This is always a tongue-in-cheek warning, but there are times when I warn hospital leaders that they have to be careful when going to the “gemba” (gemba being a Japanese word used in Lean to describe the place where the work is actually done – the front lines, such as the point of patient care).
Lean Thinkers might wonder “what is bad about going to the gemba?” Well, going to the gemba could be a bad idea and could make things worse if leaders exhibit the wrong kind of behaviors.
This old urban legend helps articulate that in a cheeky way:
Thanks to the site Snopes.com, a site that debunks (or verifies) urban legends and myths, here is one version of a classic factory story (variations are told in different settings and this story could be adapted to healthcare):
The proprietor of a shop was once passing during the packing room and noticed a boy lounging towards a field and whistling cheerfully. Thinking of all his cash being wasted on this sort of exertions, the corporation requested gruffly, “How much do you get a week?”
“Ten dollars,” the boy spoke back.
“Here's your pay for the week,” stated the person. “Now get out!”
On his as far back as the administrative center, the shop proprietor bumped into the foreman and requested him, “When did we hire that boy, and who is responsible for hiring him?”
“We never hired him,” the foreman stated. “He was just delivering a package from another firm.”
The story is a silly one, but it illustrates one possible failure mode involved with going to the gemba – jumping to conclusions and making on-the-spot top-down decisions out of anger.
A lot of the ideas can be summarized in this sentence:
The words of Toyota Chairman Fujio Cho, “Go see, ask why, show respect” are now famous as basic lean principles.
In the urban legend, the shop owner went to the gemba, but he didn't stop to ask why. Arguably, he didn't show much respect by jumping to the conclusion that the boy he kicked out was lazy and shirking work.
As Shook explains, respect doesn't mean being nice all the time, it includes challenging people, but it includes making things better for workers:
Most of all, respect means doing what we can to make things better for workers, which starts by not making things worse. And we still find leaders doing more of their share of damage even as they try to help!
Which leads to the first rule of gemba walking: “Do no harm!”
The shop owner should have talked to the boy. Let's say it was an employee – asking “why?” about the idle employee might uncover a process problem, equipment breakdown, or delay. That's the problem to go after rather than blaming the person who is idle.
If leaders are going to behave in “old school” ways, it might actually be better to stay in your office and the conference rooms. Now the urban legend I shared is a really obvious portrayal, but what are some more subtle examples of the “wrong” sort of gemba behavior? What would make you want your CEO to go back to the office?
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