Do you need to make it mandatory to participate in continuous improvement?

Every month or two, Greg Jacobson, MD and I have an “Ask Us Anything” video discussion with questions submitted by members of our KaiNexus community.

You can register for our next episode, number 14, which we’ll hold on August 15th. The registration process will allow you to ask a question, if you like. You can view them live through our webinar platform and the recordings are available on YouTube and through the KaiNexus podcast feed.

For the most recent episodes, including number 13, we’ve also chopped up the 30-minute discussion into separate videos for each of the questions, which you can view in this playlist.

One of these questions was, basically:

Do you need to make it mandatory to participate in continuous improvement?

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Here is what we said:

Transcript of the Video

Here is a transcript:

Mark Graban: “Is it necessary to make improvement mandatory, to set a goal for how many projects people should be involved in? It seems like people won’t participate unless we make it mandatory.”

All these questions today actually I think have a couple of questions within the question.

Upcoming KaiNexus Webinar July 27 (Mark Graban):
Strength in Numbers: Improving from the Bottom-Up

For one, I wouldn’t call these projects. If we’re trying to get people involved in improvement, calling something a project is going to sound like a big change that may trigger the amygdala, and people might say, “I don’t have any big ideas. I don’t have time to participate in a big project.”

I would use a term like improvements. How many improvements should people be involved in? I’ve worked with and studied a lot of organizations that have set goals or haven’t set goals. They’ve had aspirational goals, “We’d like to do two improvements every year.”

Some organizations will set kind of a quota or a target, saying, “You must do x in a year.” Sometimes targets and goals and incentives can get dysfunctional. To me, the real spirit of continuous improvement is self-motivated. It’s something that we want to do because it makes our work easier, because it helps our patients or our customers. It helps the long-term good of the organization.

To me, the thing that drives improvement activity is the variable of leadership, activity, behaviors, level of effort. This is not about being smart with improvement. It’s about working hard at improvement and continuing to do that.

I’ve seen organizations without goals, targets, incentives do extremely well with continuous improvement. It comes down to, again, that variable of leadership. How do we engage people?

Greg Jacobson, MD: I think Daniel Pink’s book Drive really breaks down the behavioral science here really well. I would argue that CI expert should probably be in their professional reading…50 percent of what they read should not be about Lean. 50 percent of what they read should be about behavioral science. This is 100 percent about humans and how to motivate humans and how humans work together. If you haven’t read it, you should literally as soon as you’re done with this webinar go pick it up, visit there electronically and start reading it.

You will understand more about yourself, understand more about your interpersonal relations. You’ll understand more about your colleagues at work. I think it speaks a lot to this specific topic.

There are certain places and times when quotas are the right way to motivate people. Continuous improvement is not one of those places, you hit in on it, Mark, because of the dysfunction that it brings. You say, “You have to do an improvement a year, two improvements a year, one a month.”

All of a sudden, you’re creating an environment that’s going to reward junk, and it’s going to reward the wrong thing. We work with a number of organizations that have done both. We work with a number of organizations that have flip-flopped between them as well. It’s been really interesting to see the result.

August KaiNexus Webinar (Warren Stokes, HonorHealth):
How to Leverage Lean for Long-Term Success (Under Short-Term Pressures)

One organization we’re working with that initially had a quota of one or two improvements per months says just volume of improvement… We said. “OK, we’re not going to do a quota anymore. We’re going to kind of move more to the Daniel Pink incentive.” Internal motivation and intrinsic motivation. They realized, “Wow, we have a lot fewer ideas, but the quality of those ideas are actually creating much bigger impact in the organization.”

I would definitely challenge you, if you’re thinking of going down the quota route, then really think of it more as rewarding accomplishment. Use a badge system, recognize people, give small tokens. Starbucks gift card you talk about a lot, Mark, as a great…Not that we’re promoting Starbucks. It can be any…I  think what you’re going to end up realizing is it’s going to feel better, and it’s going to ultimately drive greater and better impact for the organization which is what this is all about.

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Mark: That’s well said.

One other point I’ll make is that that goal, that target, sometimes becomes a limit. We want you to do four per year. People do their four. They say, “I’ve got another six ideas, but I’d better hold them in my back pocket because I don’t know if I can come up with four ideas next year. They might ask for six next year.” So sometimes at least people holding back which is not [a good thing].”

