Galileo On Gemba

What was observed by us is the nature or matter of the Milky Way itself, which, with the aid of the spyglass, may be observed so well that all the disputes that for so many generations have vexed philosophers are destroyed by visible certainty, and we are liberated from wordy arguments.

Galileo Galilei was a Tuscan (Italian) physicist, mathematician, astronomer, and philosopher who played a major role in the scientific revolution.

My paraphrase: “When going to gemba with a spyglass and learning to see, we are liberated from wordy arguments in a conference room.” 

If you liked this post, then try:

• Kant Go To Gemba 

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Last Week’s Event

The team did an outstanding job last week.  A couple of their targets were to increase on-time starts for lab draws in the cancer clinic and create visual systems to see demand.  They met their targets and really caught the spirit of improvement.

One factor that made the workshop a success was having a patient’s parent involved.  The parent was able to come in and explain their experience and perspective.  Their participation created a lot of value for the team.

This event demonstrated the power of going to gemba.  A team-member commented how it always felt chaotic but could never pinpoint where the chaos was coming from until they observed and broke it up into pieces.

Last but now least, I saw how important data is for an event.  I am a data consultant so this was impactful to me.  Data in other events seemed to stop after establishing the current state of a process.  This team was looking at cycle times and percentage scheduled during time of day all week.  This helped them figure out specifically where to make improvement adjustments.

I had a great time and learned a ton!

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Effective vs Efficient

I think Lean practitioners should replace the word EFFICIENT with EFFECTIVE.

This thought has been ruminating in my mind since reading Timothy Ferriss “The 4-Hour Workweek“.  The book explains how you do not want to spend your time being efficient on tasks that are not effective.  It reminds me that we do not want to be efficient with non-value-added tasks, we want to remove those wastes. 

Lean is sometimes lumped into the category of “efficient changes” but it really goes deeper than that.  Lean is all about optimizing effectiveness.  Procedures will become efficient as a result of the attention to being more effective.  By stating our purpose to increase effectiveness, the efficiencies will follow.  Replacing a simple word has a deep impact.

I recommend Kevin Meyer’s post from Evolving Excellence about how this book can apply to Lean thinking: Productivity: Eliminate Before You Optimize.

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Seyi Oyesola: Rich hospital, poor hospital

This TED video made me reflect on the how much Lean is needed in hospitals around the world.  When we consider the challenges in our US hospitals, think about some of the images you see in the Nigerian hospital.

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How To Have Better Meetings

Art Petty on Management posted some helpful articles lately that I think are valuable.

1: The Meeting is Never for Decision-Making: A Product Management Lesson I Learned at Matsushita

The meeting is the ceremony.  All of the decisions are made individually.  You never want to show up at a meting that you called without having reached agreement with each stakeholder ahead of time … Leaders invest in people they trust and have a sense for, and the ceremony of a group meeting is the wrong place to try and build your trust and credibility. 

2: Leader: Are Your Meetings Straight Out of A Dilbert Comic Strip? 

3:  How to Improve a Dysfunctional Meeting Culture Without Removing the Chairs  

… rave against the time-wasting, dysfunctional debating society events that masquerade as meetings in many corporate settings … Keep the focus narrow.  Operations meetings are not strategy meetings and vice-versa … Manage the clock and the agenda maniacally … Every once in awhile, create meetings without boundaries for brainstorming, idea generation, market discussions etc.  Operations meetings and process meetings must run like clockwork.  Creative meetings are essential to feed the energy of the organization and the boundaries should be relaxed for these occasions.

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Square Watermelons

Bryan at Training Within Industry posted an outstanding article (with pictures) about Square Watermelons.  I love how the farmers questioned sacred cow knowledge and discovered a way to innovate!

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Knowledge Workers 2.0 Video

I discovered this great video from Roger W. Farnsworth at Execultive Thought Leadership. This slideshow was created at http://www.acidlabs.org/.

I think there is a lot of great thinking here for Lean leaders.

