Operational Excellence Mixtape: December 21, 2018


Mark's Note: I've known Ryan McCormack for many years now, thanks to his previous work in Lean healthcare and his attendance at Lean Healthcare Transformation Summit events. He's been sending out an excellent curated email on Operational Excellence. You can sign up to receive them (these are separate from any Lean Blog emails you might receive). I asked Ryan if I could archive these emails to give them a more permanent home on the web… and he agreed. Thanks!

Healthcare – Creating Value for Patients

Healthcare is probably the only remaining industry where one can routinely encounter fax machines and pagers.  The NHS (UK) has banned the purchase of fax machines as it seeks to (finally) modernize its tech infrastructure.  Canada, please follow suit ASAP.

“Never events” still occurfar too frequently.  Errors such as operating on the wrong person are preventable, yet they continue, such as this local case at CancerCare Manitoba.  This article implies that overworked nurses are the cause, but this seems lazy to me, as it also then follows that the problem is solvable simply by adding staff, which is rarely true, or by assigning blame to individuals.

One of the reasons EHRs are not conducive to great workflows is because they were designed primarily for revenue generation.  

Think chatbots are just for tech help when you have problems with your cable? Chatbots are being used to help patients navigate their care.

Operational Excellence

OpEx leaders and practitioners rely on facts and data for analysis and decision-making, but those of us who have been at this for a while know that facts are not often enough to change people's mind.  This article explores the psychology behind why people deny facts.

That productivity and cognitive function deteriorate with longer work hours is not debatable; it has been studied countless times across many industries.  The heroic myth of the great leader who never sleeps endures nonetheless, but not because of actual results. Boasting about how many hours you work is a sign of failure

Great problem solving is often about having better questions, and not rushing to have all the answers.  Adam Grant reminds us that  “..career success is rarely about finding the right solution to a problem — it's more about finding the right problem to solve”, and that “academic excellence is not a strong predictor of career excellence” in this interesting piece “What Straight-A Students Get Wrong”.   This helps explain why OpEx practitioners with great problem-solving mindsets usually outperform those with many ‘belt' certificates and alphabet-soup profiles (or ‘collectors' as I call them), as related in this article by Mark Graban “We've trained a gazillion belts in healthcare. Why aren't things better?”.  You can't simply train your way to excellence.  

The “5 Whys” is an ubiquitous and sometimes maligned approach to uncover root causes.  There are many criticisms, primarily based on its focus on single causal pathways and sometimes circular or unproductive logic.  Pascal Dennis distills the power of 5 Whys as a teaching routine and the helpful categorization of the 3 types of root causes.

OpEx leaders often complain that senior leadership “don't get it”.  Jeff Hunter suggests that empathizing with senior leaders and helping them apply PDSA to the strategic management process can help to demonstrate the power of lean thinking. 

Leading & Enabling Excellence

Read this from WIRED:  Dr. Elon and Mr. Musk: Life Inside Tesla's Production Hell.  

“People support what they help create” says Keith Krach in this podcast with Whitney Johnson on Transformational Leadership.

In the digital economy, command and control managerial mindsets are replaced by leaders who can cultivate an innovation-minded and agile culture.  Trust and empowerment are essential leadership characteristics to enable results.

It is now more widely held that a focus on increasing shareholder value, distributing gift cards, and installing ping pong tables are not sufficient to deeply engage employees.  Propellernet, a UK firm, boasts engagement rates of 90%, by creating a human-first approach.

Coaching – Developing Self & Others

Take a break people! The myth of longer hours = productivity endures despite evidence and experience to the contrary and the well-established Parkinson's Law,  Here's a great piece from the Economist on why working longer hours doesn't automatically lead to increased productivity.

Coach Meg reminisces about a 2008 video called How Coaching Works – and it's still fresh 10 years later.

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Ryan McCormack
Ryan is an operational excellence professional with over 18 years experience practicing continuous improvement in healthcare, insurance, food manufacturing, and aerospace. He is an avid student of the application of Lean principles in work and life to create measurably better value.


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