The Discussion from LinkedIn

I posted the video to LinkedIn and it spurred a lot of discussion. I’ll share some highlights below (and avoiding some of the nonsense discussion that often occurs there)…

I’ll bold points and phrases that I think are particularly worth noting.

Dean Tarnovsky:

“If you are just starting out, look for people within your value streams to volunteer. If the culture is not conducive to volunteering, assign people to the initial several teams. If after some time results are visible and people feel the positive change, AND participation is promoted and supported, people will sign up.

However, if staff return to their offices to double the work, an annoyed supervisor and coworkers, and even more importantly, recommendations are not implemented, supported, sustained and built upon, staff will try to get out of participation whether you mandate it or not.

Back to the initial point, your staff will know whether then organization is really committed or not very early on, likely before the first event, basing it on organizational behavior in the similar instances from the past.”

William McDade

“There is very little that is as powerful to change one’s mindset than being part of a great Kaizen and driving breakthrough change that you didn’t expect when you started. Lean done well drives a new level of positive change in your customer’s eyes that wasn’t previously thought possible. It’s up to leadership to make the difference between so-so CI and great CI.”

I added, in response:

Right, but keep in mind “a Kaizen” doesn’t always mean “a Kaizen Event” and that small, incremental improvements are really the life blood of Kaizen, not just the “breakthroughs.”

Patricia Gladen

“No, people do not like to be pushed or told what to do and not to do – I say just let them work it out themselves- we like to see and feel good when we accomplish.”

I think leaders need to encourage and support Kaizen… creating that environment in which people feel safe and empowered to speak up, take action, and participate in improvement. We don’t have to force it.

Bill Kluck

Replying to Patricia:

“Excellent point. When people are forced, they may even sabotage your efforts. The best way to proceed is to find those that support the change, and want to work toward it. They are your biggest asset!”

Paul Steven

As with all things simple, that doesn’t mean it’s easy. Within the same company we have examples of getting people engaged and sustaining excellent results when give the space to learn and grow, however next week, we shall assist a struggling department through clear direction. They need to improve now. I see lean and Blanchard’s situation leaderships as utterly connected. In some situations we direct, others we coach and others we delegate within a framework. Therefore you may look for volunteers if you have that luxury within the situation based upon a need for learning or results, but let’s not pretend Toyota would ever ask. Within Toyota you must be part of it.”

I replied:

Asking and encouraging people to participate is not the same as “making it mandatory” or “forcing” people to participate.

Alan Wikler Psy.D.

“Lean culture and improvement is the natural outgrowth of a management approach that respects and empowers all staff to make improvements. Mandates and quotas violates respect for people. Improvement need not even be encouraged. Management needs to spend time in the gemba, get familiar with the people and their processes and simply empower them to do what they want to do to meet the customers needs and make life easier for themselves in the process. Recognizing their efforts will lead to more improvements. No quotas needed.

Sam MacPherson

“It is a critical role of leadership to provide every platform and every opportunity for every member, everywhere, everyday, and every way to participate and contribute to continuous improvement and problem-solving.”

Thanks to everyone who commented on LinkedIn.

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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14 Comments

  1. Mark Graban
    Twitter:
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    Comment on Facebook:

    Mike Sporer:

    I’ve seen this play out in a non-profit. It takes time, but once the culture of continuous improvement gets footing, most people get on board. This is especially true if the top management is passionately engaged. Those who don’t “get it” eventually get sorted out and usually leave or get terminated. It is frustrating when transitioning. It sort of becomes mandatory without mandates. Persistence matters.

  2. Sam Selay says

    Mark and Greg,

    I’m really struggling to resolve some conflicting facts:

    Fact #1 Art Byrne has had undeniable business success by starting with dramatic change as outlined in the Lean Turnaround, and the Lean Turnaround Action guide. He has led world class lean transformations at Wiremold and Danaher, and now at JW Childs.

    Fact #2 Behavioral science has shown that incremental change is both easier for people and more sustainable than dramatic change. Dr. Robert Maurer did a great job explaining this in The Spirit of Kaizen.

    To give Art credit in the introduction of the Lean Turnaround Action Guide Art Byrne referenced the fact that “By pursuing the practice of “daily improvements” and “good thinking, good products,” Toyota not only has become the world’s largest automotive manufacturer (as of this writing) but has given the rest of us a system and approach that can be used to improve any company.”

