Tag Archives: lean leadership

Meta-Lean 2: Empiricism and Humility

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Developing an Attitude of Science

LMMPhoto4aThe primary task of a manager is to think. The future success of the organization is dependent upon his or her ability to think clearly, critically, and creatively.

The greatest enemy of continuous improvement is arrogance, particularly on the part of leaders, and the opposite quality of humility is a requirement of learning and improvement.

In my previous post I introduced the idea that there are “big thoughts,”  or over-arching cultural principles that are essential to creating a genuinely lean culture. I suggested that the principle of Unity was the first. The second is what I will call the principles of Empiricism and Humility.

It might seem that empiricism and humility are two different things, but let me suggest that they are necessary corollaries.

Last night I watched the Charlie Rose interview of Jeff Immelt, the CEO of General Electric. I recommend the entire interview to you. It is insightful and intelligent. But, toward the end Charlie Rose asks Jeff Immelt what is the one piece of advice he would give to MBA students today if he was speaking to them at the Harvard Business School. His answer was “Humility and the curiosity that goes with it. The big mistakes you make are when you stop asking questions. But, if you are always hungry and digging for that extra piece of knowledge, that is how the world works.”

I think you would be hard pressed to find a better piece of advice for any executive or manager.

Correlation, Causation, or None of the Above?

Continuous improvement, or lean management, is built on the ability to discern fact from fiction; causal relationships from correlative relationships; anecdotes from data trends and statistical analysis. Unfortunately, our culture is doing a very poor job of helping students, and the population at large, develop these abilities. China, and many developing countries are outscoring the U.S. in math and science education with the U.S. ranked as low as 31st in math scores. This is a frightening trend with dramatic economic consequences.

Here is just one small example of this disability. Well.. actually, it isn’t that small!

It is constantly argued that lower taxes produce economic growth and higher taxes reduce economic growth. This is repeated so many times in the public press and political discourse that it is assumed to be true. The fact is that there is no demonstrable causal relationship between economic growth and tax rates. According to a study by the Congressional Research Service, a non-partisan body, there’s no evidence that tax cuts spur economic growth.

If anything, the chart below demonstrates a slight correlation (not a causation) between higher growth and higher tax rates. Don’t misunderstand, I like low taxes as much as anyone! But, what I like, is completely irrelevant to the facts. And your ideology or political leanings don’t change the facts! The facts are easy to demonstrate, but the facts are rarely looked at and given very little regard in the public discourse. Why is this? It is because we have become more ideological in our thinking and that frees us from the burden of analyzing the facts.

Dr. Deming’s 14 Points and an Attitude of Science

Dr. Deming was constantly preaching that we must manage by the “facts”, by the data, not by slogans, objectives, or other efforts to create fear or intimidation. He was, of course, a statistician and he believed in the power that comes from understanding your data.

I began my career in behavioral psychology which is heavily research and data oriented. B.F. Skinner used to say “the pigeon is never wrong.” In other words, when you conducted an experiment and the subject (a pigeon, for example) behaves in a way contrary to your expectations, the actual behavior trumps any theory you might have. It is the equivalent of saying, the employees are never wrong, in regard to their level of behavior or motivation. They are responding to the nature of contingencies, the consequences to behavior in the real environment. As the manager of those contingencies you are, therefore, responsible for their behavior. This is an attitude of science or empiricism.

My earliest work in textile mills in the South involved getting plant supervisors to post graphs that demonstrated rates of quality, waste, etc. and then have the supervisor lead a team meeting when they would discuss the data, ask why it was going up or down, reinforce improvement, and discuss what they could do to improve in the coming week. It was simple, but effective. Seeing the data on a graph, even by hourly workers, who in some cases were illiterate, had a powerful effect on their behavior. They responded to feedback, the visual display of the facts of performance. And, they could analyze data in its simplest form.

