Mark Graban's leanblog.org - Lean Healthcare, Lean Hospitals, Healthcare Kaizen, Lean Thinking, Lean Manufacturing, Toyota Production System

Lean or “L.A.M.E.”?

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Many of the “anti-lean” stories I hear sound like descriptions of situations or methods that I would hardly describe as “Lean.” There are many problems with the word “Lean,” (see one such example) but we're pretty well stuck with it.

  1. “Lean” is often used in a negative sense that has nothing to do with the Toyota Production System, as in “we have very lean staffing levels,” meaning “we don't have enough people to get the job done.” That's not the Lean concept at all. A Lean organization makes sure we have the right number of people to do the work the right way.
  2. There is no official ‘keeper of the lean” to officially bestow the “lean” title on any practice or behavior. We're free to describe pretty much anything we like as “lean,” the only downside might be getting mocked in the lean community, but that's not much downside, is it?

For example, this “5S” program in the UK that was described as “demeaning.” From the news reports, this didn't sound very “Lean,” (in a Toyota sense) in terms of doing anything much to reduce waste or improve things for employees. Does this give “Lean” a bad name or does it give the consultants and the managers a bad name? People tend to blame “Lean.”

When companies use Lean methods to drive layoffs, something most Lean consultants (myself included) say you shouldn't do since it understandably drains any employee enthusiasm for lean, does this give “Lean” a bad name or that company a bad name? People blame “Lean” and say that “Lean” led to their layoffs.

When this guy got the idea, somewhere, that Gemba walks led to more bureaucracy and paperwork. If that the was the case somewhere (and it shouldn't be if a Gemba process is implemented properly, would “Lean” get the blame for wasting managers' time?

We need a phrase that describes these “bad” or misguided attempts at Lean, things that give Lean a bad name.

How about something like…

LAME: “Lean” As Misguidedly Executed

Lean As Mistakenly Explained?

Can you think of a better phrase?

We need something to describe what bad managers do when they purposely distort or accidentally misunderstand Lean. Maybe this will catch on, or maybe it's lame.

This way, when we see a “lean horror story,” we can refer to it as the “LAME method” instead of a “Lean method.”

Do you have any “LAME” stories to share for others to learn from?

More “LAME” posts and stories.

Please post a comment and join the discussion. Subscribe to get notified about posts daily or weekly.

Mark Graban is an internationally-recognized consultant, author, and speaker who has worked in healthcare, manufacturing, and startups. 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 book is an anthology 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. His next book, to be released in 2018, is Measures of Success.

55 Comments
  1. LeanPrinter says

    Since most (if not all) failed attempts to become Lean are due to senior leaderships’s failure to educate, engage, and evolve, how about Lacking Any Management Ethics?

  2. Kevin says

    I like it. Easier to describe and keep consistent than the “real lean” vs. “fake lean” that we talk about a lot.

    I do think that “distort” or “accidentally misunderstand” is a little narrow. Some leaders (and the previous commentor is right) simply don’t have the capability to understand, they are misinformed, etc.

    Kevin

  3. Dean Bliss says

    This reminds me of a discussion I heard about yoga, which is not only exercise, but a philosophy. Those who treat it as “exercise” move away to the next thing, while those who embrace the philosophy get the benefit. When yoga “contests” started popping up, it was an indicator that those participating didn’t “get it”. The same can be said of Lean – or, for those who don’t understand, LAME.

  4. […] so superficial that it might actually be harmful. This might fall into the subset of “L.A.M.E.” that stands for “Lean As Mistakenly […]

  5. […] what the poster calls “Pretend LEAN.” That’s another way of explaining my term of “Lean As Misguidedly Executed,” or “L.A.M.E.” Other Posts That May Add Value:Manager Tools PodcastTwo Global Value Streams Passing In the […]

  6. […] no, it’s a L.A.M.E. (Lean As Misguidedly Executed) story on NPR’s All Things Considered. No wonder some people […]

  7. Robert Drescher says

    Unfortunately most people jump on any bandwagon, I have seen supposed Lean consultants that double as outsourcing experts for China. That rates a lame, why would we expect businesses whose owners and managers only care about now be expected to actually implement lean, not likely, but if they can use it as a short-term fix they will, or at least pretend they did.

