Category Archives: Gemba

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

Seek Multiple Views

This quote has been sitting with me a while and I hope it is relevant for you too.  So often, even a gemba experience may be different for people.  Even though facts are found at gemba, people may only see certain things and not the whole picture (like the four men & elephant story).  I think the Respect For People principle is at play here too because it suggests to mutually respect multiple perspectives and put together into one common view.

“Most disagreements about the right solution, decision, or course of action are really disagreements about the interpretation of current reality…Most statements about current reality are not wrong; they are incomplete. The person who adopts this principle seeks to put multiple views of current reality together to build one common and more complete view of it.”  – The Hitchhiker’s Guide to Lean: Lessons from the Road by Jamie Flinchbaugh and Andy Carlino

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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

World Class Blog Post

Have you dreamed of eating the Grove Café’s world famous pancakes or been lucky enough to try them yourself?  What?  You never heard of them before now?  It almost sounds like a classic Onion article.

Many hospitals aspire to be “World Class” but there is no measure to know if they succeed at it.  Just like the pancakes, only that hospital seems to define themselves as achieving that level of success.  For that matter, I am not sure what would make them stand out with that definition since a Google search of “world class” and hospital returned 47,300,000 results.

Do patients choose a hospital based on a world class definition?  Similarly, do local “top doctor” magazines drive patients to hospitals or is the US NEWS” Top Hospitals” issue a key deciding factor (despite its questionable criteria)?

I would worry about achieving the level of “World Class” (whatever that actually means) since being at the top of  a benchmark usually does not inspire people to improve once attained. 

I think a better mission for hospitals is to strive for “perfect care”.  Patients deserve predictable clinical outcomes and they shouldn’t get harmed or sicker by being in a hospital.  Patients want better customer service and should not have to experience any unnecessary waits.  Lastly, healthcare should have a fair and reasonable price for their co-pay and insurance.

Hospitals need to ask their patients if they want to be treated at someplace famous or where they will receive perfect care.  If forced to choose one over the other, which would they pick?  Focusing on the means (providing perfect care) will help hospitals achieve outcome of being deemed world class.

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Filed under Consulting, customers, Data & Charts, Gemba, Hansei, Health Care, Improve With Lean, Improvements, Kanban, Lean Hospital, Lean Hospitals, Learn Leadership, Learning Organization, Problem Solving, Quality, Respect For People

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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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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Do You Have A Play Lab?

While cleaning up various packaging after my son’s first birthday, I noticed an interesting pamphlet from toy manufacturer Fisher-Price.  They have a “Play Lab” where they observe kids and families using their products to determine how to make them better!

Watching how your customers interact with your products and services will help your organization be more successful.  You will be able to better understand their needs to create new things to satisfy them.  You will spend time improving what matters because you are able to improve based on what problems you see them experiencing.

Here are a few quotes from the flyer:

…start in our Play Lab, where thousands of children test our toys in a fun, nurturing environment.  And our product designers get right down on the floor with them.

Have more than the customer-facing staff observe your customers.  Help others see how their work supports your customers.  Have leaders gain first-hand knowledge of how your products and services are being experienced.

…Fisher-Price does thousands of in-home tests – so we can really grasp how kids interact with our toys, how toys fit into their lives and how they play.

While simulated environments can tell you a lot, there is even deeper learning when observing in a natural setting.

 …we created Mom Panels, informal groups where moms can see our toy development and let us know what works for them and their children, and what doesn’t.

Engaged and loyal customers will tell you what is broken about your system if you just ask.  They will also tell you what is valuable to them.

Does your organization have a “Play Lab”?  If not, create the opportunity for many different people to be able to watch your customers use your products and services. 

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Filed under Business, Communication, Gemba, Improve With Lean, Improvements, Learn Leadership, Learning Organization, Problem Solving, Quality, Respect For People, Value Added, Waste

Are You “Under New Management” Yet?

I often see restaurants and other businesses with signs outside advertising “Under New Management” and wonder why they need to advertise this to potential customers. It got me to thinking how Lean success requires new management as well to be successful.

I think local businesses hang announcements about a leadership change because they want to tell customers they will receive better service than before. Maybe they now offer better quality, improved customer service, superior product selection, friendlier employees because they are happier, safer conditions, or a combination of all. Lean transformations provide similar benefits but they require new management to achieve them.

The leadership team might be the same people as before, but their management practices will need to change. Remember, improved results were not being created and sustained under an old management model.

Below is not a comprehensive list, but here are some of the changes to traditional leadership:

  • Decisions are made based on data and observation, not just charisma and intuition
  • Leaders act as coaches and teachers to develop people to solve problems deeper in the organization instead of being the one to solve them
  • The voice of the customer is primary focus
  • Standardized work is followed by leaders and not just those in production
  • Credibility is earned by practicing Lean and not just sponsoring it or speaking positively about it
  • Ability to fire-fight is not a sign of great Lean leaders; removing root causes to prevent fires shows lean competency
  • Use long-term thinking for selecting activities and strategies
  • Practice Respect For People for all staff, customers, suppliers, and other stakeholders
  • Manage both the means and results by understanding how processes produce outcomes

Becoming “under new management” is not an easy task but it will help your organization remain competitive in the years to come.

