Healthcare – Creating Value for Patient
Canadian healthcare is where “pilot projects come to die”. There is a lack of a culture of innovation in Canadian health, partly due to its fragmented nature and reliance on academic and government echo-chambers to devise solutions.
Two data points do not make a trend. Reporting on ER Wait Times in Winnipeg continues to focus on monthly fluctuations and two-point comparisons, rather than actually seeking to answer the only question that matters: “are wait times improving?”. The Winnipeg Sun and WRHA continue to issue reactive reports either too soon declaring victory in the battle against waiting, spending time rationalizing (probably) normal variation, or determining that countermeasures are failing – all based on two-data point comparisons. I suspect the truth (not that you will find any from any reports), is that these data fall within an expected range of variation. Mark Graban writes about the waste involved in this type of reporting, and what to do differently here.
One of the many barriers to improving value in healthcare is measuring value. Here the Wall Street Journal looks at the challenges in even determining what routine knee surgery actually costs. It's difficult to create measurably better value when one can't measure value….
Is it better to scale your lean efforts “inch deep – mile wide” or “inch-wide – mile deep”? The “model cell” approach is often debated in lean communities. Here's a piece in support of doing a deep dive in a focused area – but don't call it a “pilot”. John Toussaint of Catalysis also advocates for the use of the “model cell” to learn and scale transformation efforts in healthcare. Is there a right way to scale up transformation efforts? I think it depends (major cop out, I know).
One of the most frustrating questions for improvement professionals is “why don't proven improvements or ideas immediately catch on and scale up? “. Too often, we expect improvements with demonstrated results to “spread” across our organizations. This is rarely the case, and there are many reasons for this. Here is an article from Stanford Social Innovation Review describing the reasons for the “stagnation” chasm that examines reasons proven social innovations don't catch fire – I think many of these principles apply to operations as well.
Is Toyota agile? Aren't agile principles similar to those of the Toyota Production System? I was surprised to learn that Toyota has been on an agile journey for two years.
Lean practitioners are often tasked with explaining why lean principles are effective. Michael Balle attempts to navigate this argument in his post “Why lean works”.
Leading & Enabling Excellence
Many organizations lament that people “aren't accountable” and that accountability will solve all their problems. This is often a case of mistaking blame for accountability, which can result in a culture of fear and
Why do people believe in some leaders and not others? Not surprisingly, perceived competence and trustworthiness are important to establish credibility as a leader.
Here are some sure-fire ways to erode trust by bullying employees.
Coaching – Developing Self & Others
Humility is key to self-development. It's hard to learn if you already know everything.
Are you learning to learn faster? Steven Spear challenges us to apply improvement principles to our own learning processes.
Books, Videos, Podcasts
I'm currently re-reading some OpEx classics such as:
A 1994 book about Deming called Deming's Profound Changes: When Will the Sleeping Giant Awaken? by Kenneth Delavigne and J. Daniel Robertson. I found this at a used bookstore for a couple of bucks – it's a great read so far.