Category Archives: Change Management

Test Beliefs Against Data

I like this quote because it touches on a couple of other ideas I have read before. One author I like (Joiner) states that all leaders need to treat decisions as experiments.  Lean challenges HiPPOs (Highest Paid Persons Opinion) to use data in decision making instead of through assertiveness or by being charismatic. The quote below is a good reminder to always experiment with theories to be able to show data if the theory is true or not. It also helps me really notice when opinions are made verses asking for objective data to support.

“In a world without data, opinion prevails…Most managerial dictums are hypotheses. A hypothesis by nature is useless unless proven by data…Asserting an opinion as a fact is a lot easier. Pretending that our assuredness reflects objective truth is certainly convenient …we need to test our beliefs against data…Managers must see themselves as experimenters who lead learning, not dictators who impose control.” – Peter Scholtes “The Leader’s Handbook pages 29,33

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Filed under Business, Change Management, Communication, Data & Charts, Gemba, Health Care, Improve With Lean, Improvements, Kaizen, Lean Hospital, Lean Hospitals, Learn Leadership, Personal Development, Plan-Do-Check-Act

Change Through Repeated Action

“Beliefs, behaviors, assumptions, and attitudes do not change through study, conferences, seminars, and training classes; they change through repeated action. This is not dissimilar to breaking unhealthy habits such as smoking or overeating. The consistently repeated lean actions and restraint from doing old non-lean things are undoubtedly ‘painful’ in the beginning(source: The Kaizen Event Fieldbook by Hamel pages 61-62)

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The Waste Of “Managing Up”

Time spent trying to please your boss is processing waste and provides no value to your customers.  Leaders and staff need to recognize this as a major cultural problem because it will negatively affect the long-term success for your organization.

Mark Lovas, one of the best leaders I have ever worked with, blogged in “Being on purpose and off self“:

Leadership: how much time do your people spend trying to please you versus getting the desired results? Are they experts at managing their leaders and mediocre at doing the actual thing? Are they getting good at the job or managing up? I’ve found a tremendous amount of time can be wasted by approval seeking within a company. Powerpoint, meetings, and calls devoted to finding a sense of confidence in the organization, not doing the actual thing.

In my experience, most leaders are not people who consciously demand this sort of activity, but it often persists because those that manage up often receive public praise and promotions.  You would be surprised how much time is spent when staff feel the need to game the system to look good for the boss.  Think about how that time could be better spent doing Kaizen!

Spend time assessing for “managing up” behavior.  It will be a challenging improvement because the causes will be deeply embedded in the system.  The benefit will be a clearer focus on the customer, freed up time to use in creating value, and capacity for future improvements.

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Filed under Business, Change Management, Communication, customers, Gemba, Improve With Lean, Kaizen, Learn Leadership, Personal Development, Productivity, Waste

Be A Difference Maker

2012 is the year to be a difference maker for all of us.  We have a lot of opportunity to make things better for our customers and better engage our teams.  Here are some tips to make a deep impact this year:

  • Embrace The Kaizen Spirit: Masaaki Imai says “The Kaizen spirit encourages thinking about how to change, rather than why it can’t be done.”  Don’t let the excuses (even really good ones) hold you back from looking to find a way to make a difference.  As Mark Graban suggested recently, let the identified barriers become your first problem statement.
  • See How Your Role Makes A Difference: Seek to discover how your role directly makes things better for customers or how it supports those that interact with them.  Also consider what you can do to make a difference with the people on your team by being a better listener, encourager, or other things that help people make improvements.
  • Be Approachable: If people avoid talking with you, you can’t make a difference because you will not understand the current situation.  Being inclusive allows you to build trust and begin to help influence positive changes.

I am sure many of my readers are already making huge impacts on people’s lives and in the organizations they work with.  What other suggestions do you have for people to be a difference maker this year?

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Relieving Workplace Mayhem

Does your workday frequently feel like mayhem?  I have talked with many people who feel like their job is filled with unnecessary chaos.  I believe a lot of organizations self-inflict themselves with craziness.  There is a way to stop the mayhem!

Overburdening people (and equipment) is a form of waste.  Your organization must first identify where people experience this waste.  Usually it is very easy to find just by asking who feels they are overwhelmed. 

