Yes, We Need Staff Ideas – But, How to Manage Those Ideas?


It's always great to see stories in the major media outlets about engaging front-line staff in improvement ideas. Recently, we had a piece in USA Today that I blogged about  and now we have one in the Wall St. Journal titled: “For Bright Ideas, Ask the Staff.

The article starts on a very promising note, saying, “Companies are moving beyond the suggestion box.”

Amen to that. The traditional suggestion box might be well intended, but in practice it's “where good ideas go to die,” as a client of mine once said. Suggestion boxes are slow, batchy, opaque, and non-collaborative. Most of them just don't work. But, thankfully, we have alternatives, including the Lean “kaizen” model of Masaaki Imai and Toyota.

From the article:

In an effort to cut costs and create new products and services, firms are seeking ideas from their own employees on everything from money-saving strategies to product design.

This is true in healthcare and it's the focus of my upcoming book on “Healthcare Kaizen” (or continuous improvement).

Again, from the article:

It's often the employees—rather than outside consultants—who know a company's products and processes best. According to management experts, many of the most innovative companies tend to solicit ideas from staff throughout the organization, not just the executive ranks.

As an outside consultant, my role is to teach healthcare professionals and managers about Lean principles and Kaizen principles — and they come up with amazing improvements that make for better patient care and better workplaces — and better financial results for hospitals.

The article also sites a professor who is one of the inspirations for our Healthcare Kaizen book, where we cite and quote him.

But it's often hard for rank and file workers to be heard: Research has found that the average U.S. employee's ideas, big or small, are implemented only once every six years, says Alan G. Robinson, a professor at the Isenberg School of Management at the University of Massachusetts, Amherst.

But, the article focuses on new technology-driven solutions that are more like the old fashioned suggestion box than they are like modern Kaizen.

The article describes software systems where employees submit ideas (that's a good start), but the downsides include:

  • “a team of senior managers will review an idea within 30 days of its submission and notify the employee of its status.”  (that's much slower than Kaizen, where ideas are often evaluated and implemented COLLABORATIVELY within a few days)
  • At PriceWaterhouseCoopers, only 140 of the 3,300 submitted ideas were implemented (with Kaizen at Toyota or my co-author's hospital, up to 90% of ideas, or some iterative variation, are implemented)

140 out of 3300 is only 4.2% What gets people more engaged and excited about improvement – 4% or 90%?

I'm not sure I like the trend of employees “voting” on the ideas of others. Kaizen is not a popularity contest where only the top few “best” ideas get implemented. Kaizen is built upon small, low-cost, low-risk local improvements that can be implemented quickly by a team and their supervisor. We don't need or want everything to run through a huge bureaucracy.

In the WSJ comments section, somebody wrote that we should just pay employees more for ideas and then we'll get more. But Prof. Robinson counters there and there is data (from Robinson's book “Ideas Are Free”) that suggests BIGGER rewards lead to FEWER ideas (due to jealousy and dysfunction that comes from payout systems that are inevitably deemed to be unfair by employees).

Some companies pay financial rewards for ideas (typically as a percentage of cost savings, which can be tough to measure) but Dr. Robinson says that isn't usually an effective tactic for drawing submissions on a continuing basis. What drives most people to submit ideas is a real desire to make their work easier and cut through hassles, rather than monetary rewards, he says.

I know some healthcare organizations that pay for implemented ideas (usually just a small token, like a $5 gift card) and some that only give non-financial recognition, including thank yous, newsletters, and bulletin boards. In an effective Kaizen system, people generally want to make their own work easier and they want to improve things for their patients or customers. You don't need to pay people if you have an effective system and culture that helps them get their ideas implemented quickly.

Our upcoming Healthcare Kaizen book talks about these practices and principles. Our healthcare improvement software from KaiNexus (where I am “Chief Improvement Officer”) is built around the model of implementing MOST ideas, quickly and effectively, not just a lucky few that survive a voting or “American Idol” type process.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. One other point to make about the senior manager review of improvement ideas: it seems crazy to have people who aren’t intimately involved with the work sit in judgment of the value of the idea. Sure, if the idea involves something that affects the whole company or the whole value stream, the senior manager perspective is needed. But if it’s a local issue, that perspective is often flat-out irrelevant or wrong.

    • Amen. I spent an incredibly delightful day with some Kaizen leaders at Franciscan St. Francis Hospital in Indiana, the hospital of my co-author for the Healthcare Kaizen book, Joe Swartz.

      The managers I met today really get it — empowering yet supporting staff in Kaizen, not micromanaging it. Will blog about it.

  2. If senior management involvement is needed for *most* ideas, or even for more than, say, 20% of them, then something is wrong with the organization. With a well-designed organization run by intelligent and motivated people, ideas get acted on by the lowest level which has responsibility and authority for the relevant work.

    Ironically, much of talk about “nonhierarchical organizations” and “teams” and “delayering” etc has led in practice to environments where the only person with any real empowerment to do anything significant is the one at the very top. And he, in turn, of course has limited decision bandwidth and knowledge.

  3. Providing ideals to senior management is similar to taking my better half out to dinner. There is just a hunger with no real vision. First she will say “You decide on the place to eat”…OK…Barbeque… no I’m not in the mood for that…OK then seafood…. no I had that for lunch…Mexican…no… lets just stay home then an eat leftovers…but I want to go out for dinner. Arrrrg…

    In other words it’s much easier to provide relevant ideals if management provides a clear picture of wanted outcomes. Just hungering to be Toyota isn’t enough.

    • Agreed, David, and we address this in the book. When getting started with Kaizen, it can be helpful to just ask people for ideas that make their own work easier. But more effective Kaizen programs have alignment between improvement ideas and the strategic directions and goals of the hospital and the department. ThedaCare, for example, uses the formal lean strategy deployment process to help align Kaizen that’s driven by the front line staff.


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