    The LAME above is close but not quite Lacking All Morals & Ethics, maybe we can create a set of awards or a reality TV show on Fake Lean.

  8. […] i ämnet. Tyvärr känns risken stor att det blir ytterligare ett exempel pÃ¥ lean failure (eller LAME som jag tycker är en träffande term). leanLAME, lean ← Evidensbaserad lean? Leave […]

  9. […] and respect for people.   This way of thinking is just, as my Lean colleague Mark Graban puts it, L.A.M.E thinking!     We saw some of the same previously  when the Wall Street Journal published a front page story […]

  10. […] sounds like L.A.M.E. (Lean as Misguidedly Executed as coined over on the Leanblog by Mark Graban) and not lean.   If you had hiccups in procurement, lean behavior would ask questions around what […]

  11. Anna Smith says

    Hi Mark,

    This post has been on my mind – I’m trying to figure something out: My almost blind 92-year-old awesome grandmother had hip replacement surgery at a local hospital. She was treated like a Queen, made many friends and felt genuinely cared for.

    Then she transferred to a rehab center. Apparently, the nurses there meet every morning to discuss patients’ progress, new developments, goals and the like. The staff maintains a rigorous schedule, sets challenging goals for each patient and follows-through with specialized training; all processes seem to be optimized and effective.

    But my grandmother does not feel taken care of, she is miserable. Her drinking cup is labeled with her name on it, but she can’t read it. At lunch, a nurse sits with her while she is eating, but she is afraid to eat (and spill food all over her). She is not laughing much and not having a good time like she did at the hospital.

    From an organizational perspective, what went wrong?

    1. Mark Graban says

      Hi Anna – thanks for your comment. For the sake of context, are either of those organizations using the lean methodology, to your knowledge?

      It sounds like the rehab center might be focusing on the technical and the clinical sides of care, without having as much focus on the caring side of health care, from a holistic standpoint? Are they treating her condition more than treating the person?

      1. Anna Smith says

        Thanks for your reply. I had assumed that the rehab center was trying to be lean, but I just visited their website and they are apparently big on TQM.
        The other, ‘good’ hospital belongs to the Health Promoting Hospitals Network, http://www.euro.who.int/en/what-we-do/health-topics/Health-systems/public-health-services/activities/health-promoting-hospitals-network-hph
        And yes, the rehab center is treating her condition more than the person. They are “missing a soul” (quote my dad).

        Anyway, lean methodology is not used anywhere – so nevermind the question :) Still very interesting, though…
        Thanks!

          1. Tony says

            When my 89-year old mother was in hospital last year I was amazed at the difference in attitude between 2 sections of the same hospital. She was unable to stand, walk, or care for herself, yet in one ward it was as if it was a burden for several of the nurses to help her with eating, toileting, etc. Food would be left out of her reach, she would be expected to fend for herself when it came to scalding hot drinks, she was often kept waiting to go to the toilet until it was too late, and her skin was torn on several occasions from removing adhesive dressings. Yet when she had a major stroke and there was no hope for her, she was moved into a specialist stroke unit and the care she received there was extremely loving. The first thing the head nurse said to me when I met her was ‘We do things differently here’. I really have no idea what kind of management principles were in operation in the two departments but I found the difference them extraordinary and inexplicable.

            By the way, this is my first visit to your site and I will be a frequent visitor in the future. I am looking forward especially to listening to all your podcasts. Thank you.

            1. Mark Graban says

              Thanks for visiting Tony and for that cogent description of the differences between those two units. Everybody deserves the best care possible and that means I hope everyone gets to benefit from that “different/better” approach (often facilitated by Lean) that leads to a better environment for patients and staff.

              I’m sure in that one unit, it was a “burden” because the staff had too much waste to deal with… not because they were bad or inherently uncaring people.

