I'm just fine! Wish I Could Say the Same for Health Care in this Country.

This morning, I read the following email sent to me by my good friend, Jeff Fuchs written to his lean students after a recent medical visit to his local emergency room. Jeff is the Director at The Maryland World Class Consortia and a great lean thinker!


I have copied it below with permission and some edits to remove classroom specific instructions to his students. Please read his story about his patient experience. As Jeff and I both hope, may it help stimulate some healthy and thoughtful commentary as we look to improving not only outcomes but the entire patient-family experience.

From: Jeff Fuchs
Sent: Monday, July 25, 2011
To: (All his Lean Students)
Subject: "I'm just fine!" Wish I could say the same for health care in this country.

All,
I am getting back in control of my in-box after my unfortunate absence on the last of our three days together week. My sincere apologies. As the message header indicates, “rumors of my demise are greatly exaggerated.” Just a reminder: You still have your homework. You still have your capstone projects. And now you have your make-up training on cellular production. More on all that in a while.

I am sorry for throwing your day off last Thursday, but I had to bring my body into the shop for some unscheduled maintenance. As we all heard Sir Ken Robinson observe on Wednesday’s video, some of us just view our bodies “as a way of getting our heads to meetings.” Proper upkeep falls by the wayside from time to time, and this is what happens. A bit of detail is in order. I was up to answer nature’s call at 4:15 a.m. on Thursday, and instead of the usual heartbeat, “thumpita-thump, thumpita-thump, thumpita-thump…,” what I felt was more like “thumpita-thump, eeerrk! thumpita-eeerrk! thumpita-thump…errkk!...”

I grabbed my keys, wallet, cell phone, and a good book and drove to the Emergency Room. You may have missed your day of training, but let me tell you that “class was in session” at the Baltimore Washington Medical Center ER when I showed up for school at 5 a.m. Four hours later, (Let me say that again, “FOUR HOURS LATER”) we were still monkeying around with forgotten paperwork, twice redone blood draws, shift change meetings over my bed, staff that was making three trips to my room to restock inventory, and rolling me through a series of three “patient inventory” transactions between some lab and back to my ER bay of “move, wait, process, wait, move, wait” for X-ray, sonogram, and ECG, respectively.

I told you folks. I TOLD you to your face! “When I am through with you, if I am successful, I will make you as miserable a human being as I am. You will see broken processes all around you.” Welcome to my world. Behold, the sad customer/piece of meat-inventory:


Now seriously, don’t he look sad? Pity the poor victim of broken process.

Naturally, in a case like this I couldn’t resist going into Consultant Mode. In spite of being hooked up to the monitor, IV, oxygen, etc. like a marionette, the monitor kept losing my continuing thumpita-errk heartbeat, so the nurses had to keep walking back to the main desk an average of every 11.3 minutes (but who’s counting) to see if I was dead yet and to reset the monitor. How thoughtful of them to give me an ER bay where I could see their goings on. Their wasted motion, their absence of mistake-proofing or visual controls, their failed attempts to communicate with each other, failed service opportunities, excessive patient transportation, and more. How very thoughtful.

After three hours of fear, boredom, and frustration cocktail, I used a pen left behind by one of the nurses and began sketching out a nurse/patient spaghetti map of my morning on the back of an IV wrapper I found on the floor, along with a crude value stream map. (There are a few things wrong in that last sentence. Please use a black or blue ink pen to circle them. We’ll review your answers next session.) The ER staff found my doodles and efficiency ravings…amusing. I’m sure they did not have much time to be interested in the “bored consultant in room six” at the same time they had to deal with the cut up guy the cop brought in handcuffs, the construction worker who just fell off a scaffold, the guy sleeping on a gurney in the hall who nobody knows where he came from, or the other poor folk who needed their full attention.

The attending physician diagnosed me with “atrial fibrillation”, an eminently treatable condition. We’ll see in a couple weeks what the follow up says. They admitted me for observation, where I was subjected to other process design and systems management horrors which I shall not relate to you with at this time. Suffice it to say, I got an education in that fourteen hours. The lesson for me: Healthcare is broke. It’s broke bad. I mean, if I had a clone army of a thousand Lean Jedi Knights, we’d be swinging our Lean Lightsabers for decades trying to unhose healthcare in this country. Lean Facilitator Certification Program students, your future in this industry is secure.

