Happy Nurses Week – Lean Can Help


This week starts the celebration of International Nurses Week, which leads up to Nurses Day on May 12, which is the birthday of the legendary Florence Nightingale.

Hug a nurse today. Or do whatever you can to help.

Nurses are the backbone of any hospital (and are key in most every other healthcare settings). Doctors may get all the glory, but, as many people say, nurses run the hospital.

I've been fortunate to work with many nurses over the past nine years. I was talking about Lean and process improvement last week with Suz Kaprich, who now works with the KaiNexus team. As we were talking about her backgrounds, Suz talked very matter of fact about her days as a critical care nurse and how many resuscitations she had done. That ability to restore life to another person… that's not an experience I will ever directly have. I won't ever be trusted with a patient's care.

That's why I'm so passionate about working to support our nurses by helping create better workplace environments… working with nurses and their leaders. Nurses are far too often overburdened (“muri” in Japanese and Lean speak) in the workplace. There's unnecessary stress that a Lean factory would never tolerate. Jobs, even those with a lot of variation, would be designed and staffing levels would be set at an appropriate level that allows people to do the right work the right way without rushing or cutting corners.

Nurses spend far too much time acting as their own material handlers – something a Lean factory would never tolerate. When I take nurses to the Toyota Plant in San Antonio, they are amazed (and jealous) of Toyota's small army of support staff who make sure the right materials are in the right place, in the right quantity, at the right time. They're also jealous of the “andon cord,” that allows an overburdened employee (or one who sees a quality problem) to pull a cord and immediately get help.

Nurses also get personally blamed (and sometimes jailed) for errors and mistakes that are very systemic in their nature.  A Lean factory would never tolerate this. It's the role of leadership to create systems, processes, and a culture that allows safety and quality to happen reliably and consistently. We shouldn't insist that people “be careful” and never make mistakes – nurses are human and humans make mistakes. Lean and the patient safety movement agree that we need to design systems that make human error less likely, rather than blaming them when it occurs.

You should be able to read the full PDF of this article:

From Toyota to the Bedside: Nurses Can Lead the Lean Way in Health Care Reform

I agree with the article in saying that Lean healthcare is not just about engineers being of service to nurses. Nurses can and must be involved in improving their own workplaces – they are the experts. We can teach them Lean concepts and coach them on Lean methods, but nurses are the key. I know many nurses who have transitioned into full-time Lean and process improvement leaders.

Nurses are ideal leaders of Lean work

Leading a complex Lean transformation of a large hospital department is a natural role for nurses, who have experience leading multiple-disciplinary teams, are trained in assessment, and are system thinkers. Nurses also bring added advantages to the role of Lean leader–an uncompromising commitment to patient care and the natural ability to view hospital systems through the lens of the patient.

Hug a nurse today. Or help them through your own Lean efforts. Or, better yet, teach them Lean and help them lead the improvement work.

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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.



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