  12.  | Karabin

    […] dette blogginnlegget fra 2007 irriterer Mark Graban seg over at mange LEAN-prosjekter egentlig er LAME-prosjekter. Med […]

  13. […] Regarding Lean, we have now quite some company that went for a Lean management system. Some were highly successful, other less, but it seems hat failure is generally associated with either not believing in Lean (self-fulfilling prophecy) or not doing “real Lean” (which generally means that Lean activities have been focused on tools and not on the management that should go with them – that’s L.AM.E. (Lean As Mistakenly Executed)) […]

  14. […] What I described above, though caricatural (or is it?) is still what’s even been given a name: L.A.M.E. (Lean As Misguidedly Executed). […]

  15. […] How many Lean programs start with an objective of reducing costs? How many of them are named “Lean” when it’s spelled “L.A.M.E“? […]

  16. […] about how to apply 5S in a knowledge environment is rampant, as these stories of “lean as misguidedly executed” (LAME) attest. I believe that’s because people focus on the easily visible, outward […]

  17. Matt says

    LEAN has been the buzzword for the last year from management as well as the provincial initiative. I recently took the white belt training and had a pretty good consultant from Oregon I think.

    Anyways, the very first thing Toyota had to do prior to implementation was bring the union and management together. Have real discussions and remove as much “in-fighting” as possible. The next step was for mgmt to cancel meetings and spend “time on the floor” in order to actually understand flow, issues, etc.

    #1 and #2 have not been done, yet there are tons of RPIWs, weeks in training for managers and one day for union staff. Are they missing the very fundamentals of LEAN?

    1. Mark Graban says

      Thanks for your comment, Matt.

      I’m only being a bit facetious when I ask what a “white belt” is. The whole “belt” business is a Six Sigma invention. So that gives me pause. I guess you got so-called “Lean Six Sigma” or “Lean Sigma” training? Toyota doesn’t do “belts” nor do many organizations that practice Lean/TPS.

      RPIWs are only one part of the Lean equation. Why is the training so skewed toward so much more time for managers?

      Yes, getting people to somewhat set titles aside to work TOGETHER in seeing, understanding, and solving problems a Lean discipline that should be practiced – not just training and not just events.

      The story of NUMMI would probably be a helpful thing to study, since the Toyota plants in the U.S. are non-union. NUMMI was an exception, but Toyota seemed to collaborate and partner with the union pretty well – judged by the results.

      http://www.lean.org/shook/displayobject.cfm?o=1166

      1. Matt says

        Thanks for the quick reply. I guess i is a hybrid system then :) I’m very new to the philosophy. Will finish reading the NUMMI article today.

        I think we don’t have to set titles aside, but certainly the egos that sometimes come with them. We all are working towards common goals that are mutually beneficial, so it would seem an easy task .. lol

        Will be interesting when (or if) the first RPIW happens in IT here, and what sort of ratio of management to workers there will be. Its 1:10 in the workplace.

        Is there supposed to be a Kaizen Office with 20+ staff? I know we have a large organisation, but I do wonder about that too :)

        1. Mark Graban says

          Is there supposed to be a staff of 20+ in a kaizen office?

          Yes, if you need that many.

          I’m not trying to be difficult, but there’s no magic formula. Having a kaizen office as a central function can be helpful… but it’s probably something that should be ramped up over time. ThedaCare has 20+, but that doesn’t mean you need that many now. The numbers depend on the size of your organization, your lean maturity, etc.

          By the way, I think “setting titles aside” means exactly what you said – leaving egos out of it (and not having the most senior person always getting their way or always being right because they are more senior… or because they are a doc, etc.).

  18. Matt says

    Its good to challenge, I have no problem with that :)

    I really do hope some good comes from LEAN, as Health Care does seem to always have tremendous waste. Although I think the Shared Services initiative can potentially address much of that.

    Most staff are quite frustrated by the disconnect between the workers and managers. Time spent as peers and “in the trenches” would benefit this organization to the nth degree. This is where I was very impressed with our LEAN consultant. He spoke of cancelling all meeting and experiencing the everyday issues, workflow etc of the staff.