By the way, one final note on my lean healthcare field trip. The “good book” I mentioned that I snagged on my way out the door was Toyota Kata, the one I described with such admiration on Tuesday morning, lamenting that I had not had the time to read it. Well, there you go. I plowed through half of it. Would have gotten further, but had to watch a really good Jerry Springer and eat my tasteless hospital food (Overcooked mac and cheese, gray asparagus, canned pears, and a drink that arrived completely frozen solid.). So, remember what I said: “A true lean leader is a lifelong learner.”

Put your left hand on the computer screen, raise your right hand, and repeat after me: “A-true-lean-leader-is-a-lifelong-learner.”

Here’s me “enjoying” my incarceration:



Pick up a copy of Toyota Kata. Will change your life. It’s an easy and interesting read. You can finish it in a weekend. Or two bad Emergency Room visits. Whichever.
Thanks, all. I look forward to seeing you again soon!

Very best,
Jeff

Jeff Fuchs
Director
The Maryland World Class Consortia
401 East Pratt Street, 17th Floor
Baltimore, MD 21202
http://www.mwcmc.org/

Thank you Jeff for sharing your story. Despite your scare, you maintained your wit and humor. I wish you a speedy recovery and may God bless you! My prayers are with you.

Masaaki Imai on Gemba Walks in Seattle

Masaaki Imai June 2011 KAIZEN Institute USA forum

View more presentations from Mike Wroblewski

Last week I had the wonderful opportunity to go Gemba Walking with Masaaki Imai to several Seattle Companies. I will talk about that experience in a follow up post but thought you might like to see Mr. Imai in action in this slideshow.

Children’s Hospital of Saskatchewan Getting Lean

One of our hospital clients that we are helping guide on their lean journey, in particular, using the 3P lean approach, is Children’s Hospital of Saskatchewan. It is amazing to see the lean thinking that has grown since we started this build project. As you can see in this video, many care providers are participating in this design following the 7 flows with a patient centered focus. One point not highlighted is that several customers (recent patients) also participated in the 3P process to provide their input.

At this time, we have not completed the 3P process. Next up is the design development where we will mock up life size scale rooms to test out the layout and process improvements before we start construction of the new Children’s Hospital.

Stay tuned as we progress on this lean journey!

Dilbert on Kaizen

Here is a recent Dilbert strip poking fun at Kaizen. Kaizen is NOT something that is done to people as it seems in this joke yet in many companies that is the sad reality. This joke also gives new meaning to having someone with outside eyes on the kaizen team. When done in the correct spirit, kaizen is powerful.

Did this Material Come In?

On a recent business process kaizen to improve a warehouse receiving process, our team was focused on improving the time from when the material arrives at the dock door and it is entered “correctly” into the system as received. On too many occasions, the material does not get entered properly in the system and ends up lost somewhere in the facility.

Typically, the invoice would arrive in Accounting some time later and the Accounting would write “Did this material come in?” on the invoice copy if the system did not show receipt of the material. Then forward the copy to Purchasing. Purchasing would contact the supplier to confirm shipment and send out a search party into the plant to locate this missing material.

This problem is so common that Accounting got tired of hand writing “Did this material come in?” on the invoice. To kaizen this process, they purchased a hand stamp with “Did this material come in? to eliminate the wasted time hand writing.

How often do we improve the wrong tasks? It is not true kaizen to improve something that should not be done at all. Before we jump to improvements, ask what the function is and what the value is. Take the time to look deeper. Our kaizen should look at improving the value. In this case, why did the material not get entered properly in the first place?

That’s just what our kaizen team investigated. After several rounds of experiments, we improved the receiving process and the time to “correctly” enter the material into the system was reduced by 86%. In addition, we set up a measurement system to closely monitor the process for sustainability and further kaizen. Soon this stamp can be eliminated.

Stand Up Meeting Humor

I found a copy of this recent Dilbert Comic Strip on a stand up meeting white board taking a poke at stand up meetings. Funny except for hitting people with office supplies. But it does cause me to reflect on stand up meetings...are they done just because others are doing it? What is the value of our stand up meeting? Can we improve?

Free Lean Healthcare 3P Training

Coming up next week, Chris Schrandt and I will present for an afternoon on the theme of Using 3P to Support Healthcare Facility Design. Both Chris and I are active in health services design projects Canada, the USA and New Zealand. We each bring over 20 years of direct experience in applying TPS principles to manufacturing and service organizations. So if you are interested in learning more about 3P design, please join us next week in Seattle.

