Tag: Government

Podcast #198 – Harry Kenworthy, #Lean in Government

Podcast #198 – Harry Kenworthy, #Lean in Government

MP3 File (run time 39:17)

harryEpisode #198 is a discussion with Harry Kenworthy about his work bringing Lean into local and state governments. We had a great conversation that touches on the influence of Dr. W. Edwards Deming and many other concepts that might be of interest even if you’re not interested in “Lean Government” and the work happening there.

Harry is Principal and Manager of the Quality and Productivity Improvement Center (QPIC, LLC), a consulting organization he founded in 1984 and has been with full time since 2004. He worked with Dr. Deming in 1983-85 on a series of 2 day seminars throughout the US, sponsored by MIT. He has spoken at over 90 conferences on quality, productivity, Lean, and Six Sigma, and has been published several magazines including Quality Progress and Purchasing. He also had working relationships with Dr. Joseph Juran and Dorian Shainin.

He was one of the first practitioners to apply LEAN in the Government sector in the mid-90’s.

Here is an article by Harry, shared with permission (PDF link): Getting Started on a Lean Government Journey

Weekend Fun: Skinny Cow Handling

Weekend Fun: Skinny Cow Handling

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

By February 22, 2014 3 Comments Read More →
Preaching to the Choir: Lean Works Everywhere

Preaching to the Choir: Lean Works Everywhere

Screen Shot 2014-02-04 at 8.04.44 PM

Some of you might have seen it, but I wrote a piece for the LinkedIn Influencers series about how the “Lean Manufacturing” principles are being used in various “knowledge work” settings – including healthcare, education, software, government, financial services, etc. Here it is:

“Lean” is Not Just for Manufacturing – It Applies to Knowledge Work of All Types, Too

When I write for LinkedIn, I try to write for a broader, general business audience. By comparison, I presume the audience here is already interested in Lean, at the least.

By February 7, 2014 0 Comments Read More →
Podcast #188 – Daniel T. Jones on 25 Years of Lean & the Future of Lean

Podcast #188 – Daniel T. Jones on 25 Years of Lean & the Future of Lean

MP3 File (run time 31:13)

jonesMy 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

By December 18, 2013 1 Comments Read More →
Detroit Elects a Lean Thinking Mayor? Will it Make a Difference?

Detroit Elects a Lean Thinking Mayor? Will it Make a Difference?

duggan

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:

By November 14, 2013 10 Comments Read More →
We STILL Need to Reduce Waiting Times for Veterans

We STILL Need to Reduce Waiting Times for Veterans

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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.

By November 11, 2013 2 Comments Read More →
The Affordable Care Act – Good, Bad, or What’s the Difference?

The Affordable Care Act – Good, Bad, or What’s the Difference?

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.

deanblissIn 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.

By October 28, 2013 2 Comments Read More →
And Here’s Why I’m Cynical about “Lean Government”

And Here’s Why I’m Cynical about “Lean Government”

Screen Shot 2013-10-16 at 8.46.27 AM

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.”

By October 17, 2013 9 Comments Read More →
Don’t Let Looking at Data Blind You From Seeing Reality

Don’t Let Looking at Data Blind You From Seeing Reality

A couple of red traffic lights against a blue skyI 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.

By September 10, 2013 18 Comments Read More →
How Often Does This Get Repeated? CMS and the Underpants Gnomes

How Often Does This Get Repeated? CMS and the Underpants Gnomes

gnomeI’ve recently heard of a scenario in healthcare that I suspect is pretty common, or at least it’s not the first time I’ve heard of this scenario.

There have been stories in the news, but without naming names and without any inside information, here is what is reported to have happened in one of these recent cases:

1) Hospital brings attention on itself by performing a wrong-site surgery on a patient

2) A state-level agency comes in to inspect the situation and finds a number of other problems, including shockingly unsanitary cleaning practices in the O.R., expired medications, and things the state rightfully recognizes to put patients in jeopardy

Right now, this begs the question of whether these SAME problems don’t also exist at other hospitals. There might be risks to patients even if there has NOT been a recent wrong-site surgery.

By September 5, 2013 9 Comments Read More →
Podcast #180 – Dan Florizone, Lean in Saskatchewan Healthcare

Podcast #180 – Dan Florizone, Lean in Saskatchewan Healthcare

MP3 File (run time 34:14)

dan florizoneJoining 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

Snowden-Proofing the NSA

Snowden-Proofing the NSA

USB Flash DriveRegardless of whether you think the NSA leaks that Edward Snowden admitted to make him a hero or a traitor, it begs the question:

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.

What I’m Reading: Good News and Bad News on Patient Safety & Government Processes

What I’m Reading: Good News and Bad News on Patient Safety & Government Processes

books in a stack (a stack of books)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.

NY crime lab improves efficiency with ‘Lean Six Sigma’ process

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.

Less Margin, No Mission?

Less Margin, No Mission?

Bring on the TaxotereI’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?

The Folly of Visual Inspection and the TSA

The Folly of Visual Inspection and the TSA

Just so you know...

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.

Louisiana’s Online Suggestion Box Will Fail; Connecticut Lean Efforts Might Not

Louisiana’s Online Suggestion Box Will Fail; Connecticut Lean Efforts Might Not

Oscar the Grouch - shoreditch

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?

U.S. Presidential Limo Breaks Down Due to Fuel Filling Error in Israel

U.S. Presidential Limo Breaks Down Due to Fuel Filling Error in Israel

oopsFrom 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).

Stuff I’m Reading, February 21, 2013: Transparent Errors, Hidden Gorillas, Gaming of Systems

Stuff I’m Reading, February 21, 2013: Transparent Errors, Hidden Gorillas, Gaming of Systems

Screen Shot 2013-02-20 at 8.11.47 PMIt’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.

By February 21, 2013 3 Comments Read More →