    1. Mark Graban says

      Yes, closing that gap between workers and managers is an important step in the Lean process.

      My post title aside, it’s not “LEAN” in all caps… I will change that. Lean isn’t an acronym… so it is always puzzling to me why so many people type LEAN when they don’t type SIX SIGMA.

  19. Matt says

    Definitely not an acronym, good call ;)

    i will look more into Six Sigma as well.

    Cheers

    1. Mark Graban says

      Actually, I wouldn’t suggest that… you have your hands full with Lean. Six Sigma adds complexity and overhead that you probably don’t need at this point in your journey.

  20. […] L.A.M.E. (Lean As Mistakenly Executed) is giving Lean a bad name. The article’s lead paragraph says is all: “The lean manufacturing model, when applied to knowledge work, is a race to the bottom where humans are reduced to robots and creative output to widgets. The work is process-mapped to death, and management demands “faster, better, cheaper.” The concern is not for the experience of the end customer or the growth of the company, but rather ‘what can the customer live without so that we can save more money?’” […]

  21. […] Unfortunately, lean is often practiced as a set of tools, it is hard whilst people are learning about lean for this not to happen sometimes, I know I have fell into this trap myself on occasion. I’m sure many of you have heard of value stream mapping, 5S, 7Wastes, 7Flows, Ishikawa diagrams, Rapid Improvement Events (RIEs), or as Virginia Mason calls them Rapid Process Improvement Workshops (RPIWs) etc, these tools can and do deliver great improvements and there are great teams using many of their ideas across the country, for example in modules with the Institute’s fabulous Productive Series. But that is all they are, tools, and like any tool they need to be used and applied with care, caution and thought. Unfortunately on many occasions I have seen these tools applied in isolation, without supporting infrastructure, out of context and inappropriately, usually by well meaning ‘experts’, in a way that some would describe as ‘toolheads’ and others would describe as ‘fake lean’ or ‘L.A.M.E.’. […]

  22. […] There  are literally hundreds, if not thousands of books out there related to the topics of Lean and continuous improvement.  I know because I’ve spent a good majority of my adult life reading most of them.  Unfortunately, the vast majority are frankly not very good.  There are many self-proclaimed “senseis” out there claiming to have unlocked the secrets to Lean success .  In reality, these so-called “experts” are nothing more than Lean consultants with very little proven, real-world success re-packaging outdated and ineffective approaches as the next best thing.  As Mark Graban says, that”s L.A.M.E. not Lean. […]

  23. […] sales folks, suppliers, etc. – i.e. all stakeholders. I also assume the aggregates exclude LAME, Wagile and other such faux approaches which claim to be working in certain ways, but fail to live […]

  24. Alan Jackson says

    I like this moniker. I suggest using #LAME as a hashtag. LAME is to Lean (LEAN As Misguidedly Executed) as PINO (PRINCE in Name Only) is to PRINCE

    AJ

  25. Tristan Kromer (@TriKro) says

    Wonderful acronym that brings the message home.

    I suppose it’s all par for the course. Same thing happens with every new idea, but it’s certainly discouraging and makes change much harder when all terms are eventually bastardized.

    I sometimes don’t even talk about lean. Whatever terms the organization is using works fine for me!

    1. Mark Graban says

      I understand the “whatever term works” approach (some hospitals use branding like “Process Excellence” instead of “Lean”), but one advantage of using a term like “Lean” (or other consistent terminology) is that people can more easily connect their work to the improvement work done by others in their field…

  26. […] Bob Emiliani has coined the term, “Fake Lean” and Mark Graban has developed the acronym L.A.M.E. (Lean As Misguidedly Executed).  The deviousness of fake lean is that from 10,000 feet, it may look and sound like […]

  27. Ovidiu Contras says

    Mark – here’s a true story:

    We were all excited when we received the approval to visit the famous Lean site. All we heard of was how great their moving line is. One Lean executive even expressed his annoyance when we independently wanted to make the contact, as he was treating this particular site as the best kept Lean secret. Some team members were skeptical about the applicability of the concept to their reality – so the visit was incorporated into our Lean transformation plan – with the clear intent to inspire. So here we were, all packed in the bus, joyfully anticipating the experience.

