Archive for Kaizen
In next week’s podcast, I have authors Joe Swartz and Mark Graban discussing their new book, Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements. The book centers on healthcare, however, I believe many of the “lessons to be learned” can be applied to anyone in continuous improvement.
An excerpt from the podcast (Listen to the podcast, Engaging Front-Line Staff with Kaizen):
Joe: You’re allowing Lean to grow organically. We talked about the different cultures that exist in a hospital. So how do you get engagement and consensus?
Mark: People in healthcare really prize and value this idea of autonomy, “I get to do things my way,” especially, doctors and surgeons and, sometimes, nurses and other healthcare professionals. I think that just goes to show why the old, top-down change model doesn’t work in that environment. In fact, there was a doctor who commented on my blog this week, who said, “There’s some sort of new protocol that was just forced out on everybody from on high, and not everybody agreed that this is the thing we should be doing with patients.”
The one thing he highlighted, he didn’t understand the problem. What problem is this addressing? It was a very low level of staff engagement and it certainly wasn’t Kaizen, it wasn’t anything Lean. Some senior medical or administrative leader will say, “OK. Well, we learned here’s some best practice from some other organization. Everyone needs to do it.”
Well, usually that doesn’t really translate to a lot of change. People nod their heads. “Uh?huh, uh?huh.” Then, they don’t do it.
This Kaizen model sometimes is very time?consuming. You’re building consensus. You’re trying to get people on the same page. It doesn’t mean that people magically agree, but when you go through the steps of making sure you’ve identified and communicated a problem and you’ve talked about the root cause and you’ve talked about, “Here’s this countermeasure and why we think it’s going to work.”
When you have that type of communication, as Joe mentioned and as we talk about in chapter eight of the book, you can do a lot to engage people and bring people on board, when you involve them in this type of improvement. A little bit of involvement goes a long way. A lot of times, people just get bent out of shape, “You never involve me. You never communicated.”
It’s understandable, why they balk or do not want to be involved. I think that’s where the things that we have in the book and in this Kaizen model, the softer side of Kaizen, if you will, I think there’s a lot to contribute to try to help people engage physicians and staff members in a better way.
About the authors:
Joseph Swartz is the Director of Business Transformation for Franciscan St. Francis Health of Indianapolis, IN. He has been leading continuous improvement efforts for 16 years and has lead more than 150 Lean and Six Sigma improvement projects. He is the co-author of Seeing David in the Stone: Finding and Seizing Great Opportunities.
Mark Graban is a consultant, author, keynote speaker, and blogger in the field of “Lean Healthcare.” In June 2011, Mark joined the software company KaiNexus as their “Chief Improvement Officer,” to help further their mission of “making improvement easier” in healthcare organizations, while continuing his other consulting and speaking activities.
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Can the principles of Lean be applied to your daily life? Dan Markovitz, founder and owner of TimeBack Management certainly thinks so. He has developed a consultancy specializing in improving individual and organizational performance through the application of lean concepts. Dan has backed up his claim in his latest book, A Factory of One: Applying Lean Principles to Banish Waste and Improve Your Personal Performance. Dan feels Lean can be just as powerful for yourself as it for organizations.
After talking to Dan, I reviewed the 5 basic principles of Lean:
- Identify Value
- Map Value Stream
- Create Flow
- Establish Pull
- Seek Perfection
I certainly found an interesting relation to how I apply them from an organizational standpoint and how I could use them to improve my day. Dan gave a few tips and encouraged me to find the root cause of several of my most nagging problems. I can’t say the choices were easy but I was certainly able to address them and make decisions accordingly. Now, if I can only sustain it!!!
In a past blog post, How do you handle inputs into your life?, I discussed the book A Factory of One: Applying Lean Principles to Banish Waste and Improve Your Personal Performance. Next week’s Business901 Podcast features the author, Dan Markovitz, founder and owner of TimeBack Management. Timeback is a consultancy specializing in improving individual and organizational performance through the application of lean concepts.
This is an excerpt from the podcast:
Joe: If you really sit back and take a look at what you are doing or have to do, that you have much more control over the situation than you think. Applying the Pareto Principle, you have a lot of control?.
Dan: “I think often we do. I think oftentimes there is a lot more room for improvement than we realize. We just haven’t bothered looking. We just say, “Oh yeah, I get interrupted all the time.” “Oh yeah, I get these problems.” But we don’t really understand why because we’ve never stopped to really grasp the situation. The other thing, where I think Lean is really important, comes in the notion of visual management. I hear people saying all the time, “You know, I feel like I’m always reactive. I’m not proactive. I’m always being tactical. I can never be strategic.”