Here are some examples of what you may find (also note that most below do not have a paying customer waiting for the outcome):

  • Leaders asking for non-standard reports with quick deadlines (usually to sit on their desks for weeks before they look at them)
  • Constant edits or change of direction to documents because planning is often done after the content was created
  • Support departments get projects dumped on them without ever problem solving around their ability to have capacity to do the work
  • Somebody’s procrastination or lack of planning becomes another person’s urgent priority

The next step is to acknowledge this kind of mayhem is a problem.  This step is difficult because firefighting heroics and the rush of adrenaline from last-minute deadlines becomes “how things are done around here”. 

As an outside observer, I usually see little need for subjecting employees to this kind of work condition and believe it lowers engagement.  Until teams align that overburdening staff is a problem, it will continue unabated.

The final step is to identify the root causes of the mayhem and eliminate them. 

What sort of unnecessary mayhem do you experience in the workplace?

(NOTE: The attached video is only related to this post because of the title and I thought it was a cool rockabilly song!)

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Walk The Talk

I learned a lot at the recent Lean Healthcare Transformation Summit and will blog my reflections from it.  The first thing that stands out to me was the consistent effort leaders were making to walk the talk.  I think the list below is a great start of what will help leaders help transform and sustain their organizations.

  • Go see, ask why, show respect, and learn
  • Practice respect for people as individuals, engage their heads & hearts, and don’t shame or blame.
  • Be humble
  • Lead as though you have no authority
  • Teach and ask questions
  • Persevere
  • Experiment
  • Be inclusive of everyone
  • Be free from the “smartest society” trap and don’t fear appearing to be outed as incompetent

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Filed under Business, Change Management, Communication, Consulting, Encouragement, Gemba, Improve With Lean, Lean Hospital, Lean Hospitals, Learn Leadership, Respect For People, Standard Work

Book Review: Toyota Under Fire

 

“Toyota Under Fire” by Jeffrey Liker and Timothy Ogden is a highly recommended book for leaders, Lean-thinkers, and people interested in media criticism.

I initially thought it would solely be about the recall crisis which NASA has already vindicated the company.  The book also details the challenges faced by Toyota during the recession.  The authors provide candid information about how the company could have done better and show how they turned the crisis into an opportunity to become stronger.

The final chapter transforms Toyota’s story during the crisis into lessons other organizations can use to help them be prepared for a crisis.

The book helped understand the power of the Toyota Way and reaffirms why they are a company to be admired.  There are many great insights into the thinking of the people in the organization.  Some of my favorites were about how deeply respect for people is practiced, the examples of how important it is to be close to the problem to be able to improve it, the importance of culture, and how the five why’s were used to accept responsibility of the problem.

For those interested in media criticism, this book provides a lot of data that was distorted or omitted in the news during the recalls.  The examples of sensationalized reports with no follow-through once disproven will serve as a reminder to take what we consume from the news with a grain of salt.

One thing I found surprising in the book is that many cited sources were from bloggers and websites.  Since the traditional media seemed slanted against Toyota, these other sources appear more neutral.

Liker and Ogden’s book show how Toyota practices the Toyota Way.  It is not just about theory and philosophy but a demonstration of how it was recently done.  This was an excellent book.

Disclosure: A review copy of this book was provided to me by the publisher.

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Joiner’s Wisdom: Customer Centered Employees

“Employees will not be able to give customers the attention they deserve if they fear making a mistake, if they get blamed for problems that are outside of their control, if chaos prevents them from doing their work efficiently, if decisions depend on a manger’s whim instead of data and logic, or if managers focus more on figures than on customers.  They need to believe they are an important part of a team that operates to serve customers.”Brian Joiner: Fourth Generation Management, Chapter 6: Customer Focused Strategies, page 100

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Does Technology Actually Provide “Solutions”?

Technology can sometimes seem like the right way to address issues but most people do not know about the extra problems it can create.  You may get a short-term win with technology but end up suffering in the long-term.

If your hospital or organization in on a Lean journey, technology can sometimes go against your philosophy and management system.