    At the site, the hosts were really welcoming and invited us into a conference room, where they gave us a presentation about the effort and the motivation behind the transformation – and then it was time to go on the shop floor.

    Everything was there: the shadow boards, the ANDON lights and musical signal, the Kanban cards, the dedicated stand-up meeting place with all the indicators posted, the suggestion system and the carts made from easy-to-assemble materials… Our skeptical team members saw how the product was moving while being assembled and how raw materials were brought to the line as kits.

    As we were walking, we were asking a lot of questions that revealed what’s unseen to the eye: this beautiful Lean display was in reality a huge Push line, triggered by the MRP system coordinating all activities, running big batches and failing to complete the product where it needed to be completed, overcrowding the “hospital” off-line area ….

    No wonder that, as it was mentioned in the introductory session, the expected transformation results were not there. Of course, it was “much better than before” … but with equivalent transformational timelines, this one was achieving a small fraction compared to the reference I was giving in my previous post (Wiremold).

    Turns out the inspiration for their genuine effort came from a consultant that used be an employee for an iconic automotive OEM. Nothing wrong there, except that the consultant didn’t live the several-decade transformation the particular OEM went through, but just lived the system once it was well established. What we were seeing was the result of trying to mimic it… just the Lean Form, no Lean Substance.

    1. Mark Graban says

      Thanks for the story. People forget (or never learn) that Lean / TPS isn’t just about tools and things you can see with your eyes (the practices).

      It’s also about the management system and philosophy… that’s what helps create a Lean culture.

  28. […] example of “LAME” (to borrow an excellent phrase from Mark Graban), […]

  29. […] paradoxical when an organization implements a change project aimed at flow efficiency (read: Lean), in which the project around the same time partially creates the […]

  30. […] That’s not really true, but JIT and Lean production. It’s L.A.M.E. or Lean As Misguidedly Explained. […]

  31. […] If Lean project leaders are forcing changes on people and aren’t seeking input (or are shooting down all ideas), that really shouldn’t be described as Lean at all. It’s more likely an example of L.A.M.E. or Lean As Misguidedly Executed. […]

  32. […] this, because a primary concern is that doing so leads to confusing Lean with what Mark calls L.A.M.E. (aka fake Lean). In addition, the slogan undermines what I believe to be the goals of […]

  33. […] very large NHS organisations. It may very easy to become impatient and slip into the delivery of LAME/Fake lean, even unintentionally, or in reaction to urgent stakeholder demands, or whilst facing new […]

  34. […] Lean “not introduced correctly” would be what I call L.A.M.E., not Lean. Lean is actually the best alternative to healthcare layoffs and Lean organizations (in […]

  35. Forward to 2016 |

    […] My main aim, however, is to remember why I established the website in the first place. I wanted to create a UK health service presence on Lean, to encourage other people to look at the techniques, and approach, and to decide if it might be useful for them. I wanted to make information available that avoided, as far as possible, Mark Graban’s LAME label (Lean as Misguidedly Executed). […]

  36. […] WHAT? Toyota doesn’t engage staff in continuous improvement? That’s, frankly, ignorant and it’s a great example of L.A.M.E. — Lean As Misguidedly Explained. […]

  37. […] The other day, somebody from a major global manufacturing company emailed to tell me they were using this video in a Lean training class as a cautionary tale. Let’s avoid annoying people with “Bad Lean” or L.A.M.E. […]

  38. […] often leads to situations that are L.A.M.E., not […]

  39. […] One previous post (and read more about what I call “L.A.M.E.“) […]

  40. […] the pejorative definition of LEAN as “Less Employees Are Needed” or what Mark Graban calls as LAME. Lillian Gilbreth, in her 1957 speech advises us to keep this in mind when improvement activities […]

  41. […] there is a term used to describe the mis-understanding of lean.  The term, coined by Mark Graban is LAME.  Lean As Misguidedly Executed.  In the dairy industry, lame is a real condition that negatively […]

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