I had a chance to visit one of their community hospitals, Hillcrest Hospital, as well as the main campus. It was a very stimulating visit and it was great to see the progress they were making in building a “culture of improvement.”
Mark’s note: Today’s post is something that Drew Locher originally published in his email newsletter (sign up here), but he’s allowing me to post it here. I’ve met Drew through the Lean Enterprise Institute, as we’re both LEI faculty members, and we’ve crossed paths as various conferences. His newsletter resonated with me because it parallels my writing about “L.A.M.E.” or what Bob Emiliani calls “Fake Lean.“
I wrote a blog post about this for the KaiNexus blog, previewing the webinar and summarizing the steps of the PPS method:
Today, I'm sharing a link to some free "Lean 101" material that the AMA has created for physicians. I'm not sure when this initiative launched, but I just learned about it... the AMA is offering some online education about Lean in healthcare...
If you’ve got time over the weekend (or in the near future)… about three hours to be precise… these
three four podcast episodes from Gemba Academy are outstanding and they’re well worth the time.
Here’s my latest cartoon collaboration with a skilled artist (and medical assistant), Carrie Schurman.
You can see the whole series via this link.
In the Lean world, we talk a lot about how “firefighting” is bad in an organization. What do we mean by that? We mean people are putting out proverbial fires all day, reacting to problems as they occur. Leaders and staff are often fighting the same fires day in and day out.
One question I was asked to ask during my Japan trip was to see if “Quality Circles” are still active in Japanese companies. I think the term was brought to the U.S. in the 1980s and 1990s, but generally wasn’t widely adopted for a number of reasons – probably due to management mindsets and organizational culture, not a lack of willingness on the part of American workers. At GM in 1995, people talked about failed attempts at forming QCs (and management mainly blamed the workers, sadly).
A key point in the application of PDSA (and a key to A3 problem solving), is to avoid jumping to solutions.
We Plan — and this includes understanding the problem and the current state of our process or system. We don’t jump right into Do.
Today is the first day of the 5th annual Lean Healthcare Transformation Summit. Follow along on Twitter with hashtag #HCSummit14 to see my tweets and thoughts from others. I will be adding updates to this post during the day, as well. These are not meant to be complete notes or a transcript… but quotable and interesting thoughts or comments from each talk.
In the Kaizen process, we ask everybody to identify problems (or opportunities) and then to write down an idea that could potentially solve the problem (or at least solve it to some extent).
What’s written down on the card (or submitted into KaiNexus software) is the starting point for discussion within a team and/or with a supervisor.
When coaching an organization on Kaizen recently, I got a really good question from a physician who had taken the excellent week-long Lean healthcare training at the University of Michigan. She said that, in the Lean training, they said you should never “jump to a solution” in the course of problem solving. She raises a good point.
MP3 File (run time 35:10)
My guest for episode #193 is Mark Jaben, MD, talking about our brains, Lean, and change. Mark has been a guest blogger for me before and it’s great to talk to him today about his research and experiences. In our conversation, Mark talks about “the troublesome features of our brain’s operating system” (such as our “hidden brain”), how the A3 problem solving process fits with the way our brains work, and how to deal with “resistance” to change. Mark has also helped talk to some healthcare organizations about KaiNexus and we both presented at a conference last year.
For a link to this episode, refer people to www.leanblog.org/193. Also check out this “
Mark’s note: What follows is a guest post by Keivan Zokaei about the necessary and unsurprisingly overlap between Lean principles and environmental stewardship. I wrote about this dynamic in a 2010 blog post: “Lean Leads to Green, Which Supports Lean,” about the work done by one of my former clients, Children’s Medical Center Dallas.
By Keivan Zokaei, S A Partners
“Lean and green is free, but it is not a gift[i]“. It might seem counterintuitive, but lowering our impact on the environment means lowering costs. The reasons are the same ones that underpinned the “quality movement” of 1960s and 1970s. When making poor quality products (or services), we waste time, energy, and resources. So, not making mistakes in the first place is much cheaper and also guarantees better customer satisfaction. By the same token, sustainable business means not wasting resources and energy, which, in turn, means cheaper and better products.
Hosted by Steve Hoeft, author of the book Stories from My Sensei: Two Decades of Lessons Learned Implementing Toyota-Style Systems, I had a chance to visit Scott & White Hospital in Temple, Texas. With his permission (but without editorial review), I am sharing some stories from my visit to their excellent health system (which is in the process of merging with the larger Baylor Health system in the Dallas / Fort Worth area).
Baylor is one of the largest health care providers in North Texas with about $4 billion in annual revenue. Scott & White, with a national reputation for quality care and efficiency, is dominant in Central Texas. (link)
Here’s a fascinating article: “How Toyota brought its famed manufacturing method to India.”
The piece starts with a story about a classic Toyota management practice — “Genchi Genbutsu, or on-site inspection, which is at the core of the Toyota Production System (TPS). Nakagawa, who has been a TPS practitioner for four decades, doesn’t believe in seeing things on his computer screen – he prefers to go where the action is. “Can a computer smell? Genchi Genbutsu is very important because only on-site will your sensory organs be alert – smell, sound, vision,” he says.
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.
As are many people across the United States and around the world, I’m saddened by the violence that claimed so many lives Friday in Newtown, Connecticut at Sandy Hook Elementary School. The mass shootings that plague our country are incredibly upsetting. My friend Bob Emiliani created the graphic that’s shown at left, that represents our collective mourning.
As with many situations, it’s easier to identify that we have a problem. What’s less easy is figuring out solutions that will really prevent future violence. Complex problems rarely have simple solutions, right?
Can we have any sort of national solving effort along the lines of “Lean thinking” or the “A3” problem solving methodology or will we just have knee jerk solutions proposed?
If your organization blocks access to YouTube… shame on them. The videos I’m sharing here are two reasons you should insist they open access to the world of Lean healthcare education that exists there.
Today, I’m sharing two videos produced by the University of Michigan Health System about “Lean in Daily Work.” Their approach builds on the scientific problem solving approaches that are embedded deeply in the Toyota-based Lean methodology and philosophy.
Highlights of their management methods include:
- Daily (or by shift) team huddles
- Daily management “gemba walks” for recognition and problem identification / improvement (this is done weekly or monthly by higher levels of leadership
- Problem solving (in the form of increasingly complex “just do its,” Everyday Lean Idea” forms, and A3 problem solving)
No, this isn’t a post about the the 80s Chicago tune “Hard Habit to Break.” It’s about individual habits related to problem solving that are hard to break.
“A problem well stated is a problem half solved”
In Lean problem solving models, including PDCA/PDSA and the A3 methodology, the focus is on not jumping to solutions to quickly… and it’s a hard habit to break, for all of us.