Stuff I’m Reading March 2015: Womack, Sweatshops, Hospitals, and Surveys


As often happens, I have too many open browser tabs full of articles that I was going to potentially blog about. Too much WIP (a problem that Jim Benson will discuss in our upcoming Boston workshop).

So, it's time for me to clear out my backlog and to share some articles I've been reading with some quick notes, instead of full blog posts. Well, I got my backlog down by three. I'll try again next week with some shorter blurbs about more articles, perhaps.

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Womack on Sweatshops and Respect

In the category of “Lean for social good,” Jim Womack writes about the need for companies to prevent the use of sweatshops in their global supply chains: “Bringing Respect for People to the World's Sweatshops.” Womack defines a sweatshop as not just a workplace that's unsafe or physically brutal, but also as a workplace that doesn't engage people's minds and creativity.

“It should no longer be good enough for their contractors to stop using child labor and provide a safe working environment. Multinationals need to assist their contractors in applying best management practices and demand that they use them. In other words, social responsibility on the part of consumer goods companies should require that they show respect for low-wage workers by designing good work for them to do and by tapping the brains of the workforce, not just their muscles.”

The same should be true in any first world business and especially in hospitals.

NPR on Protecting Nurses from Injuries

I blogged recently about the need for hospitals to truly make safety a top priority (for nurses and patients). This NPR piece dives into some of the preventable harm that occurs for healthcare professionals: “Hospitals Fail To Protect Nursing Staff From Becoming Patients.”  Again, talk about a lack of respect.

Many hospital administrators overlook injuries among the nursing staff partly because they're preoccupied with other priorities. Industry sources told NPR that nursing employees have traditionally ranked low in the hospital industry's hierarchy.

“Too many hospital administrators see nursing staff as second-class citizens,” says Suzanne Gordon, author of Nursing Against the Odds. “Historically, hospital administrators have viewed nurses as a disposable labor force.”

Hospitals make some efforts to help, but you can see the systems issues at work here:

“…staff like Moore, the ICU nurse, say they kept warning Kaiser's managers that while the steps seemed good on paper, they often did not work. When the nurses would need a lifting machine to move a patient, they would discover that some other unit had borrowed it, or it was stuck behind cleaning equipment in a distant closet. Or the machine's battery was dead. And when they would urgently request a lift team, they would learn that none was available because the team members had been reassigned to other duties.

“Every day you call and say, ‘We don't have anybody to help us,' ” Moore says. “And again it would be the same thing every single day, being jerked around. And by the end of the day, nobody ever came to help us.”

Problems like this can be solved through 5S and other basic Lean practices. But, it has to first start with a culture of respect.

Are You Happy at Work? Press 1…

This WSJ article caught my eye: “Are You Happy at Work? Bosses Push Weekly Polls.” I'm a bit skeptical of surveys if they are a replacement for managers really paying attention to employees and their work, and seeing and hearing what's happening personally.

Annual or bi-annual surveys are too slow and too infrequent. This article discusses more frequent surveys. Technology makes that possible, but is that really the right approach?

In the era of status updates and instant feedback, so-called “pulse surveys” are now catching on at work. Employers say short monthly, weekly or daily polls–sometimes a single question at a time–provide data on how their teams actually feel and catch problems before they fester. Frequent surveys are even replacing annual employee surveys at some companies, bosses say, although other companies, such as Google Inc., use both.

The trend is part of a larger shift toward data-driven work in which managers are expected to use data to make decisions large and small, from broad corporate strategy to which toppings to choose for an office pizza party. Mobile apps and faster analytics have put sophisticated polling tools within reach of even small firms.

Organizations often worship at the altar of being “data driven.” As Toyota's Taiichi Ohno once said:

“Data is of course important in manufacturing, but I place the greatest emphasis on facts.”

Are employees happy? Are they doing fulfilling work? Are they being placed in unsafe conditions? Are they not being listened to?

These are things that can probably be detected without data… leaders can gather “facts” by talking to people at the gemba (in the workplace).

Last year, Sears Holdings Corp. started an effort, dubbed Project MoodRing, to record store employees' moods at the end of their shifts. Workers choose a color-coded emoticon on a screen to describe how they are feeling, from “unstoppable” or “so-so” to “exhausted” and “frustrated.” Sears estimates it will receive about 28 million daily mood responses a year.

Interesting. Whether it's an annual survey or these quick feedback methods, employees will become more frustrated and cynical if positive actions aren't taken as a result of the feedback they give.

I still like the simple measure of “# of Kaizen improvements being implemented” as a real-time gauge of culture, engagement, and satisfaction. What do you think?


Do you want to see what a “culture of continuous improvement” looks, sounds, and feels like? Check out this workshop (more of a mini conference) that Joe Swartz and I are holding in April at his health system in Indianapolis. Please come join us.

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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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