They cite the same thing that you talked about ? an email comes in that’s kind of important or my boss comes in and says, “We have to do X, Y, and Z.” I think what I see is that because we are knowledge workers our work tends to be invisible. It tends to reside in bits and bytes of electrons of data sitting in our email inbox, sitting in a document somewhere on our computer desktop, whatever.
But it’s not real visible. It’s not like an engine assembly in front of you. It’s not like a fan blade that you’re working on in front of you. As a consequence what happens is that it’s very easy to pull my attention away from what I’m working on.
I think visual management, the notion of taking the work that you’re doing and somehow making it more visible, making it more visual, enables us to better judge whether we should be responding to this new problem rather than the thing that we were working on.
So again, the simple example, Joe, would be, I am working on something and then an email comes in, and I look at it and I say, “Oh, boy. I’m going to handle this,” and I get distracted by that.
The problem is I don’t know what I’m supposed to be working on. Because my work is relatively invisible, I don’t really have the ability to say which is truly more important, this new thing that came in or this old thing that I was supposed to be working on.
And so what happens is we’re always distracted by the squeaky wheel and we start giving it the oil or the grease, instead of saying, “Gosh, this wheel maybe squeaking, but I’ve got much bigger issues to take care of.”
I think ideas that you see in something like Jim Benson’s Personal Kanban, that’s one way of making the work visible. You’ve got the physical representation of it on a white board and now you can say, “These are the three things that I am working on now. This is my work in progress. Oops. Here comes something new. Well, is it more important than these three things, yes or no?” If the answer is yes, well then, great, change. If the answer is no, well then, figure out how you are going to handle it.
Stick with what you are doing and then figure out how you are going to cue up that new thing, or hand it off to someone else or ignore it or whatever.”
Last spring, Dr Balle the Gemba Coach at the Lean Enterprise Institute and I had a conversation on Kaizen which resulted in an 8-week series of videos and a podcast. This is a 34 page transcription of the discussion. I think you will find it entertaining and will provide a different way of viewing continuous improvement and Kaizen.
An excerpt from the transcription:
Joe: Michael, when you talk about Kaizen, you talk about Kaizen on an individual basis. Can you explain that?
Michael Balle: Absolutely. Kaizen is always individual. There’s a difference in perspective, and we’re very biased by our Taylorist pasts. Our understanding we usually have is that performance is the result of processes. We all buy that, and its fine. Our thinking is that if you hit each of these processes with an improvement project, and people call it Kaizen but it’s not, then the results should be improved performance.
Evidence over the past 20 years has shown that this is not the case. What you do have is quick hits. You can have some savings, or you have some low?hanging fruit, but you don’t have the improvement we’re looking for.
The other way of looking at this is that any process is just a collection of individuals. If each individual is better at their job, then collectively they will come up with a process that performs better and delivers in performance. I think this is the key to understanding. Kaizen is an individual activity to make you better at your job. This is something we see with Lean students.
After studying Lean for a while, you ask them the question, “Do you feel you’re mastering Lean better?” and they say, “Well, no. The system, it seems still as mysterious and deep and hard to master.” You ask them the second question, “Are you better at your jobs? Do you feel you’re better at your jobs?” They say, “No debate, Absolutely, yes.” They’re confident that they’re a lot better at their jobs. This is what Kaizen is about.
Kaizen is about improving you, Joe. By doing Kaizen, you will improve how you see your job and how you perform at your job. This will make you stop making some classic mistakes, for this will also make you discover innovative ways of doing your job.
As we all pull together with a deeper understanding of our jobs, we create processes that our competitors can never touch. In order to hold those better processes, each of us has to be better at our jobs.
Dr. Balle went on to say:
Really, the essence of Kaizen is building people an understanding, a vision, of the waste their technical choices imposes on the work chain. It is an individual thing as it is their technical choices and it is a collective thing as it’s not the waste they impose on themselves but the waste they impose on their suppliers, the waste they impose on their internal customers.
This conversation was one of the reasons I delayed publishing the Lean Engagement Team and more specifically the chapter on the iCustomer and iTeam. It did not change my thinking of teamwork and individual responsibility but it did re-frame the way I viewed and described those two subjects. The book is available as a PDF download on the Business901.com website or on Amazon:
Lean Engagement Team (Marketing with Lean, Volume 2) [Ring-bound]
Lean Engagement Team (Marketing with Lean, Volume 2) [CD-ROM]