Operational Excellence Mixtape: March 1, 2019


Healthcare – Creating Value for Patients

Ontario is betting big on an untested hypothesis of reorganizing and consolidating healthcare operations and budgets predicting it will result in patients “seamlessly” moving through the health system.  Time will tell, but the history has been written.

Discharges from hospital have long been a high-risk opportunity for mistakes and miscommunication, often with harmful effects.  By reframing the traditional “discharge summary” as a clinical handoff between hospital MDs and community GPs, and engaging the right people in the redesign, Gold Coast Hospital and Health Services in Australia expects harm reduction and higher-quality transitions of care.

When hospital staff flag something that has gone wrong, it is called an incident report.  When patients do it's called a complaint.  The language we use to describe patient feedback has a detrimental influence on safety culture.

I've often wondered about the process used to take evidence-based practices and putting them into place in a clinical setting.  Apparently this process is called implementation science – here's an example of using implementation science to create innovation in dialysis clinical practices.

Operational Excellence

There are too many opex, lean, lean six sigma consultants to count.  How can you tell which ones are charlatans?  Pascal Dennis evokes Kurt Vonnegut and Richard Feynman – if advice is not simple, it's probably BS

Your customers don't care how busy you are — I repeat — your customers don't care how busy you are. Organizations continue to obsess over production rates and making sure staff are as busy as possible.  This does not necessarily ensure you are creating value for your customers.  Customer obsession is more effective for creating meaningful and sustainable change.

Insights don't have to be earth-shattering to be valuable.  Sometimes the most valuable insights are the most obvious ones, like when Google analytics discovered that meeting new hires on their first day is helpful to speed up the onboarding process – duh. I heard John Toussaint say “if you've seen one lean journey, you've seen one lean journey.”  The same applies to agile, which uses many of the same principles, according to this article by McKinsey describing two paths to agile.

An excerpt from Jeffrey Liker's book The Toyota Way to Continuous Improvement recounts a case of developing a deep understanding of improving a process (or ‘model cell' thinking) as a precursor to “rolling out” new standards.  

In an age of digital disruption, Toyota continues to improve the vaunted Toyota Production System (TPS) to meet the challenges of the present and future. Continuously improve your continual improvement methods.

Leading & Enabling Excellence

In the 1960's and 1970's, management theorists tested the following hypothesis with great results (dubbed the Human Relations Movement):  “How can we build work environments where human beings are free to flourish?”.  Why did progress stall out 50 years later?  Gary Hamel suggests there are 4 reasons: Orthodoxy, timidity, fragmentation and irrelevance.

Amazingly, I still get challenged by supervisors and managers about the value of spending time at the source, process (gemba) walks, or as Tom Peters describes Management By Walking Around MBWA.  Here's a quick synopsis of why gemba walks are helpful in Leadership Network. My question to leaders: if you don't have time to do this, what do you have time for?

Why should you lead as if you had no power, when it is obvious that power gets things done?  Michael Ballé offers his wisdom.

Coaching – Developing Self & Others

The Dunning-Kruger Effect is critical in understanding development of self and others. David Dunning, long-time student of stupidity and name-bearer of this effect, reminds us that saying “I don't know” is critical to develop oneself.  

I admit it.  I sometimes wait to respond to emails.  Adam Grant argues that ignoring emails is an act of incivility. 

Asking questions is an essential coaching skill, but you don't want to walk around like a Socratic riddler.  Here's a helpful guide on asking purposeful questions.

We often lament that people aren't open-minded when it comes to new ideas (or my idea).  Here's an interesting read on willful blindness and the psychology of why everyone is biased in favour of themselves.

“Great facilitation leaves no gaps between thoughts and deeds”.  Well said.

Books, Podcasts, Videos

You've probably read Good to Great – pretty much mandatory reading for MBAs about 10 years ago.  Jim Collins, the reculsive author of Good to Great, Built to Last, Great by Choice, How the Mighty Fall, and Turning the Flywheel emerges for a great interview on the Tim Ferriss Show.

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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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