We will cover the following topics:

What is 3P (Production Preparation Process)?
7 Wastes and how they affect Health services
Who is our Customer(s)?
Understanding the 7 Flows in a Health services facility
Applying 3P: step by step overview


Kaizen Institute is organizing this forum in collaboration with Gemba Academy and Qualis Health. It will be held in Seattle, Washington on Thursday March 17, 2011. This seminar is free of charge.

The registration details are as follows:

Cost: FREE

Date: Thursday, March 17th, 2011

Time: 1:00 PM - 4:00 PM

Location: Qualis Health
10700 Meridian Ave N #100
Seattle, WA 98133-9008

Contact: Nancy Evans
Tel: +1-888-464-3622

Old Lean Dude

My friend, Bruce Hamilton (aka the toast guy from the Toast Kaizen DVD) has started a new blog called Old Lean Dude. In his blog, Bruce gives an insightful look with his lean thinking to help us better understand the Toyota Production System. Sharing his reflections and observations on the lean philosophy we can develop our eyes for improvement.

Check out Bruce’s posts and comment back to him for two-way communication. Ask him about learning directly from the master, Shigeo Shingo. Ask him why is the sink filled with dirty dishes and isn’t a dishwasher really a batch process?

Impossible Dream

There a many times traveling on the lean journey that we get frustrated, worn down and tired. The journey is not an easy one when face day after day with naysayers and harsh critics that cling mightily to the status quo and it’s illusion of security. We face a constant struggle as change agents in seeking zero defects, zero accidents, on-time delivery in the most efficient method possible on a journey that never ends.

It would be easy to just give up and go home rationalizing in our weary minds that at least we gave it a good shot. Most practical, rational leaders might think that way. Maybe we settle too easy in compromise. Perhaps we think it is an impossible dream.

But as lean thinkers we know there is no limit to the world of possibilities with the power of kaizen. We know that developing leaders and empowering others is the right way. We know that in face of adversity we build our character, our strength. We may fall down but we find the courage to get back up. We dream the impossible dream.

Impossible Dream Music by Mitch Leigh and lyrics by Joe Darion
To dream the impossible dream
To fight the unbeatable foe
To bear with unbearable sorrow
To run where the brave dare not go

To right the unrightable wrong
To love pure and chaste from afar
To try when your arms are too weary
To reach the unreachable star

This is my quest, to follow that star
No matter how hopeless, no matter how far
To fight for the right, without question or pause
To be willing to march into Hell for a heavenly cause

And I know if I'll only be true
To this glorious quest
That my heart will lie peaceful and calm
When I'm laid to my rest

And the world will be better for this
That one man scorned and covered with scars
Still strove with his last ounce of courage
To reach the unreachable star!

The video clip was one of my favorite versions of this song, sung by the extraordinary and incredible Jim Nabors (playing the role of Gomer Pyle on the TV series I loved watching as a kid). He has one of the finest and most amazing voices in the world!

For all the lean change agents, keep fighting and reaching the unreachable!

Book Review - On the Mend

One of several books that helps me enormously to better understand the lean healthcare world is On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry written by John Toussaint, MD and Roger Gerard, PhD with Emily Adams. This book makes it simple to understand some of the challenges we must prepare ourselves for in leading change in a healthcare and the application of lean management principles in the healthcare environment.

On the Mend is part storytelling, part case study and part inspirational in writing about the lean transformation of ThedaCare, a four-hospital healthcare system in Wisconsin as seen through the eyes of the authors who lead this revolution. ThedaCare’s lean transformation journey began in 2002 and continues to this day, and the book highlights their early years through 2009.

What I enjoyed most about this book is the easy writing style that made great use of patient examples and conflict issues that brought the story to life while tackling important questions like, “How do we define value anyway?”

There were many topics covered that I found intriguing like the use of the “Collaborative Care Unit” concept. I enjoyed reading about the improvement process of a common heart attack (an ST segment elevated myocardial infarction or STEMI) to go door-to-balloon in 90 minutes or less. And why that is critical. Also covered well was the use of familiar lean tools and ideas like value stream maps, asking the “5 Whys”, PDCA, 7 wastes, spaghetti diagrams and standard work, only these were translated for the healthcare point of view. The authors focused more on the application of these tools and left the technical “how to do” for others to explain.