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If you liked this post, then try:

• Stephen Covey on Knowledge Workers
• Knowledge Economy

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Great Visual Of Waste

Jessica Hagy has a fun blog named Indexed where she uses simple index cards to visually communicate ideas and concepts. 

I thought this one fits in perfectly for Lean thinkers because we race to remove all waste because it is non-value added.  Using the word FRUSTRATON gives more oomph to the concept of NVA!

PS:  For the record, I scheduled this post before I read Kevin Meyer’s Waste Index at Evolving Excellence.  He beat me to the punch and scooped me!  🙂  Oh well, this is such a great picture, it’s worth posting again!  Sorry if this is a repeat for those who read both of our blogs.

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Be An Andon Referee

Have you ever considered how a soccer referee pulling a yellow or red card is like an Andon?

Players are cautioned with a yellow card when they show misconduct.  A red card from the referee means the player is sent off from the field.  While Andon is not used to show misconduct, we can repurpose this concept to pull the cards when we see errors, safety issues, or quality problems. 

• The yellow “caution” card is a fixed position stop andon.  The team can be cautioned of the issue and work to correct it before it moves to the next step. 
• The red “send off” card is a stop the line andon.  The team stops to get the issue corrected and the line doesn’t continue until it is resolved.

Toyota Culture says (paraphrased) “no SUSPECT cars ever make it to a customer”.  Team members need to feel comfortable to pull the yellow or red cards.  Everybody should act as a referee on the field.  Once all eyes are looking to help maintain quality and safety, more value will make it to the customer. 

Above photo used with permission from roger g1 

If you liked this post, then try:

• Remember To Add-On The Andon
• How To Thrive When Your Company Goes LEAN

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Seattle Lean Hospitals

Bill Thorness wrote a nice Seattle Business Monthly article Health Care: Loving Lean where he highlights Seattle’s Virginia Mason and Children’s Hospital & Regional Medical Center.  It is a great high level read.

If you liked this post, then try:

• Disgruntled Employees In A Lean Hospital

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Holy Lean Batman!

Have you ever considered how Batman is a great example of Lean?

• Much like Jon Miller’s Way Of The Ninja, the Dark Knight is quick, agile, and has portable access to the Batcomputer.
• He can find anything in his Utility Belt during dark Gotham nights because there is a place for everything and everything in it place. 
• The Batsignal is a visual management tool for the police to alert him when there is trouble.
• Instead of sitting at the Batcave desk, he goes to Gemba to see the crime happening in real-time.
• He is really good at coordinating with team-members Nightwing, Robin, and Batgirl.

Just like Toyota, Batman still has some work to have all waste eliminated.  I think the Batcave can use a bit of 5S.  The giant penny and robot dinosaur in the trophy room are not used frequently and probably pose a safety hazard!

Above image used with permission from DC Comics

If you liked that post, then try:

• Darth Vader, PMP 

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Kant Go To Gemba

“It is beyond a doubt that all our knowledge that begins with experience.” “Experience without theory is blind, but theory without experience is mere intellectual play.”  Immanuel Kant, German Philosopher, 1724-1804

Remember To Add-On The Andon

How important do you think andon is?  I think it is extremely important.

Kaizen workshop teams usually build great standard work or reliable methods.  I see them eliminate waste, create detailed implementation communication schedules, and ensure the auditing plan will give something to measure in PDCA.  Andon is not always added.

Andon must be built into a new or updated process to make it sustain.  If there is no mechanism to stop and fix errors before they are passed to the next step, quality will suffer.  Waiting for the error to show up in the audit or a visual management system may be too late.

Workshop teams usually have tons of confidence their new process will be flawless because they thought it out thoroughly.  Challenge and remind them the importance of andon. 

I would like to recommend two articles:  Fixed Position Stop Systemby Jon Miller at Gemba Panta Rei and Parenting Tips from Toyotaby Craig Woll at Evolving Excellence

 

Disgruntled Employees In A Lean Hospital

Management loves Lean transformations, why don’t workers on the line?

