Daily Archives: February 4, 2010

How Does Autonomy Fit Into Lean Management?

Dan Pink’s new book “DRIVE” made me wonder how Lean managementwill work with the book’s premise that knowledge workers seek autonomy.Do standardized work and job instruction sheets take away from the need to have autonomy over what tasks people do, when they do it, who they do it with, and how they do it?

The book’s premise is that old motivating ways of using the carrot as a reward or the stick as punishmentdoesnot work for knowledge workers. Knowledge workers are motivated by autonomy over task, technique, time, and team. They are also motivated by the pursuit of mastery and fulfilling a purpose. I posted a video from the author explaining the concept a couple of months ago.

Pink breaks down processes into two categories:

  • Algorithmic: Tasks where you follow a set of established instructions down a single pathway to one conclusion
  • Heuristic: Tasks which require experimenting with possibilities to devise a novel solution and no single pathway exists

Carrots and sticks work well for motivating people with algorithmic tasks (to some extent) butcause damage when applied to heuristic tasks.

One of the challenges at my hospital is that most providers think providing all elements of care is heuristic. They each have their own special skills and experiencesto create care for the patient. From a Lean perspective, we have variation and unpredictable results which cause waste. Provider teams in the hospital are working at transforming some of these tasks to be algorithmic. Weare able to meet our patients’ demands better, less people are idle, and supplies are getting closer to point-of-use.

Despite these wins, is Lean thinking taking away autonomy by transforming heuristic tasks? I do not think so but we have look at things a little differently.

Just because a task is algorithmic does not mean creativity is lost and robots are created. For patient care, maybe all of the steps leading up to diagnosis are algorithmic but the value added part is heuristic. This frees up the provider’s mental capacity to focus on the true customer problem and not on the problems getting up to the customer.

Another way of looking at this is that the problem solving part of everybody’s work is heurestic. If every task is somehow transformed into a single pathway, your staff should still have the autonomy to recognize problems and experiment to fix them. Helping people understand that their creativity will be focused on trying to improve experiences instead of trying to figure out what to do next or where something is.

Lean management should strive to motivate people as autonomous knowledge workers. Even if standardized work makes tasks look ripe for the carrot and stick treatment, recognize you are asking staff to be creative and solve problems.

What do you think?

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