enough P but not too much P…

      As for the pushups, I think back to back to the work of Dr. Bob Maurer who emphasizes starting small (it’s better than never starting at all).

      I could say “start doing 50 pushups a day” and that seems scary… I’d be unlikely to do that.

      But Dr. Maurer would say to start with one. Do one. That’s not so scary… from one, you can work up to two, and increase and you’ll be more likely to reach 50 than if you were told to start doing 50.

      Thanks for the thoughts.

  2. R says:

    Some lessons learned (still learning):

    1. Managers can be afraid to let staff loose on implementing ideas. Managers of areas embarking on daily improvement need substantial support and coaching for leading from the middle

    2. Give staff meaningful gaps/problems to address as part of daily improvement. There is a temptation by leadership to “start small”. If you start too small, you will stifle ideas and it may be disrespctful to the staff’s ability and desire to achieve.

    3. Clearly explain “why” daily improvement and the proposed gap are chosen and important to address. You may not think that your staff care about “corporate goals” or organizational direction, but you should test this hypothesis and align behaviours to a clear purpose – you might be surprised

    Too many more to list……

    • Mark Graban
      Twitter:
      says:

      R – thanks for your comment.

      1) Yes, this can be a big problem… and this requires support and coaching from the top. Managers can’t be made to feel like a failure because their employees solved a problem (they might feel this way). It has to be emphasized that it’s GOOD to have employees solving problems (it means you’re creating an environment that’s conducive to kaizen or, at the least, not getting in the way).

      2) I think it’s possible to start small (or start really small) without being disrespectful. We certainly want people working on non-trivial things. Starting small can get the ball rolling and then we can work together to solve serious quality and safety issues.

      3) Agree completely that explaining why is very important… not just local departmental goals, but also the broader aims and needs of the overall organization. People like to understand the impact of their work and their improvement work.

      Thanks for adding these!

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