Here are some things to consider if you are looking at technology: 

  • Never automate a bad process. Eliminate waste and understand what the process really needs before you find a way to make it faster. Quicker waste is still waste.
  • IT systems should fit the process, not the other way around.  In The Birth Of Lean, there was an early Toyota document with the following: “It is not a conveyor that operates men…it is men that operate a conveyor…”  So often people change processes to meet the rigidity of the technology.  Ensure the technology does not force standardization that has waste, lowers quality, or makes no sense.
  • Be able to make changes after it is implemented. So often organizations are stuck with wasteful systems because nobody has knowledge to make iterative improvements or the cost to bring someone in is so high that nobody fixes it until it is totally broke.
  • Trial first instead of piloting. Pilots usually happen after you buy the system. I have rarely seen organizations stop implementation if a pilot does not work out like they expected.  Organizations usually just change their messaging and training to fit what the technology can do instead of ensuring it does what they wanted it to do.  Trialing is part of PDCA thinking and will help ensure the IT system meets the needs of the process without being financially committed to rolling it out.
  • Know the problem you are addressing. With today’s technology, there are all sorts of bells and whistles that seem great.  Although impressive, the added features may be more than needed (overprocessing waste) and can sometimes distract from why you were looking for technology.  These ‘extras’ can also add complexity to your processes.

I think technology can be embraced in Lean organizations but it is important to ensure it is thoroughly tested, reliable, and improvable before you commit to implementing. 

Any other tips?

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Filed under Business, Change Management, Improve With Lean, Improvements, Lean Hospital, Mura, Muri, Productivity, Project Management, Waste

Shhh! People Are Learning

I had a great experience recently when I was able to sit in on a meeting that was being led by a client.  They were debriefing an event and dealing with some uncovered problems afterwards.  I was thinking of some potential counter-measures or approaches to understand the problems deeper but the team came up with everything I was thinking on their own!

As leaders and consultants, it is so important to give people the space and time to figure things out on their own.  Be there to help if struggling, but allow them the ability to experiment and try things.  Coach to the method of thinking but not the solutions.

For me, Lean is about developing thinking and getting results. Unless there is an emergency requiring quick action, no result is worth sacrificing the time spent developing thinking.  Investing in people will help organizations thrive in the long term.  A company or hospital with more Lean thinkers will be more competitive than another that is just implementing the tools.

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A C.O.W. Tale

Does your hospital have a system to ensure nurses have working equipment or they know how to get them fixed?

I recently visited a hospital where the answer would be “NO”. 

Last week, a family member needed a day surgery procedure done at a local hospital.  There were signs in the prep/recovery room touting their move to electronic medical records and no longer needing paper charts.  The problem for the nurse was, the Computer On Wheels (C.O.W.) did not work.  The nurse was unable to access or update the electronic chart!

A second nurse came in during the morning before the procedure to try to troubleshoot the malfunctioning C.O.W.  It was decided to grab a C.O.W. from another room and use it instead.  I am not sure if other nurses had to search for the missing C.O.W. now that it has been moved into our room where it sat there for four hours.  A third nurse eventually pulled it away to put back where it belonged.

The first nurse came back in and tried to access the original C.O.W. in our room and commented “This still doesn’t work yet?”

I looked at the C.O.W. and there was no signage about how to troubleshoot or who to call.  I do not know if a nurse tried calling their helpdesk out of my view but it looked like nobody knew what to do with the broken computer.  It seemed like nobody knew who was to take charge in fixing it.  One can almost infer they expected it to magically fix itself!

Three nurses spent time reacting to faulty equipment that could have been better used providing care to patients.  Instead of spending their creativity solving patient issues, they use it creating workarounds.

Lean thinking can help hospitals put systems into place to ensure equipment always works.  Procedures can be created for what to do when something is broken and how to handle.  Make things visual so staff doesn’t have to rely on memory or look up procedures because instructions are attached to the item being used.

Helping remove waste and frustration from those giving care with make a better experience for those receiving care.

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Communication Or Announcements?

Photo Source: On The Sauce http://onthesauce.net/?p=391

You have a new change coming, do you communicate or just announce it?

I define communication as two-way where input and feedback is requested and announcements as one-way “this is coming or it’s already here” kind of messages.

Announcements are not an effective way to bring your organization along on your Lean journey.  People feel done-to or it appears as though they have no voice.  Announcements give the impression of very top-down leadership even if you had some of the front-line staff involved in creating the change (intent versus impact).

For people to be engaged in the change, ensure you are seeking input and feedback from those affected.  Firstly, before you make a change or set a target condition you should have gone and seen the actual process.  Use this time in gemba to get feedback about the problem.  I have seen flipchart paper put in an area for staff to add input prior to developing counter-measures to trial.  Use staff meetings to ask for thoughts before you start improving.