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Filed under Business, Data & Charts, Five Whys, Gemba, Improve With Lean, Lean Hospital, Lean Hospitals, Learn Leadership, Plan-Do-Check-Act, Problem Solving, Root Cause, Standard Work

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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Filed under 5S, Business, Change Management, Gemba, Health Care, Improve With Lean, Improvements, Lean Hospital, Lean Hospitals, Problem Solving, Productivity, Respect For People, Standard Work, Value Added, Visual Language, Visual Systems, Waste

Book Review: Kaizen Event Fieldbook

Mark Hamel’s “Kaizen Event Fieldbook” is an excellent addition to the library of Lean literature.  Don’t let the title fool you though, there is more to this book than just the technical details behind a kaizen event.

The book definitely delivers on the myriad of details for progressing through the different phases of a kaizen event.  Instead of just explaining what to do, the author provides the reason why it is done.  The book’s emphasis on the thinking behind the actions is valuable for Lean leaders, facilitators, and consultants .  While there are a lot of similarities to how my organization conducts events, it is nice to see the differences recommended by the book.

There are many great tables and visuals throughout the book.  A few of my favorites are the decision tree for what should be a kaizen event, a table with nine symptoms of event malpractice, and a team behavioral audit for the facilitator.  There is also an exhaustive appendix with blank forms to use for kaizen events.

In addition to the technical details, the book has a lot of insight for transformational leadership.  I enjoyed the different short stories in the “gemba tales”.  I like to learn how others teach Lean concepts and the book has an excellent chapter where the author does just that.  I am glad the book also discusses the need for daily kaizen and what that looks like in relation to kaizen events.  Lastly, there is an outstanding section about the role of a kaizen promotion office and the core competencies of those who work in it.

The “Kaizen Event Fieldbook” is a book I open often and refer to.  I highly recommend it.

Mark Hamel writes a great blog at http://kaizenfieldbook.com/marksblog/ and can be found on twitter as @markrhamel.

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Lean Related Posts Roundup

Since my work banned access to twitter, it is not as easy to share great Lean related articles.  I will do this on my blog now!

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The Jury Is Out

Last month I served on a jury and really enjoyed the opportunity.   The pamphlet that was handed out to all jurors had some advice that I think is good for those in a Lean organization:

“It is enough that you keep an open mind, use common sense, concentrate on the evidence presented, and be fair and honest in your deliberations.  Remember: Don’t be influenced by sympathy or prejudice.”

Keeping an open mind is important for innovation.  So often our minds want to keep things the same or we may stretch to optimize how things are.  An open mind will help you create something  new.

Common sense is woven throughout Lean thinking.  While the concepts are simple, the applications of them are elegant.

Going to gemba will be the key piece of evidence for you to concentrate on.  The facts you witness and hear will help you make a good verdict for what improvements to make.

Lean is about focusing on your customers and what your business needs to prosper.  This focus helps you to be fair and honest while avoiding sympathy or prejudice.  Pet projects or individual agendas may not always fit into Lean thinking.

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Martyrs and Hidden Problems

There are people in your organization who live with drastic waste everyday but they do not communicate it to anybody as a problem.  I call them martyrs.

They take on work that is not value added for your customer.  They perform duties that are a waste of their skills and pay level.  Most of these activities have no thoughtful processes and are highly subject to variability.  Martyrs usually do this work without productive complaint because “someone has to get it done and nobody else will do it.” (I say productive complaint because they most likely share their frustration with coworkers and families).

Leadership must actively identify and help martyrs. 

  • Only by observing people doing the work will leaders see the problems martyrs face – because they will not tell you.  Some do not even recognize it as a problem. 
  • Help these martyrs recognize problems and do everything you can to help them solve it. 
  • Assist them with understanding processes so they can remove waste from their work.

My 2009 Hansei: Scarcity inspires creativity and innovation.  How can I help harness that inspiration?

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Rent-A-Wait and Inflexibility

Inflexible staff responsibilities and lack of cross-training leads to customer waiting.  Simple changes can help your organization easily achieve customer satisfaction.

My wife and I rented a car for our vacation last week and experienced a very unnecessary 20 minute wait to return our car.  This company definitely was not a Lean Enterprise.

The rent-a-car location has two connected offices.  One office was for Cars and the other was Trucks.  We returned the car about an hour after it opened only to see a sign on the locked door for the cars division stating they were dropping off a customer and to call a number if needed.  We called the number and was advised the Car Division employee would return in 20-25 minutes. 

We went into the Trucks Division office and two employees were talking together.  They were not on the computer or phone.  They advised they can only take the keys from us but could not give a receipt or change the credit card like we wanted to.

About five minutes later, a guy in coveralls drove up and parked behind the building.  We saw him enter a back door of the Cars Division.  We knocked on the glass and the new guy advised us he just takes care of the cars and would only be able to take the keys from us.

After 20 minutes, the Cars Division salesperson showed up and took care of us.

Our waiting could have been avoided by having more flexibility between divisions.  If the Truck staff was not silioed and was able to cover the Cars returns while they dropped off a customer, we would have been more satisfied.  From our perspective, the employees all worked for the same company and I did not care if they were in different divisions.

Another way to avoid customer wait would be to provide credit card and return authority to the person who takes care of the cars.  If the company is hiring people who they do not trust with customer credit cards to take care of the cars, then I seriously worry about the quality of the vehicle I am renting.

This experience just drives home the importance of physically going to see how your customers interact with your company and products.  The contermeasures I provided are simple and easy to implement but you have to see the problem to know it is a problem.

My 2009 Hansei: Scarcity inspires creativity and innovation.  How can I help harness that inspiration?

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