The authors did a nice job of emphasizing that the lean healthcare focus is on the patients and the care around them, identifying value for the patient and minimizing the time to treatment. Ultimately, it comes down is finding better ways to save lives and improve outcomes which are goals we all can rally behind.

I highly recommend On the Mend to both healthcare and non-healthcare lean leaders to read and then read it again. There are many valuable insights to any lean journey found here to helps us find our way. However, don’t read this book and expect to find any silver bullets. As we know, silver bullets do not exist in lean, only hard work and dedication to the continuous improvement process.

Overall, I think the lean healthcare journey is best described in this book in the words of the authors, “There are no right answers or everlasting solutions, only incremental improvements to be tested and implemented as employees get closer to the goal of identifying what is value to the patient, then delivering it reliably.”

Full Disclosure: I did receive a complementary copy of this book from the publishers to review.

Ambiguous Visual Controls

It has been extremely exciting this past year to enter the lean healthcare world to learn, share and improve processes with the spirit of kaizen. I will certainly post on my lean healthcare experiences later this year. For now, I'd just like to share an ambiguous visual control that that I stumbled upon during one of my Hospital visits. Do you think this causes any confusion?

I am Insane

During a recent kamishibai training session, I received the best compliment of my lean sensei career to date. At least I’m taking it as a compliment. The President of the company said to me, “You are insane.”

After conducting a session on leader standard work, I introduced the use of kamishibai boards to senior management which in this case included the President and his staff (plant manager, department heads of sales, engineering, etc). Kamishibai boards are a simple audit card system using layered audits. Audits are one of the key elements of a lean management system to identify process problems and engage all levels of management closer to the process. It forces the attention of management to focus on the process.

We went to a newly constructed audit board created by the team leaders and supervisor, reviewed how to use the audit cards and practiced doing a real audit using the cards. At first, the senior management was a little apprehensive to go out to gemba to audit the process but grabbed an audit card anyway and started their learning process.

Almost immediately, I was getting feedback like, “How do expect me to know if the setup was right and completed in the expected time?”, “If we do these audits, it will take us all day to finish them.”, “How can I tell if the prints are the correct level?”, “How do you expect me to know if we are working to standard?”. It was a little surprising just how much negative pushback was given and this is from the senior staff, the leaders of the lean system.

My response was, “How do you think you will know the answers?”

After a round of discussion among the group, the President spoke up and said, “Mike, you are insane.” He went on to say, “You mean to tell us that we are expected to know our processes on the shop floor?”

I smiled.

Annual Management Improvement Carnival 2010 Training within Industry

For the fourth and final blog review in my contribution to this year’s Annual Management Improvement Carnival, I will feature the Training within Industry blog written by Bryan Lund.



Bryan Lund started his blog back in September 2007 with his passion for TWI and continuous improvement. I saw first hand Bryan’s passion during his excellent presentation at the 2007 Reliable Plant Lean Manufacturing Conference where we both were speakers. He gave a teaching demo of the Fire Underwriters knot exercise for us to understand the TWI instruction process.

Bryan’s blog, Training within Industry, is an outstanding blend of posts on teaching, improving and leading continuous improvement along with personal reflection to stimulate our own lean thinking. Bryan Lund lives and works in the Burlington, Vermont area.

Here are a few of his best for 2010.

Management Reality
Bryan Lund discusses daily self-discipline and his approach as he takes on a new position in his company with the help of TWI pocket card checklists.

Gandhi gets Lean
Bryan Lund faces the challenge of influencing the behavior of one piece flow over batching 5 at a time with a little inspiration from Gandhi.

Do Not Write Work Instructions
Bryan Lund teaches us to stop and think before we jump to writing work instructions by going through a 5W1H thinking exercise.

5S Thinking
Bryan Lund reflects on the purpose of 5S and questions the tracking success metric of the 5S audit score.

Stealing Monkeys
Bryan Lund encourages us to not steal monkeys off the back of others in the name of help them.

Kaizen Teian First, Kaizen Events Last
Bryan Lund presents his thoughts on growing individual kaizen skill before leaping to the large improvements of kaizen events.

Please be sure to continue reading Bryan Lund’s blog, Training within Industry, in the future and comment on his posts.

Annual Management Improvement Carnival 2010 My Flexible Pencil

For the third of four blogs reviews in my contribution the 2010 Annual Management Improvement Carnival, I will highlight My Flexible Pencil written by David M Kasprzak.