When developing counter-measures, share ideas with stakeholders or involve them in the trial.  Ask them what works or what further adjustments should be made before it becomes the new standard work.  Their input will make a better counter-measure and help them be invested the change.

After the standard work gets implemented, have leadership and key coaches on the floor soliciting feedback and providing clarifications.  The counter-measure may have some missing pieces that are only discovered after “launch” or people may not understand it enough to follow it.  This communication helps your organization sustain the improvement.

Honestly look at your “communication” strategy.  Is it really just announcements or are you actively asking for feedback to be seriously considered?  Did you bump the communication discussion from every agenda and now stuck in the mode of announcing because a counter-measure is developed and ready to go?

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Don’t Call HR Yet!

“If someone isn’t following standard work then it becomes an individual performance issue.” 

Have you ever heard a leader say something like that? 

It is important to help leaders understand that there are many reasons why standardized work may not be followed and creating a human resource performance improvement plan should not be the first step.

A leader must go and see the actual condition that is causing the employee to not follow standardized work (SW).  Leaders need to ask why SW isn’t followed.  Here are some potential reasons:

  • They don’t know about the SW: How was the change communicated?  At a team-meeting where not everyone was present?  Via email buried under other announcements?
  • They aren’t trained or capable to do the SW: They may not have the tools or the environment does not allow then to follow it.  The training provided might not have been enough for them.
  • All situations not considered when creating the SW: In order to respond to customers, the SW may not be capable to meet their needs.  Do not jump to the conclusion that there isn’t a good reason why an employee did something different.  They are on your team because of their hearts and minds and not just a pair of hands right?
  • They already discovered a better way: Help them know how to spread improvements discovered by frontline workers.
  • No leadership involvement: If leadership does not show they care the process is being followed on a regular basis and helping solve problems uncovered after implementation, then how can you expect employees to care?
  • Outcome not achieved but SW still being requiredStandardization is not a Lean goal but a tool to help improve outcomes.  If your hypothesized outcome didn’t come true, why are you still requiring staff to follow the SW?
  • You aren’t improving the SW: Over time the SW will unconsciously change if the continuous improvement of it is not designed or part of your culture.  The SW may have had elements missing or wasn’t fully tested.
  • Leadership has placed the wrong person in the role: There are some people who willfully do not follow SW.  Leadership must take responsibility for this too since they either tolerated bad behavior because of their productivity or have been so uninvolved to know a person does not fit in their new culture.

As you can see, there are many reasons why people do not follow standard work before you need to punish with HR.

What are some other reasons you have seen why SW isn’t followed?

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Lean Advice From Sobek & Smalley

“From our experience, improvement efforts in companies become ineffective when the emphasis becomes adhering to a standard tool and enforcing a certain way of doing things.  Inherently, the adherence is all well intended as a means of promoting standardization and ultimately improvement.  Unfortunately, the implementation of a certain tool or technique can become more important than improvement of the process or current situation.  In other words, the means trump the ends……place the emphasis on performing, improving, and learning rather than on conforming to templates, tools, and procedures.” – From the highly recommended book “Understanding A3 Thinking (Sobek/Smalley)” page 133.

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Fire At Will!

I have been reading the excellent book ON THE MEND about ThedaCare’s Lean journey.  The authors talk about the importance of having a burning platform to drive change since the clearest way to get someone to jump into the water is to burn the platform.

I started to think about what happens when an organization takes this concept too far and begins to torch the entire field and surrounding buildings.   Everybody thinks their platform is the one that should be lit and nobody is controlling the distribution of matches, lighters, or moltov cocktails.  Here are some of the results:

  • SMOKE FILLS AREA: Direction becomes unclear.  People can not see where they are headed. 
  • PEOPLE BECOME TRAPPED: If all the surroundings are on fire, people can not reach the water to feel a sense of accomplishment.  People will become tired trying to fight all the flames and will either melt-down or burn-out.
  • THINGS DIE: Even if firefighters quickly dash in to extinguish the blaze, not everything can be saved since the fire covers a lot of ground.  People, equipment, and resources such as water become scarce as many people fight the fire across such a wide area.  A lot of effort is made but only ash remains.

Organizations need to work at aligning over lighting only a few platforms to get effective change for their performance.  Identify your organization’s pyromaniacs to help them not set everything else on fire!

Keep on improving!

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