And, now to the lighter side of Lean for the weekend.
Hat tip to my friend and author Naida Grunden for pointing out this funny news story… apparently the State of Washington has to translate their web pages into different languages… the Spanish translation turned “lean practices” into “skinny cow handling.” I don’t think this has anything to do with “Skinny Cow” brand ice cream and products…
MP3 File (run time 31:13)
My guest for Episode 188 has been a leading voice in the Lean community for 25 years, Daniel T. Jones, founder and chairman of the Lean Enterprise Academy, based in the UK. Dan collaborated with Jim Womack on the books The Machine That Changed the World, Lean Thinking, and Lean Solutions and published other books through the LEA.
Currently, Dan is helping promote Lean in healthcare and government and is learning about the Lean Startup community by becoming an advisor to the company Elastera. He has also recently joined Twitter as @DanielJonesLean. You can also watch recently-released free videos (via Gemba Academy) of Dan, Jim, and John Shook reflecting on 25 years of Lean and other topics. In this episode, we touch on all of these questions and also take a question via Twitter.
For a link to this episode, refer people to www.leanblog.org/188.
For earlier episodes, visit the main Podcast page, w
I grew up just outside of Detroit, so I’m always pulling for the city to turn things around.
The newly-elected mayor, Mike Duggan, is the former CEO of Detroit Medical Center. Back in 2009, I blogged about a radio commercial for DMC that featured Duggan talking about healthcare quality improvement.
A hat tip goes to my dad for noticing a mention of Lean in a local news article about Duggan taking office:
Today is Veterans Day in the U.S. and it’s also Remembrance Day in Canada, the UK, and the Commonwealth countries. The poppy pin is worn as a symbol of Remembrance Day (as I wore, at left, last week while in Scotland and England on vacation).
Thanks and an enormous debt of gratitude are owed to those who have given their lives in military service.
Sadly, we still have many problems in getting timely veterans’ health benefits to retired and living U.S. servicemen and servicewomen, as I’ve often highlighted here on this day. The best opportunities, I think, for the use of Lean methods in government is to reduce the time spent waiting for access to services that members of our armed forces have earned.
Mark’s Note: I’m away on vacation through November 6… there will be some guest posts in this post during that time. Today’s post is by Dean Bliss, a good friend of mine who has worked in Lean healthcare for a long time now, in many different capacities.
In my work in Lean healthcare over the past few years, one question that I am frequently asked is “what do you think about the Affordable Care Act (a.k.a. ObamaCare)?” I have my own opinions of the pluses and minuses of the ACA, whether it is the individual mandate, the funding sources, the impact on insurance, or any other items. But my response to the question is always the same: “It doesn’t matter. It’s the law, and we have to deal with it.”
The ACA is having a profound impact on many aspects of healthcare, and where we are in 2013 is just the tip of the iceberg. Increased demands on the system, confusion about the rules, and the uncertainty of the political landscape are all significant factors in what happens going forward. But here’s the deal – we in healthcare have work to do no matter what happens.
One of the big arguments given for “Lean Government” efforts are the cost savings that are generated by various Lean projects at local, state, or federal levels.
I’ve heard stories and rumors from people who have done Lean Government work… complaints that so-called “cost savings” never lead to budget reductions because one’s power is pretty proportional to the size of one’s budget. The “use it or lose” it mindset kicks in and all sorts of stupid spending occurs at the end of the year.
The Washington Post solicited stories and has a report that documents this dynamic: “As Congress fights over the budget, agencies go on their ‘use it or lose it’ shopping sprees.”
I recently read an article (a case study) about “Lean Six Sigma” in a publication. It’s not online, so I can’t link to it, nor do I really want to call them out by name.
I didn’t like the article, in part, because it used the old, tired (and wrong) idea that “Six Sigma is for quality” and that Lean is only about “faster and cheaper.”
Good gravy, how do people NOT realize that the Toyota Production System and Lean are about both flow AND quality? For direct evidence that Lean/TPS is about both, see Toyota’s website on “jidoka” and “just in time.”) The article I read is, unfortunately, an example of L.A.M.E. or “Lean As Mistakenly Explained.”
The article talks about a scenario where a city government wants to reduce traffic accidents at one particular intersection. Since an accident is a “defect,” they called on the Six Sigma belts to gather data do a bunch of statistical analysis (assuming, it seems, that a quality problem must be the domain of Six Sigma). It took time and a bunch of meetings to plan for this formal exercise. It’s a “hard problem” that’s “hard to solve,” the author said.
MP3 File (run time 34:14)
Joining me for episode #180 of the Lean Blog Podcast is Dan Florizone (@DanDeputy), who served from 2008 until last month as Deputy Minister of Health in the Canadian province of Saskatchewan. Dan has just recently transitioned into his new role as the Deputy Minister of Education and he will also focus on the application of Lean principles across all departments of the government.