Run Chart1

Every front-line work team and, of course, every management team must become “scientists.” By that I mean simply applying the essential scientific method of a) gathering baseline data, or data of a control group; b) implementing a change in methods or conditions; then c) studying the data as it changes; and then d) standardizing what worked; and e) moving on to another experiment, another intervention to attempt to improve performance.  Letting the data speak, learning from the data, is the essential attitude of science and it is what we must cultivate in every organization. Until we achieve this we have not achieved the essential cultural characteristic of empiricism.

Scientists are humble because they know that they are not determining reality, they are merely discovering it, and most often after many, many failures. When Benjamin Franklin conducted his famous kite and key experiment to explain that lightening was electricity, he did so in a world in which the predominant view was that lightening was the anger of God punishing us for our sins. Franklin replaced superstition with science. That is exactly how most of human progress has been made and it is how most advances in production or other business methods are made. Unfortunately, in many of our organizations we are are still burning witches, rather than studying the data and experimenting.

As you go on your Gemba walk through production areas, in meetings with managers, ask for the data. See the data graphed! Ask “Why?” Teach them to become scientists!

 

 

Meta-Lean: The Unity Principle

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When the Western mind encountered lean organizations such as Honda and Toyota, we overlaid our ways of thinking, the mechanics of our mind, onto those systems and reduced them to their component parts. It is the tendency of the Western mind to employ reductionism to explain the workings of systems. But, that is not the way of the Eastern mind.

Lean Metaphysics

Some companies have engaged in what they think are lean implementations by reducing lean to component parts and experimenting with one component over there, another over here, and a third somewhere else. That is guaranteed to fail. The very idea of reducing lean to its component parts fails to “get it.”

There are components to lean: just-in-time, continuous flow, quality detection systems, plant design, teams, information sharing, etc. But, there is also something that holds them together, something that is almost metaphysical, which I will all “Meta-Lean.” It is a Zen, a philosophy, a working of the mind that is distinctly different than the workings of the mind in traditional Western organizations. Meta-lean principles hold the parts together and enable them to work together in a dynamic that leads to self-correction and improvement.

I believe that the first principle of meta-lean is what I called in a previous book, The Unity Principle. Honda took this principle to heart and sought to apply it in their U.S. operations. It is simple, yet profound. Let me give an example:

The human body is a natural system. It is organic, living, changing, adapting, and composed of interdependent parts or sub-systems. It is a “whole-system.” It can be reduced to component parts. There is the digestive system – the mouth, throat, stomach, etc. There is the respiratory system;  the cardiovascular system; and, of course there is our natural IT/IS system, our brain and central nervous system. You can describe each of these systems independently. You can remove them from the body and dissect them. But, they will be dead. Their life depends on their interdependence. The whole is greater than its parts.

The reductionist mind would view the human body as merely the sum of each of its subsystems. Yet, each of these subsystems contains no life unless completely integrated with the others. Only when the body is whole can we say that it is a human life. It is more than the sum of its parts. I think any scientist would agree that even after more than a thousand years of dissection and study of the human body, we truly do not understand the magic of its connections, its unity as a whole, which gives it intelligent life.

I will argue that lean culture, lean organizations, contain a similar mystery of life. Separate the parts and it becomes lifeless, unify the parts and a magical thing happens. It gains life as the parts interact and support one another.

The Unity of Social and Technical Systems

When I was last in Marysville, Ohio at the Honda assembly plant I also visited a supplier, Stanley, that produces headlight and taillight assemblies. The Stanley plant has no outgoing warehouse or storage area. Pallets of assembled headlights or taillights go directly onto a truck. That truck moves every two hours to the Marysville plant. The “pile” of headlights and taillights at Marysville is merely a two-hour pile. The truck must move every two hours. That, of course, is the just-in-time work flow. However, that is only subsystem of the whole organic system.

