… But I Do Have Time for Fire Fighting

This recent tweet of mine struck a nerve, apparently, based on the number of times it was liked and retweeted:

The thought occurred to me when I was teaching a day-long class on Kaizen and continuous improvement in The Netherlands that day.

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The opportunities and the challenges for continuous improvement seem pretty universal. I’ve heard variations of the concern “we’re too busy for improvement” in many countries.

The Dutch group, attending from multiple hospitals, wasn’t uniquely skeptical of Kaizen or their ability to free up time. It was a good discussion we had about how to make time for improvement.

People want to improve. Their leaders want staff participating in improvement. I see people struggle with the notion of how to make time for improvement.

One helpful strategy is to small improvement small, especially at first. Listen to my podcast with Robert Maurer, PhD on why this is a powerful strategy that suits the way our brains work.

Gathering small problems and small ideas on a board or in software provides a ready “job jar” of things to work on as time becomes available during the day ( these are often called “just do its,” but I’d prefer to call them “just PDSA its” to emphasize Plan-Do-Study-Adjust, not just Do).

Once we solve some small problems, we’ll free up time to work on more (and, often, larger) improvements. People will build capability and enthusiasm.

For all of the talk about “not having time for improvement,” I think it’s interesting that I’ve never heard anybody say “we don’t have time for fire-fighting.”

Why?

Because leaders might say they HAVE to respond. They HAVE to fight fires in the proverbial sense.

OK.

So why not MAKE time for proactive process improvement to prevent fires? Why not MAKE time to not just put the fire out, but also understand how to prevent the next one?

Why don’t we feel like we HAVE to practice continuous improvement?

I made a “Lean Meme” around this theme, based on this popular “disaster girl” meme. See more at LeanMemes.com.

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Here it is as a tweet if you’d like to click and share:

Or here is a version that’s not tied to Twitter (if your organization blocks that)… click for a larger view:

Do organizations subtlety and unwittingly reward leaders who put out visible fires instead of rewarding and promoting those who prevent fires and catastrophes?

Hear my podcast with a real life fire captain and paramedic who knows about Lean:

Podcast #278 – Tom Bouthillet, Lean in Fire Fighting (the Real Kind) and EMS

Here is a video (that I blogged about) with Kim Barnas, formerly of ThedaCare, and now the President of Catalysis, giving a lecture about shifting Beyond Heroes as her book is titled:

Here is a short Lean talk that I gave on the topic of finding time for improvement… how can we shift from making excuses about not having time to taking action to choose to free up time?

What do you think?

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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 book 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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7 Comments

  1. Karen Dunn Skinner
    Twitter:
    says

    We run into this argument all the time. It’s particularly pervasive in our industry because lawyers are rewarded for the hours they spend on client work. Very, very few firms reward attorneys for non-billable activities, and improvement falls squarely into the “unbillable” bucket.

    So far, the most successful method we’ve found to shift folks from making excuses to making improvements is the most basic of all: money. We start many engagements with financial analysis that exposes margins and profitability. It takes support (and chutzpah) from the management committee to make this work, because telling a partner that her $2M book of business isn’t actually profitable can be a tough conversation. But it’s a conversation that creates incentive for change.

    Ideally, we would like to see more law firms redesign their compensation systems to reward improvement and other business-building activities. Until that happens, we will continue to battle the “firefighting” mindset.

    1. Mark Graban
      Twitter:
      says

      Hi Karen!

      The same is usually true with physicians, unless they are completely on salary. They’re paid and reimbursed mostly for their patient work, doing surgery, etc. How can they make time for improvement?

      I guess part of the argument I’d make is that they’re not paid for “fire fighting” either.

      So, they can waste time every week fighting the same fires, or invest some time in improvement as to prevent future problems and future wasted time.

      That should make the doctors (or anybody) more productive and hopefully happier.

      Best,
      Mark

  2. Lori Bonderson says

    Hi Mark,

    I work in the long term care industry. Some of our facilities and agencies (skilled nursing, home health, hospice, assisted living) are so short staffed and bedeviled by high turnover that it seems they spend nearly all their time putting out fires. As a result, continuous improvement and all it entails in terms of time, resources, and necessary skills is a very hard sell. As a quality improvement consultant for my organization, I spend a lot of my time trying to convince people to use our tools and methodology to make improvements, and how improving processes to make them more efficient will actually help them in the long run in so many ways! I also talk about getting some wins by starting small and then celebrating those successes.

    Really, what we’re trying to do is build that culture of quality, and it is an uphill slog. BUT – it is also so important for us to keep trying, because I believe if we don’t improve, our future is murky at best.

    Your posts are very helpful and reaffirm what I am doing and the message I keep delivering. Thank you!

    Lori B.

    1. Mark Graban
      Twitter:
      says

      Thanks, Lori. I’m glad the posts help. You’re fighting the good fight.

      Does anybody ever add up how much time they spend fire fighting?

      Probably not… fire fighting feels good. There’s an immediate “effect.”

      People are too busy to think about how much time they are wasting in their old approach.

      “But we have to fire fight!”

      No.

      Talking about “fire fighting” in this reactive way is, as I often mention, totally unfair to professional firefighters, like a friend of mine who works in Nevada. We’ve talked about how they spend more time PREVENTING fires by educating the community… they aren’t responding to calls and putting out real fires constantly.

      1. Lori says

        Great point about your firefighter friend. Think I might use that in an upcoming training session. Thanks!

        1. Mark Graban
          Twitter:
          says

          I have visited his station. There are elements of Lean… 5S, error proofing, safety focus, standardized methods…

          I should ask him to do an interview for a podcast or even just to get his thoughts to share along these lines. We’ve chatted about it before, but more “off the record” (or not because I was going to write about it).

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