I've been talking to a lot of healthcare organizations about Kaizen and continuous improvement. There are many organizations embracing the methods that Joe Swartz and I wrote about in Healthcare Kaizen. I think there's some momentum building out there for making sure that Lean isn't only a bunch of projects — instead, having everybody engaged in improvement (as Imai says: everybody, everywhere, every day).
But, I've also heard a somewhat disturbing pattern of organizations saying they aren't ready for Kaizen because their senior leaders aren't “on board” yet. They think Kaizen makes sense, but they are going to wait. Until when?
I understand the importance of having senior leaders understand Kaizen so they can model the leadership behaviors that are necessary for Kaizen to thrive. This is true at Franciscan St. Francis (Joe's system), as well as places like ThedaCare and Virginia Mason Medical Center where the CEOs are working every day to create and build a culture of continuous improvement.
That said, how do you build a culture of continuous improvement if you don't start working at it? I thought of an analogy the other day…
At left is a young Michael Jordan, one of the greatest basketball players in the history of the NBA (he's turning 50 this week).
Let's say the 11-year old Michael said he liked the idea of playing in the NBA. Let's say he said, “I'm not going to start playing or practicing basketball until I grow to be at least 6′ 3″, because I wouldn't be good at basketball if I'm tall. I'll wait until I am ready for basketball.”
Let's say he was 16 years old and he suddenly shot up in height from 5′ 10″ to 6′ 6″ in a short period of time, as some kids do. So, then he starts playing basketball because he's tall enough. He's now a very tall and very inexperienced player. His basketball development is far behind kids who started playing when they were young. Maybe it's too late to catch up and achieve the dream of being an NBA player.
Sidebar – when I was an undergrad at Northwestern, the men's basketball team had a 7-foot center who was just terrible. He didn't start playing until his senior year in high school and he was just an uncoordinated mess. He once dunked the ball into the wrong basket when he was in junior college before transferring to Northwestern.
So, while your hospital is sitting there saying, “we're not ready for Kaizen,” other hospitals (maybe your competitors) are practicing Kaizen and they are getting better at it. Can you catch up if you start a few years later?
When you start playing basketball, you're going to be pretty bad. You don't know how to dribble, or how to shoot, or how to play the game. The same is true with Kaizen. You might, in a way, dribble the ball off your knee a lot… but you have to keep playing. That's how you get better.
If you don't start playing, you can't get better. Great players don't wait until they are tall enough for the NBA to start playing.
Unlike basketball, we don't need rare Michael Jordan-type talent to be successful with Kaizen. Everybody can practice Kaizen… you have to be willing to start. You have to give up the fear of being terrible at it first (and I rarely see people who really are terrible, even at the start). There are so many challenges facing healthcare – what better time is there than now to start engaging everybody in improvement.
Did Toyota become a Kaizen culture overnight? Of course not… look at their data (which I believe is from the book 40 Years, 20 Million Ideas: The Toyota Suggestion System):
It took 20 years to get up to two suggestions per person per year. Toyota wasn't an overnight success with Kaizen.
Look at the data from Joe Swartz's organization (updated with 2012 data):
They got to about two suggestions per FTE by 2010 – four years into their program. And they've maintained that… because they keep working at it. They weren't afraid to start.
Starting somewhere and showing the impact of Kaizen might be the best way to get leaders on board. “It's easier to act your way into a new of thinking than it is to think your way into a new way of acting.”
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