This is another excellent new blog I stumbled upon this past year which just started last March. I was fortunate to have met David in October at the Northeast Shingo Prize Conference along with bloggers, Tim McMahon and Mark Hamel. At the conference, we attended several sessions together and had multiple opportunities to share ideas and thoughts on continuous improvement. David takes his lean thinking beyond the traditional shop floor and directs his focus on organizational effectiveness and leadership.

David lives and works in the Greater Boston area, dealing with the many challenges of fostering the lean approach at his company, the setting for many of his stories.

Here are a few of his best for 2010.

Why Performance Appraisals are Still Used and Why Team Building Still Suffers
David Kasprzak theorizes the often criticized performance appraisal system with lack of true teamwork in companies today.

The Rules are the Problem
David Kasprzak shares a great story illustrating that the way in which you approach a problem determines the way in which you solve it. I especially like the “Make it look like this” solution.

Employee Recognition Doesn’t Require Vision. It Requires Visibility
David Kasprzak reveals a compelling point of view in support of an open office environment in leading by example visibility.

Rube Goldberg Leadership: Waste and Value
David Kasprzak insightfully applies the 7 wastes to leadership that is thought-provoking.

7 Reasons I hate my desk
David Kasprzak questions whether the most common office standard, our desk, adds value or not.

Change Management and the 5S Framework
David Kasprzak uses the 5S Framework beyond the traditional physical environment and applies it to management systems.

Please be sure to continue reading David Kasprzak’s blog, My Flexible Pencil, in the future and comment on his posts.

Annual Management Improvement Carnival 2010 Lean for Everyone

For the second of four blogs reviews in my contribution to this year’s Annual Management Improvement Carnival, I will feature Lean for Everyone written by Jon Wetzel.



This year I stumbled across this new blog which started just last December. Jon is the owner and operator of Lean for Everyone, located in Farmington Hills, Michigan, working to help teach new and small companies how to use Lean Six Sigma in their workplace.

I am a new reader of Jon’s posts and became an instant fan. The first thing I noticed about Jon’s posts are his long, intriguing titles that grab hold of you and draw you into his lean story. Many of his posts are inspired by daily activities in his life centered on his home which many us can relate while drawing some excellent lean learning. With a biotech background, entrepreneur spirit (he invented and patented Scented Pen) and the skill to make twist balloon animals (not kidding), you can imagine the cool insights and different perspective bursting from his mind and found in his lean posts.

Here are a few of his best for 2010.

Lean on TV: Kitchen Nightmares – Gordon Ramsay from Hell’s Kitchen a change agent?
Jon Wetzel describes the rapid restaurant improvement event steps that Gordon Ramsay uses to save a struggling restaurant from extinction. If you overlook the not-so-shy, in-your-face confrontational style of Mr. Ramsay, you learn that his recipe for improvement is actual quite appealing.

Lean for Health: I’m performing a kaizen on myself at MyFitnessPal.com
Jon Wetzel writes a series of posts on his personal fitness improvement journey using MyFitnessPal.com highlighting the helpful visual controls found on this website.

Lean for the Home: 4 Simple Steps to Doing a Red Tag Event in Your Closet
Jon Wetzel provides a simple, visual method for seeing the waste in our closet of clothes that we no longer wear.

Lean for Home: Creating an emergency checklist for when the power goes out
Jon Wetzel illustrates the power of the simple checklist and standard work as applied to a home emergency.

5 lean things your accounting dept. can do immediately to help cash flow
Jon Wetzel provides a few simple and effective ideas for our accounting department to look at their procedures with an eye for improvement.

Lean Biotech: I got to dumpster dive in Pfizer’s supply closet. It was not a Lean place
Jon Wetzel connects with his inner Indiana Jones as he pilfers through the abandoned supplies of a closed Pfizer facility, piecing together the remnants to tell the story of their not-so-lean supply chain practices.

Please be sure to continue reading Jon Wetzel’s Lean for Everyone in the future and comment on his posts.

Annual Management Improvement Carnival 2010 - Improve with Me

It’s that time again for the Annual Management Improvement Carnival which is orchestrated by John Hunter, creator of the Curious Cat Management Improvement Blog. I have the privilege to help by reviewing four excellent improvement blogs, Improve with Me, Lean for Everyone, My Flexible Pencil and Training within Industry. Following suit with the great review formats of Jamie Flinchbaugh and Tim McMahon, I will review each blog in separate posts over the next few days.

