The System Director of Performance Improvement at Baptist Memorial Healthcare in Memphis, Tennessee, Skip Steward, is my guest this week for the first of a two-part podcast. Skip has a variety of accomplishments, qualifications and certifications in the quality improvement field that includes being a Shingo Examiner for the Shingo Institute, Certified Quality Engineer (CQE), Certified Six Sigma Black Belt, Certified Lean Champion, Certified Quality Management Systems Auditor (Exemplar Global), and TWI Job Instruction Certified Trainer.
Skip made new discoveries about standard work when he transferred to the healthcare industry to introduce Lean practice into Baptist Memorial Health Care, a network of 14 hospitals in the Memphis and surrounding area. It was there he was introduced to TWI and he quickly realized the power of good training practice in the healthcare field.
Excerpt from tomorrow’s podcast:
Joe Dager: It seems like it’s a much better approach to the professionals to introduce Lean than some of the older Lean manufacturing terms of waste and flow, and those can be very usable things, I would think TWI would be a much easier approach and have you found that to be true or?
Skip Steward: Yes, I do. I have. I have found that people are especially once they see what it is, once they actually, even people that I have, we only have 10 participants but I do have as many observers as I want and I’ll have executives and even, physicians sitting at the back and observe and normally, actually they didn’t take ‘til Wednesday, normally by Monday or Tuesday they’re like “Oh my goodness, this makes all the sense in the world.”
If you think about it, let me give you a great little story. A lot of times we tend to think that discipline professionals like nurses and lobotomist and lab folks and even physicians that, well, they are professionals so it’s okay for everyone to do their own thing, but that’s really not the case. I know there’s one example where we broke a job down with blood cultures, actually polished it up. We practiced it on a nurse, and I can remember it like it was yesterday. The nurse said, “I’ve been a nurse for 25 years and until today I never knew that you were supposed to use the blue bottle first and then the purple bottle. I just always did what I was told to do.” Well, if all you ever do is what you’re told to do, that’s when people make mistakes, and that’s when errors occur. But, that’s not even the best part of that little story. I’ve told that story so many times in my travel in the last year and a half and I had so many nurses and physicians pull me aside and say “I’m not sure why you’re supposed to use the blue bottle first either.” I’ve even had physicians that don’t work for us when I told the story say to me “I didn’t think it really mattered.” When we don’t know the why behind things, that’s where errors and mistakes and defects and even defects that maybe doesn’t harm anyone but can create waste and cost more money to be spent than necessary.
We just had some really great success. One thing I do want to say though because like many systems, IO keep calling it a system because I think there are 3 pieces that make up a TWI, the how to instruct 4-step method, the breakdown, and the training timetable that most people overlook. But, that system what I like to tell people about is the TWI system is nothing more than a counter measure. Ultimately, everything’s a hypothesis to get us from a current condition to a target condition. TWI becomes a great counter measure to get you from a current condition to a target condition. I say it that way because, unfortunately, Joe, as you know, many times people look at things like TWI or something else as a magic wand, and there are no such things as magic wands. It’s a counter measure. If you’re not getting from where you are to where your current condition to a target condition, I always ask people to check their hypothesis and their first question would be is “Are we even doing the TWI the right way?” The second question would be based on an additional countermeasure that you haven’t considered. I just wanted to point that out because I see a lot of times that people they’re looking for a magic wand and magic wands just don’t exist.
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