Associates on the line have a phone at their work station. When they find one… I repeat… ONE bad part, they pick up the phone that rings in quality assurance. A quality assurance associated immediately answers the phone. He then comes out and picks up the part. He returns to his desk and picks up a second phone. That phone rings at the supplier. The suppliers is informed of the defective part and the supplier must get back within one hour to explain what he is doing to correct the defect that was created only hours ago. Remember the two hour pile!

Notice that this human feedback loop involved only first level hourly associates. No manager got in the way to slow it down. No meetings were called. No studies made or reports written. The hourly associates were trusted to transfer information through the artificial walls of legal company boundaries that become irrelevant in a lean system.

The immediate feedback loop conducted entirely at the first level is employee empowerment, engagement, trust. Without this, the two hour just-in-time process becomes impossible. One system is entirely dependent on the other… just as in the human body.

Thinking that Unites and Thinking that Divides

In the culture of the Lakota Sioux the hoop, the circle, has sacred significance. Kevin Locke is a friend of mine and he is a well known “hoop dancer”. He told me that the Lakota Sioux, when they first encountered Europeans moving west, referred to them as Oblatongyangpi,  which means “people of the square” or just square people. Why? They carried things with four separate sides (books); when they built homes they built squares; they cut out squares to look through; if they had a lot of homes they organized them into squares; they even tried to do square dancing… almost impossible. Obviously, they loved squares with four separate sides. Each side can be measured separately and each side has a beginning and an end.

And, in the world of the Sioux, they built round homes, organized them into circles, danced in circles (much easier!) and the hoop, which has no beginning and no end, symbolizes the unity of all human beings, people and animals, earth and sky, in one organic whole created not by man, but by the Great Spirit. You may have heard the phrase “Indian giver”, someone who gives and then takes back. This misunderstanding comes from the fact that Native Americans had great difficulty understanding the idea that you “owned” a piece of property. How could something that was created millions of years ago and is eternal belong to someone who will last only an instant? The land will soon own you, not the other way around, and you will own nothing but your soul.

Westerners are obsessed with property lines, ownership, divisions between things. We employ armies of lawyers to argue over who owns what and where the lines of squares are drawn. Much of it is cultural insanity that adds no value but consumes energy.

We love to organize people into two separate categories. In the recent election campaigns we had the absurdity of the population being simplistically divided into “makers” and “takers”, “producers” and “mouchers.” It is an insane example of square thinking. Yesterday, I read that John Sununu, former Governor of New Hamphshire, weeks after the election was explaining the Obama victory by the dominance of takers over makers. The irony is that John Sununu has spent his entire career in the employ of government, taking from the people, never having started a private company or managed a productive enterprise in the private world. Yet, it is comfortable and an easy explanation to divide the population of the United States into those who take versus those who make. Nothing is so simple and the nonsense of these false divisions (and there are many) are destructive of the unity of the nation.

Divisive thinking tears apart the unity of the whole. Every genuinely great leader sought to unify people in common purpose. Every general of every victorious army understood that the army had to act in unison, marching together and claiming victory together. A divided army is easily defeated.

The sickness in many of our organizations is a sickness of division. We create compensation systems that separate and divide rather than unite. We create different forms of dress, offices, buildings and symbols that separate people into those who do labor and those who make decisions.

Lean culture and management requires the destruction of divisions. There is no division of thinkers/deciders and doers/order takers. Every associate is a thinker and every one a decision maker. Every member of the organization should be rewarded based on the success of the whole. Symbols such as the different dress codes or uniforms should be abolished because they inherently imply divisions of class.

The lean mind does not see divisions created by lawyers in the form of corporate walls. The flow of the work process must flow through the division of legal walls as if they do not exist. They are irrelevant to the end user of any product. Lean is like the stream flowing from the top of the mountain to the sea in one continuous motion. The flow of the stream is not interrupted by legal property boundaries and does not wait for management decision making.

Until the leaders of the organization have understood the power of unity over division and have meditated on the creation of unity within their organization and the unity of flow through all the walls and silos of departments or companies, you have not adopted lean culture or thinking.