I’ll start things off with Improve with Me written by Brian Buck. Brian is a lean healthcare practitioner from Tacoma, Washington and started writing his blog back in December 2007. I sadly missed a couple of opportunities to meet Brian last year as I traveled to Seattle but hope to met him on one of my future trips.



As a regular reader of Brian’s posts, I have gained a broader perspective on improvement. Here are a few of his best for 2010.

Strategy Deployment Challenges at a Hospital
“Just because a project is a good thing to do does not mean it should be done now. It is very easy to spend time and resources on these “good” projects if your organizational strategy is not deployed throughout all levels. The challenge our organization is facing is there are other strategic initiatives losing momentum due to competing resources.” This post links to a nice video feature Dr John Toussaint from ThedaCare Center for Healthcare Value on their hospital lean strategy.

Advice for First Time A3 Authors
“Writing an A3 is a wonderful tool to solve problems and share the thinking that goes into resolving issues. I have some tips to help first time A3 authors that I hope will be valuable for you.”

Doing Silly Things
“It is amazing to me how often people want to implement something or suggest how to change a process without ever connecting their thoughts to a problem or desired outcome. As an internal consultant at a hospital, I frequently get presented with proposed changes where we have to back-track to discover the problem. Here are some reasons I think this happens”

Fire at Will
Brian Buck provides some thought provoking points to the “Burning Platform” approach to drive change.

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.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”.”

I like Brian’s posts because he presents great examples from his lean healthcare experiences that stretch my manufacturing-centric point of view on lean improvement along with providing his insight to the lean approach.

Please be sure to continue reading Brian Buck’s Improve with Me in the future and comment on his posts.

Managing Mura

One of our challenges in lean manufacturing is to try to level unevenness, called mura, through the value stream is improve the flow. Mura is one of the 3 M’s along with muda (waste) and muri (overburden).

When thinking of mura, we typically think of the demand pattern for our product or service. A cyclical demand profile is fairly common with many products especially seen in seasonal products like lawn mowers, snow blowers, Christmas trees, fruit cake, swim suits, etc. Even caskets have a seasonal pattern, believe it or not. It seems to be the nature of most products and we accept it.

But what about self inflicted unevenness?

I was visiting a company (not a client) recently that has a problem with mura (unevenness). Every month 50% of the total monthly sales occur in the last week of the month. This pattern is pretty consistent each and every month. As you can imagine, the impact through the value stream is like a pig going through a python every month. During the last week of the month, the plant is running high overtime to meet this demand and the following week they are having down days due to low demand.

I learned that they have a monthly sales target to hit every month. This metric is one of the “Must Do” metric driven by management with all the normal rewards and punishments the go along with it. Hit the target means raises, bonuses, promotion and keeping you job. Missing the target means poor reviews, no increase in wages, performance turnaround plans and job loss.

Under this “Must Do” metric, the sales department made decisions and acted to meet the target every month which, in this case, meant making “deals” that cut the price at the end of the month. It did not take long in the market for the savvy customers to see the pattern of price deals towards month end. So as you can imagine, more and more customers waited until the last week of the month to buy which exasperated the situation.

Bottom line, this mura has not only resulted in higher cost but lower sales revenue (however they are making up for it in volume, right?)

I have seen the same push at year end especially when bonuses are at risk. Do anything to make bonus is the primary short term mindset. Is this happening at your company this time of year?

The main problem with goals like monthly targets, quarterly targets, year end targets and bonus driven targets is they potentially can drive the wrong behaviors. Goals and targets are not bad things to have either professionally or personally, they are great things the have. Just be aware of the behaviors and actions that go along with effort to achieve them.

For simplistic countermeasures: Stop doing that. In this case, don’t make the ritual price cuts at the end of the month. Look deeper at how sales promotions affect the value stream. Try to think more long term and figure out what behaviors (ie number of customer touches) are desired to achieve the results (sales generated). Focus on these behaviors deemed to have the most impact. Brainstorm with your team (sales and operations together) to find a better way.

Management Improvement Carnival #118

Got Boondoggle is proud to host another edition of the Management Improvement Carnival. Please check out the following posts from follow lean thinkers in recent weeks. Enjoy and learn!