    Ultimately, the goal is to create a culture of continuous improvement, where episodic events and projects are not needed and everyone is making improvements, every day, everywhere. However, even Paul Akers at FastCap had to start with projects and events as with other lean thinking organizations in other industries such as ThedaCare and Virgina Mason within healthcare.

    Is there a right or wrong way? I don’t know. I do know that Taichi Ohno didn’t have a manual to follow. Toyota had challenges and obstacles to overcome. People tried things, ran experiments, got better, and improved.

    As a disclaimer this question was based on a great article the Daniel Markovitz wrote awhile on LI titled. Dan should get all the credit. I just feel it would add value to your audience.

    SMALL STEPS OR BIG STEPS: WHAT’S THE RIGHT WAY TO BEGIN IMPROVEMENT?

    1. Mark Graban
      Twitter:
      says

      Thanks for your comment, Sam.

      Is there a “right” way or “wrong” way? Probably not. Are the “dramatic” changes in Art’s work a series of relatively incremental improvements in the grand scheme of things?

      I’m not sure ThedaCare or Virginia Mason “had” to start with events. I think they were advised to do so. Would things have gone better if they had started with smaller Kaizen improvements like Franciscan St. Francis did? I don’t know. All of those organizations eventually incorporated different approaches to Kaizen… projects, events, smaller improvements.

      I think we need all forms of improvement. It depends on our situation. I generally suggest starting small and not forcing people to participate because I think there is good science, theory, and evidence about that. But, if a hospital is literally on the verge of bankruptcy (not just having a smaller positive margin than last year), then you might need more drastic measures, even layoffs.

      If a hospital has major pain points regarding E.D. patient flow, maybe you need to start there with a big project, some events, AND incremental improvement??

  3. Bob Emiliani says

    By way of analogy, you can begin learning to play guitar any way you want, but at some point (if you stick with it) you have to learn that there are right and wrong ways. This is true of any practice.

    1. Mark Graban
      Twitter:
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      That’s one reason why it helps to have a coach.

      The definitions of “right” and “wrong” can change over time… somebody can create “better.”

  4. Oscar Daniels says

    I think a simple change in the “branding” around CI events could remove the need to make them mandatory. If I tell my employees, “We need to improve and we’re going to have a meeting to talk about”, they will feel I am dissatisfied with their work and will be concerned that they are going to be criticized or exposed.

    If you tell those same employees, “We are going to have an Easy Event” where we are all going to get together and talk about how we can make our jobs easier, people won’t come in with that sense of fear. It also empowers them to bring their own ideas to the table, because THEY are the experts on how to make their jobs easier, not the supervisor or lean consultant.

    1. Mark Graban
      Twitter:
      says

      Thanks for your comment, Oscar.

      You’re right that telling people “we need to improve” might not be an effective way to engage people and spur participation. “We need to improve” is probably factually correct, but that telling action often leads to very natural and understandable pushback and defensiveness.

      Even saying “you need to make your work easier” can lead to defensiveness, because of the telling.

      How do we “invite” participation or, as leaders, get out of the way of improvement work that people would naturally want to do?

      They’re the experts in their work, but they’re also the experts about themselves and why they’d want to change and improve and participate…

      1. Bob Emiliani says

        As I’ve always said, make kaizen fun and people will flock to it. Easy to say, hard to do. Requires lots of experimentation.

        1. Mark Graban
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          says

          Is “fun” really the blanket term that appeals to all people and personalities? Maybe if some individuals don’t want “fun,” let them make it what they want it to be.

  5. Bob Rush
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    A wise Japanese CEO told a group of us many (MANY) years ago that “participation is not mandatory it is simply a condition of employment.” You have to do whatever is required to get the people to make constant improvements, and I am with Bob E. on this you have to make it fun. Sometimes you laugh and sometimes you have an Eeyore that wants to be the negative person that you drag screaming and kicking towards fixing things. I never say you have to do this but I do know who is all in and who is not. Know your people and use the method that gets them to participate.

    1. Mark Graban
      Twitter:
      says

      It’s ideal if everybody participates. It’s the responsibility of leaders to create an environment in which people want to participate. That includes making it fun.

      Forced participation and compliance won’t lead to much benefit… that’s my view.

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