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The other day, I watched the online archive of a webinar given by Mike Hoseus, co-author of Toyota Culture: The Heart and Soul of the Toyota Way
You can use the link at the top of this post to listen the free audio archive (with registration) and even download the slides in PDF form. The message that he sent is applicable to any industry.
One story that intrigued me was Hosus talking about how, when he was an early employee at Toyota's Georgetown Kentucky plant, he was sent to Japan to work on the assembly line for 30 days. Before he could be a team leader (the first level of supervision at Toyota, with 4 to 5 direct associates reporting to him), he had to work the line.
Why? “To build empathy” for those doing the work. How great is that?
Compare that to the old GM approach (still in place when I started in 1995) of taking a freshly-graduated engineer and making them the supervisor over a process they didn't understand, supervising people they might have trouble relating to. That was a formula for disaster.
Now looking at healthcare, it's much more common for charge nurses, supervisors, or team leaders to be promoted up from the rank and file. Most of the managers (even executives) have done the work of the people they manage. A VP of nursing tends to be a nurse. I do know one extremely effective laboratory director who came in from a nursing background — she was effective, but had a lot of work to do to build trust and respect from the staff.
So, in the cases where managers are promoted up — that natural empathy should be there. But why do healthcare leaders often fall into the same types of manager and supervisor behavior that I saw at GM, a non-Lean environment?? Why do managers plead for people to be careful, to work harder, to suck it up and not complain… they should feel empathy, but I guess the greater management system that they're now a part of sends the same message… keep your head down, don't make waves.
That's why the cultural transformation effort required for Lean seems so similar to me comparing manufacturing to healthcare. It's all about how you lead. It's all about having empathy and being a servant leader, not being “the boss.” Having empathy doesn't mean being a pushover – it means being able to put yourself back in the shoes of the people doing the work.
What do you see in your organization, in terms of supervisors or managers — do you have to build empathy? Do you have to help them not lose their sense of empathy once they become part of management?
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This blows me away… When I started as an engineer in manufacturing, before I even heard of lean, on my first day I asked if I could work on the production floor for a couple of weeks to understand the processes. I was denied. "Just work with the people, observe, and find out what the issues are," I was told. Later, when quality issues arose and our quality standards weren't matching with what our CUSTOMERS wanted, I suggested we bring in some dealers whom we sold directly to, so we could provide some samples of parts we made so we could understand how they defined quality/value. These processes were related to visual/aesthetic criteria – attributes, not variables data – nothing that could be quantified very easily. And, this was in the days just before the worldwide web was launched, so digital photos and email weren't around yet. "We don't want to take the time to do that," I was told.
I'm told this former employer of mine has now embraced lean. I'd believe it only if I re-entered their walls and observed for a couple of weeks.
Thanks for the comment. I should have added in the post, but you just jogged my memory… when I was at GM, I was allowed to work on the engine assembly line for about 45 minutes one day.
This was done under very tight union rules and oversight… so here I was, putting parts on an engine with all of 30 seconds worth of training. I was terrible at the job.
In hindsight, they should have NEVER let me build real product without real training… but that's how it was done. Try to dumb the work down to a point where it could be taught (so they thought) in 30 seconds.
Not lean.
In many organizations, it seems that when a person becomes a first-level manager/supervisor, they are so inundated with paperwork (or "screenwork") that their primary function becomes feeding the administrative system rather than doing anything really related to the work. My perception is that this is particularly bad in retail chains.
A good question for the job candidate to ask the potential future employer during the interview process… "What will my training look like?"
Almost all of the non-clinical leaders in my org came out of top business schools straight into the executive suite and don't have a clue about what it is like to work in healthcare. Similarly I can't think of a senior nursing leader (and there are many) that has done patient care in the last 15 years.
So how do they lead improvement? They hire a bunch of consultants to come in and tell them how to do the job they should be doing if they weren't so detached from the operations they are supposed to be leading.