Who is Responsible? by Jon Miller – “The word "responsibility" means to bear a duty. When one is responsible, it is because one has taken on a burden or duty. In keeping with lean principles this should not be overburden, or unreasonable duties, but it is critically important that individuals take responsibility for the role they have accepted.”

Guest Post: Going to Gemba with Grandma by John Wetzel- “I saw something that I would never have discovered if I hadn’t gone to the gemba.”

Hoshin Kanri: Steel, Needles, Tubes and Logic by Ron Pereira – “And as it turns out, during the taping of Gemba Academy’s Lean Lingo course, Brad broke down the characters of this mysterious word. And in doing so, really opened my eyes to what this word means.”


He Should Have Seen It by Mark Rosenthal - “We talk about 5S, separating the necessary from the unnecessary, a lot, but usually apply it to things. What about information?” (Also read the link in this post!)

Voice of Customer (VOC): What does it mean? By Mark Wheeler – “Most companies have some type of VOC program in place. Many programs fall short of delivering measurable value. This failure often lies at the definition level of VOC. But how do you actually define it?

Lean Safety

Can you kaizen a process making productivity gains without using a stopwatch?

Most of us practice and teach the value of data driven improvements however there are ways of getting the same results without clicking a stopwatch. One such kaizen approach is described by Robert Hafey in his book Lean Safety: Transforming your Safety Culture with Lean Management.

While leading a kaizen event, Bob directed the team to leave their stopwatches in their kaizen toolboxes and use direct observation of the process with an eye towards safety. More specifically, the team was trained to look for only four conditions in Gemba: Out of Neutral, Excessive Weight, Straining, and Repetitive Tasks.

Out of Neutral: A condition when one of our body parts are out of the neutral position while performing a work task, i.e. when our arms go above our shoulder, our shoulder joint is out of neutral.

Excessive Weight: When someone moves or lifts a heavy object.

Straining: When someone strains to exert physical force to an object.

Repetitive Tasks: Anytime someone is asked to repeat short duration tasks repetitively.

As the team took note of each occurrence, they brainstormed ways to eliminate the condition. For instance, if they observed the operator lifting a heavy object, they did not reinforce the proper lifting techniques. Instead, they looked for ways to eliminate the need to lift in the first place.

After implementation of these improvements, the job was easier and better which led to productivity gains. The interesting result was the natural evolution from a batch process to one piece flow based on improvement of these ergonomic elements.

Sounds like a simple and focused way to make a job easier and better looking at muri (overburden) versus our traditional viewpoint of always looking for muda (waste)!

In Lean Safety, many of the lean tools like A3, 5S, standard work, poka-yoke, 5 Whys and process mapping are adapted towards improving safety. The tools are not new however the applications towards safety give us a different take in using our lean tools. In addition, Bob has provided many examples and real life experiences from facilitating lean safety kaizen events. Overall, this is a very good book written in an easy to read format with a passion for safety that all lean practitioners can learn from.

For more information on Lean Safety, Bob has a new blog site called Lean Safety which he started posting his thoughts and ideas on continuous improvement focused on safety.

Welcome Bob to the blogging community! And as Bob says. “You can continuously cope or you can continuously improve, the choice is yours.”

Driving Lean Across the Organization

One of the more unfortunate expressions, in my opinion, found in the lean community is “driving lean across the organization”. I hear and see this all the time. It can be found in lean books, articles, job postings, job descriptions, reviews, etc. “I want someone who can drive lean across the organization” or “To drive lean across the company, we need …..”

What comes to your mind when you hear the expression “driving lean across the organization”? How would you drive lean across the organization?

Is this what we really need to do to move towards being a lean company? Can we sustain efforts if we drive them? What happens if the driver leaves the company? What about respect for people or engaging the employees?

As a lean leader (both internal and external), I have been asked in the past to “drive” lean across the company. Having someone, especially an outside consultant, tasked with driving lean is not the best way to become lean. Sure, you most certainly will get some fast results but it will not be sustained and it may cause more damage to the organization than the gains you achieved.

To begin changing our lean culture, instead of using the term “driving”, can we choose better words to reflect a better approach? How about leading the way, guiding, teaching or setting the example?

Now, how would you lead the way? How would you set the example of the lean approach within your organization? Would your course of action be different than if you drive lean?

(photo credit: AP Photo/Nasser Shiyoukhi)