The idea of the Unity Principle is simple. The idea of whole-systems is simple. Yet, putting these ideas into practice is not simple and requires dedicated effort.

 

 

 

 

Teamwork In Healthcare – Keys to Continuous Improvement

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There are many models of excellent health care service and they have a few elements in common – teamwork and collaboration. You can quickly assess the quality of teamwork in your organization. My most recent book can help you improve it, directly and efficiently.

The Mayo Clinic  – Built on Teamwork

The Mayo Clinic has long been a model of superior health care service. Their core competence has been described as “teamwork.”[1] A recent book on the Mayo Clinic described their culture this way:

“Mayo Clinic is a collaborative organization, a pliable institution that assembles the expert care teams for individual patients. Imagine a huge store that sells everything, with experts in every department who work together to help customers. This is how Mayo Clinic is designed for medical customers.

Teamwork at the Mayo Clinic is not optional. It is the system you join when you agree to work there. One of the Clinic’s doctors described it this way. “The Mayo culture attracts individuals who see and practice medicine best delivered when there is an integration of medical specialties functioning as a team. It is what we do best and most of us love to do it.”[3]ers. Patients don’t get just a doctor; they get, in effect, the ‘whole company.’ Some patients see more than one Clinic physician. Typically, the first doctor to treat a patient is responsible for coordinating the care plan with other Mayo clinicians and the patient’s hometown physician.”[2]

Lean Management – the New Normal

But the Mayo Clinic is not alone in this regard. As lean management becomes more prominent in healthcare the emphasis on teamwork and continuous improvement will become the new normal. ThedaCare, a four hospital healthcare system in Wisconsin has become a model for lean management implementation in healthcare. Here is how they describe their new normal process:

“Instead of responding to hierarchy and heroically firefighting in an environment of shame and blame, Collaborative Care teams now meet in daily huddles to review any issue with patients or work flows. When problems arise such as a medication error or a patient fall, team members use PDSA (plan, do, study, act) cycles to determine what happened, find a corrective plan, implement it, and study the results on the process. Teams then create new standard work or if the change did not achieve the desired results, the PDSA cycle begins again.”[4]

It is not hard to see why the future success of your health care organization will require a culture of teamwork, processes designed and improved by teams, and primary care teams whose focus is on how to provide the best possible care to their clients. To the degree that we can all work together, seamlessly, without interruptions, walls or silos between groups, we will meet the needs of those who matter most – our clients. That is the purpose of my just published HealthCare Lean workbook.

Here is a quick to to determine whether or not your organization is doing what it should to promote teamwork and continuous improvement:

  1. Every employee, regardless of level or function, is assigned to a team with shared responsibility for improvement in their work area or function. How to test for this? Simple, walk around the work areas, from intake to surgery to the cafeteria, and simply ask ten employees “What team are you on and what is the responsibility of your team?” Ten out of ten employees should know the answer to this question.
  2. As another ten employees: “What was the last improvement, or experiment to find improvements, conducted by your team?” Ten out of ten should know the answer.
  3. Sit in on employee team meetings. Can’t find them? You fail. While observing team meetings observe the following:
    1. Is there a standard agenda?
    2. Is there a facilitator, a trained team member, who moves the conversation along and clarifies decisions?
    3. Are they reviewing data, their own scorecard?
    4. Do they review action items or prior decisions to follow up on those planned actions?
    5. Are they using some disciplined and simple problem solving model such as PDSA?
    6. Do they record decisions or actions with an action register including What, Who, and When?
  4. Do you have coaches who provide training and coaching to teams to make them effective?
  5. Have teams mapped their work flow, defined standard work, and eliminated waste from their processes?

The above five items are simple tests of the degree to which your organization is living lean, practicing teamwork. This must now become the new normal in every healthcare organization.


[1] Berry, Leanard L., Seltman, Kent D. Management Lessons from May Clinic. McGraw Hill, New York, 2008, p.49.