I just read Jon Miller ‘s great post Improving Healthcare Delivery by Studying Toyota where he discusses the Seattle PI article To build a better hospital, Virginia Mason takes lessons from Toyota plants.  His article is fascinating and informative.

I found a gem in the Reader Comments for the article on the P.I. website.  Check them out and come back and read the rest of my post.  See any commenters from Virginia Mason who seem burned by Lean?  I saw quite a few.

While accepting change is ultimately up to the individual, I think Lean practitioners should do everything possible to help them with the process.  Management and Lean facilitators can easily write off a person who doesn’t embrace Lean as not being a team player.  We need take the harder path and communicate to people on their level.

• Train your workshop teams to have two way communication when they implement improvements. 
• Ensure the team engages the staff to understand their needs before they design the process(es). 
• Help the team avoid being so dogmatic about their change(s) that they do not believe the CHECK step is needed from the PDCA cycle.
• Work with the managers of openly Lean-hostile employees to reach common ground.
• Always communicate (and practice) your organization’s “respect for people” pillar.

Some people will resist change no matter what you try.  Just don’t fall into the trap of writing someone off before you exhasted everything to communicate to people.

  

Lean Articles

** Updated the links ** 

I am in a workshop this week so I wanted to share some articles I have enjoyed recently.

101 Kaizen Templates: Kaizen Newspaper by Jon Miller

• Lean Topic:  KAIZEN – A visual way to involve people in giving improvement ideas to areas other than their immediate work area or job scope
• Excerpt:  The only responsibility of a non-manager or non-team leader is to identify the problem and write it down on the kaizen newspaper, number it, identify the type of problem (safety, category of waste, etc.) and take a stab at a cause or root cause. The kaizen newspaper frees people from bringing the solution along with the problem and in that sense it is very different from the kaizen idea suggestion system. … The kaizen newspaper is a daily management tool and should be read and acted upon each day.

Lean Leadership In Healthcare White Paper by Richard Doss and Cameron Orr

• Lean Topic:  GROW LEADERS – This 9-page paper suggests a focus on the leadership behaviors that are crucial for Lean to progress beyond limited pilot studies and get sustainable results.
• Excerpt:  Take note of the statement there is “no such thing as organizational change, only personal change” (source unattributed). Lean Leadership in healthcare, as in any other industry, is dependent on the transformation and behavior of individuals. Training courses, culture change initiatives, rapid improvement teams, etc., will have only limited impact unless Lean leadership is developed on a one-to-one basis. The good news, however, is that behavior can change very quickly. Given the right support, the rest of the stakeholders will begin to mimic the Lean leadership behavior.

The Physician Culture and Resistance to Change, Part I by Richard L. Reece, MD

• Lean Topic:  DEVELOP EXCEPTIONAL PEOPLE – Tips for understanding why physicians resist change and suggestions for handling them.
• Excerpt from Part I:  To understand why physicians have resisted, you have to get inside their minds and skins. … These cultural characteristics may reflect a self-centered, narrow-minded, and shortsighted worldview. But these traits dominate many physicians’ minds and can’t be dismissed.
• Excerpt from Part II: Certain specialists, including heart surgeons, cardiologists, orthopedic surgeons, general surgeons, neurosurgeons, and oncologists – the economic lifeblood of most hospitals – are accustomed to acting decisively in clinical matters. This decisiveness carries over into business affairs. … Physicians ask to be trusted to do the right thing, to be considered professionals, to be paid for productivity, and seek information systems that provide relevant information and speed patient flow.
• Excerpt from Part III:  In The Effective Executive (Harpers, 1956), Peter F. Drucker state leaders igniting fundamental change share these traits: They rely on courage rather than analysis to dictate their priorities.  They pick the future rather than the past. They focus on opportunity rather than problems.  They chose their own direction, rather than climbing on someone else’s bandwagon.  They aim high, for something that will make a difference, rather than something that is “safe” and easy to do.  They seek fundamental contributions to improve society.