Thanks to Quality Digest for publishing an article I co-authored with Gregory Jacobson, MD, a co-founder and the CEO of KaiNexus, a software startup I am working with as we go to market with web-based technology that helps initiate, manage, and spread ideas that come from clinicians and front-line staff.
You can read the full article, “Putting the ‘Continuous' Back into Health Care Continuous Improvement” on the Quality Digest website, but I'll share some related thoughts here. You can comment on their website or have some discussion with the crowd here.
The main motivation for the piece is our belief that the word “kaizen” has unfortunately become associated with weeklong improvement events. This often seems to be especially true in healthcare (where they might be called “rapid improvement events” or “rapid process improvement workshops.” Events might lead to improvement, but they're episodic, not continuous.
The word kaizen is sometimes translated from Japanese as “change for the better.” A successful and sustained event would fit into this definition. But the context for the word kaizen is most often about “continuous improvement,” as in small, low-cost, low-risk local improvements that are implemented by the people who do the work and their supervisor. Norman Bodek's “Quick and Easy Kaizen” approach is an example of this continuous improvement.
Masaaki Imai's seminal book “Kaizen” does not talk about kaizen events or blitzes. He writes about three types of kaizen, including management-oriented kaizen (big, strategic improvements) and group-oriented kaizen (teams of people working together on departmental or sitewide improvements). Arguably, group-oriented kaizen could be practiced through an event. The main bulk of Imai's kaizen was on individual-oriented kaizen – taking local improvement action in your own area. This is the focus on my upcoming book “Healthcare Kaizen” and it's a major focus in our KaiNexus software, at this point in our development.
I'll try to summarize my thoughts this way: kaizen events are not inherently bad. They are often mismanaged and become a slow, ineffective, bureaucratic slog. But they don't have to be. Kaizen events are, as you might hear in a cereal commercial, “part of this complete nutritious breakfast” that also includes kaizen as daily continuous improvement. As Imai says, everybody, everywhere, every day.
You can have your events… but maybe just leave the word kaizen out of it? You can call them “kaikaku events,” after the Japanese word for “radical improvement.” Let's reclaim kaizen for this staff-driven daily continuous improvement.
Note: Mark will be a guest on the internet video broadcast “Quality Digest Live,” with the editor of Quality Digest, Dirk Dusharme. I hope you can tune in.
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