Dan previously had over 25 years of healthcare management experience, including a five-year stint as CEO of the Five Hills Health Region. Dan and I first met a few years back when we were at a Lean healthcare conference hosted by Cindy Jimmerson. I really enjoyed talking with Dan and have closely followed the Lean healthcare transformation work being done in the province.
In the episode, we talk about Dan’s introduction to Lean, his 2005 visit to Seattle to learn more, and how Lean is part of their “patient first” model. Lean has been a shift from “tradition
How is the National SECURITY Agency so bad at securing its own information? They’re better at snooping than securing, I guess.
This article has an explanation: NSA leaker Ed Snowden used banned thumb-drive, exceeded access.
Here’s the latest in my “What I’m Reading” series, where I clear out some of the inventory of articles I’ve read, but haven’t blogged about.
It’s great to see Lean used to help improve government operations – productivity AND quality.
If someone said you could increase the efficiency of your jurisdiction’s crime lab by 200 percent, you’d probably initiate an investigation into possible illegal use of controlled substances.
I’ve re-read this article a number of times: “Cancer clinics are turning away thousands of Medicare patients. Blame the sequester.”
It’s a sad situation – the federal government, via Medicare, has cut the reimbursement to cancer clinics for chemotherapy treatment as a result of the across-the-board “sequestration” budget cuts. Root cause here? Lack of leadership in Washington D.C., perhaps, or blame the voters.
What’s sad is that some cancer patients are being TURNED AWAY from the clinics due to the cuts because the doctors say the patients are “unprofitable.”
First, do no harm?
I’ve never been a big fan of the TSA or any form of visual inspection. I wasn’t a fan, either, of the automated x-ray technology that was used in (and then removed from) American airports while being banned in Europe over safety concerns.
Relying on 100% human visual inspection doesn’t work because, well, we’re human. We get bored, we get distracted, and our brains often see what we expect to see rather than the actual signals that are sent from our eyes. Visual inspection often fails whether it’s Toyota workers inspecting the paint on a new truck or a pharmacist double checking a medication.
I’m a critic of traditional suggestion boxes, since they are usually garbage cans for ideas. Boxes collect anonymous complaints (not good) and managers often ignore what’s in the box (not good either).
I thought I had heard it all in terms of bad suggestion box practices, but here’s a new one. As described here, Louisiana State Rep. John Schroder, R-Covington, has set up on online email suggestion box for state employees. OK, I would be skeptical of that already.
The ridiculous rule in this system? “Workers will not be allowed to send suggestions to the email while they are on the clock.”
What the what?
From today’s news: “Backup presidential limo on its way for Obama in Israel after fuel filling failure.”
U.S. President Barack Obama’s trip to Israel was tripped up by a preventable error – the Presidential limousine was mistakenly filled with diesel fuel instead of gasoline / petrol.
One of the limousines in Barack Obama’s fleet has broken after reports that it was mistakenly filled with the wrong fuel at the start of the US president’s visit to Israel.
Another limo is on its way from Jordan, according to Ma’an News agency, citing Israel’s Channel 10, to replace one that was filled with diesel instead of gasolene.
This is clearly a preventable error… one that could increase the risk of harm to the President if the vehicle broke down in an unsafe location. I’m curious to hear if there will be any “root cause analysis” and corrective actions taken to prevent a future re-occurrence (or somebody will just be punished).
It’s time again for a regular feature I call “Stuff I’m Reading.” I have too many browser tabs open and my Mac is bogging down (root cause of this?), so it’s time to share some links that I may or may not blog about more fully in the future.
The president should make medical errors a priority — to save both lives and money: Paul O’Neill (hear my podcast with him) writes an open letter to President Obama encouraging him to “announce that you have ordered each of the veterans’ hospitals and U.S.-based military hospitals to connect with the Internet at 8 a.m. every day to post every hospital-acquired infection, every patient fall, every medication error and every injury to a caregiver that occurred during the previous 24-hour period. Announce that this will commence March 1, and that it is your intention to require all U.S. hospitals and nursing homes to start doing this on April 15.” O’Neill says increased transparency will lead to better safety.
In the Kaizen approach, stealing the ideas of others isn’t a negative thing. If somebody else implemented an idea and you can use that idea in your area, a Kaizen organization ENCOURAGES the borrowing, stealing, adoption, and adaptation of ideas. There’s no shame in that. This idea was being preached at one hospital I visited yesterday, which was nice to see.
But… USA Today had a blurb the other day about one idea you shouldn’t steal. It’s an idea that’s already proven not to work – paying bonuses based on the value of improvement ideas.