Operational Excellence Mixtape: February 28, 2020

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Healthcare – Creating Value for Patients

Developing a culture of patient safety requires the ability to raise risks without fear of reprisal.  This post from leanblog.org about a nurse who failed to report a critical incident for fear of being immediately fired without question reminds us we have a long way to go.

When first learning about designing reliable processes, I was introduced to techniques for estimating measurement error in order to assist in detecting a signal from the measurement system.  James McCormack has published an article that includes an interactive calculator to show that results may vary due to the imprecision of medical measurements.  

Methods of incremental quality improvement applied to a system have long been challenged for credibility and acceptance in healthcare, but this appears to be changing over time.  Healthcare has long favored Randomized Control Trials as the only accepted evidence of beneficial practices, and has often eschewed programs of practical operational experimentation as unscientific, preventing the scaling of best practices.  This article reviews some of the challenges of achieving continuous quality improvement in pediatrics in Canada

Operational Excellence

“Standard work will reduce us into unthinking robots” – a common refrain encountered when standardizing work practices.  The truth is, standardizing work liberates your brain and hands to focus on higher-value and creative functions.  A Starbucks leader describes how Standardized Work Can Set You Free.

When introducing KPIs, there is often a focus on the sophistication of the metrics or the tools and dashboards that display them, rather than a focus on driving helpful behaviours. If the people who are expected to use the metrics to solve problems don't understand them, there's not much point.  Stacy Barr reminds us that KPI engagement matters more than KPI sophistication.  

Key Performance Indicators can be easily distorted and gamed to achieve almost any narrative.  Even the Securities Exchange Commission (SEC) is providing guidelines on the Use of Key Performance Indicators in Management Discussion and Analysis.  It's easy to imagine what behaviours necessitated these guidelines.

Why do some ideas end up being the next Uber, and others the next Bic's disposable underwear (yes – this was really a thing)?  Deeply understanding a customer's triggers for purchasing and removing barriers to purchase, according to Rotman Magazine's Bringing Ideas to Life.

Managing disruptions often results in short-term measures like cost reduction.  To build resiliency in the face of disruption, focus on developing people over short-term measures.  

The robots are not coming as fast as people fear.  The real problem remains a lack of skilled workers.

One of the first modern-era workers to lose his job because of AI, chess champion Garry Kasparov encourages us to embrace AI in the workplace and the associated benefits

Leading & Enabling Excellence

Low levels of psychological safety can actually result in disaster.  Pioneers in psychological safety, such as Barry-Wehmiller, establish “default trust”, make it safe to speak up, and make it safe to fail.  

An easy way to demonstrate your mistrust in employees is to install monitoring software to encourage staff to remain at their desks at all times under the guise of “transparency” and “effectiveness”.  Barclay's installed Big Brother monitoring software, but has scrapped it based on backlash, for now at least.

I've been following the Wells Fargo “fake account” scandal for years. This month, the US government fined Wells Fargo $3 billion as part of a settlement related to this scandal, but the settlement doesn't provide for customers or employee damages.  

Coaching – Developing Self & Others

Recognition is an important driver of engagement, but celebration should be balanced by reflection on what could be improved.  Here's How to Practice Hansei, the Japanese Art of Self-Criticism.

Coaching and helping others can be addictive.  To help avoid the dark side of coaching, here are 4 ways to Overcome Your Obsession With Helping Others.

All mentors can coach, but not all coaches can mentor.  Mentors should be invested in the long-term growth and development of others.  The 3,000 Year Old Lesson in Executive Mentorship

Books, Podcasts, Videos

Command and control leadership can result in considerable harm and damage, and a culture of people doing what they're told.  I'm enjoying reading Turn The Ship Around! : A True Story of Turning Followers Into Leaders by former US Navy Captain David Marquet. Don't have time to read this book?  Check out David Marquet on Coaching for Leaders 454: How to Ask Better Questions.

All improvement is incremental.  Steve Spear, author of The High Velocity Edge and the seminal article Decoding the DNA of the Toyota Production System, joins Mark Graban for a great discussion on leanblog podcast episode #358 – Steve Spear on Evolving our Knowledge and Learning on Lean

Can you be self accepting without losing the drive for excellence?  Brene Brown and Tim Ferriss get deep into striving vs. self-acceptance in episode 409 of the Tim Ferriss Show.  

Operational excellence relies on the scientific method.  Scientific inquiry involves testing a hypothesis by exploring uncertainty until there is sufficient evidence to reach a reasonable conclusion. But consultancies and “product-defence” often subverts the scientific method.  I'm reading The Triumph of Doubt: Dark Money and the Science of Deception to learn more about how uncertainty is weaponized.  

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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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