Operational Excellence Mixtape: January 17, 2020


Healthcare – Creating Value for Patients

Sometimes you just need to get a team together and improve.  Here's a good example of use of A3 thinking to improve opioid prescribing in outpatient rheumatology

Reducing harm requires the conditions to speak up, raise concerns, and make mistakes. A study shows hospitals with high levels of psychological safety are more likely to have comprehensive infection control programs

I have bad news for healthcare leaders.  There's no silver bullet to improve quality of care.  Governments, regulators, and healthcare organizations have spent the last 30 years trying to find the perfect organizational structures, economies of scale, and “controls” to rein in costs and improve care.  On balance, costs have increased and quality…who knows?   Case in point, the New England Journal of Medicine studied the merger and acquisition of hundreds of hospitals and found that quality got worse or stayed the same.

The 2010's saw an explosion of electronic health records and a corresponding erosion of the time a doctor spends with patients.  Technology is both the cause and the solution in 2020 – Eric Topol describes how AI will change medicine.  On the other hand, rushing in with technology to save healthcare could be risky, as Scientific American explores in Artificial Intelligence is Rushing Into Patient Care – And Could Raise Risks.  

A good comparison of when simple human-centred design outperforms sexy tech design.  

Operational Excellence

One way to design a better product is to figure out how to make it worse.  When Going Evil is the Perfect Technique. 

Many problem solvers are skilled at “breaking down the problem” into small enough pieces until it can be readily solved.  Descartes advice from the 17th century to “divide each difficulty into as many parts as feasible and necessary to resolve it” rings true in 2020.

“Pilot” is sometimes used to describe small-scale interventions, and omits the fundamentals of a basic experiment.  Here's a local story of how not to run a pilot, including testing an intervention in a different place than the baseline was collected, not collecting any data on the test, and substituting materials at the last second.   

Chowa, “part of Sekisui House's practice of kaizen, or constant improvement–in its goal to make home “‘the happiest place in the world.'”.  Kaizen and the Art of High Volume Home Building in America in the 2020's.

Automation of clerical work is accelerating.  Many avoid discussing the upcoming changes to work with their clerical staff because it is assumed that they will be fearful of re-skilling and “losing” their current work.  However, most employees are excited about the possibilities to learn and practice new skills, so it is important to start discussions as soon as possible to plan for re-skilling for higher-value functions.   

Kaizen is a way of life at Pall Biotech, a global biotech validation company. It's refreshing to hear someone categorize kaizen as innovation.  

Leading & Enabling Excellence

Beware the HIPPO in the room – the Highest Paid Person's Opinion.  

Leaders – you don't necessarily need to be the top technical expert in your department.  As routine work becomes automated, leaders need to rely on and empower staff for innovation, problem solving, and critical thinking.  Here's how to succeed without being the smartest person in the room.  

The New York Times reviews some internal messages released from Boeing show the deep cultural challenges that probably contributed to the 737 MAX debacle.  It just keeps getting worse.

An inspiring article by Mona Sen on how Multiple Sclerosis has made her a 24/7 problem solver.

Coaching – Developing Self & Others

Want to be a great leader?  Be a great coach. 

I have no time for that.  I'm too busy.  How come these are the most common refrains today despite advances in technology?  Here are 3 Theories For Why You Have No Time.  

When we're busy and under pressure, our brains will “tunnel” our focus – which would be a good thing if it helped us focus on the most important tasks.  Alas, it tends to create focus on low-value urgent tasks at the expense of tasks related to important long-term objectives.  Treat time and bandwidth as a trade-off when planning your time to avoid scarcity of time, tunneling, and poor decisions.

Recognizing and avoiding drama at work.

Books, Podcasts, Videos

Looking for leadership books to read in 2020?  Check out  Adam Grant, who picks 20 Leadership Books to Read in 2020. 

One of my favourite books of 2019 was Atomic Habits by James Clear.  If you don't feel up to reading it, here's a 25 minute podcast on HBR Ideacast The Right Way to Form New Habits

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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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