[2] Ibid. p. 50.

[3] Ibid. p. 52.

[4] Toussaint, John, Gerard, Roger A., and Adams, Emily. On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry. Lean Enterprise Institute, Cambridge, MA. 2010. P.28.

The Practice of a Lean Management System: Achieving Economic Efficiency and Social Intimacy

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Many years ago one of the first books I read on management was Peter Drucker’s The Practice of Management. In it Drucker defined and extolled the virtues of the management profession and gave credit to Alfred Sloan the longtime CEO of General Motors for developing the model of professional management in much the same way we speak of Toyota today. The system that Alfred Sloan created at GM was built on the theory  of management as a distinct profession, separate from engineering and other specialties.

Womack’s View of Modern vs. Lean Management

Jim Womack’s (founder of LEI Institute) recent book, Gemba Walks, contains a number of interesting and helpful short essays. These are Womack’s more recent meditations on the implementation of lean management. One of the more interesting, in my view, is his essay on Modern Management vs. Lean Management in which he contrasts the system of management build by Sloan at GM and lean management as it was built at Toyota.

What then is the contrast between the “modern management” of Sloan and the lean management of Toyota/Honda? These are the contrasts that Womack describes:

This is a great list and you could literally write a book with a chapter on each of these contrasts. Let me make a few comments on these contrasts by putting them in the context of a matrix I have long used to describe the transformations of organization cultures from the family farm forward.

Modern management at General Motors created a social class system, a disunity or social strata, and that disunity was the ultimate cause of collapse, as it has been in every civilization.

Social Intimacy and Economic Efficiency: The Miracle of Lean

Those of you who have participated in one of my seminars have no doubt heard me discuss the idea of sociobiology, that there are not only physical, but behavioral characteristics that are genetically passed on because of their contribution to our survival. For most of human history, beginning on the Serengeti Plains of Africa where we hunted antelope in small tribal groups, human beings have worked in family units.  The family farm and the small craft shop structure are only the more recent examples of work systems where there was high social intimacy, high interdependence, and high trust.

This so-called modern management that Womack speaks of began at Ford with the specialization and separation of work and management, the separation of doing versus deciding, and the isolation of workers who were instructed to “do your own work.” This instilled fear and created the loss of the social intimacy that had become the “natural” work environment for the human species over the previous millions of years. The work system and organizations of both Ford and Sloan had become contrary to human nature. This led to the natural rebellion, the need for association, the need for “brothers” in the union as inner city youth seek the safety and security of their brothers and sisters in gangs. Seeking security in groups is healthy psychological survival behavior in the presence of isolation and fear.

The industrial revolution and the revolution in management and organization had created great gains in productivity, economic efficiency, but had destroyed the social intimacy necessary to well functioning human beings and well functioning social systems.

Each of Womack’s contrasts between “modern management” and lean can be seen in this light. Decisions being made remotely versus decisions on the spot is another way of describing the class system, the alienation of leader and led, top to bottom, which almost always results in rebellion from below. The same is true for “staffs improving the process versus teams and those close to the work” improving the process. Similarly, standardization by staff groups versus standardization by line managers and those doing the work is another symptom of the this vertically disengaged culture. Experiments by those doing the work, versus imposed plans from above is the same. Each of these contrasts described by Womack illustrate how lean management is solving the social and psychological alienation created by both Ford and Sloan.

Lean Could Follow Modern Management: Pride Precedeth the Fall

While I generally agree with Womack’s analysis he does leave out an important historical context. The system of production created by Henry Ford was a great advance over craft-shop production in economic efficiency. Resources were made more productive – capital, labor and materials. However, as that system conquered the world of manufacturing it led to the excess of specialization or fragmentation of work, the dis-empowerment of workers, inhuman working conditions, bullying supervision and the natural response of unionization as a counter force. Ford’s system, still extolled by Toyota, became barbaric.

Similarly, there was much initial good in the system of management created by Alfred Sloan. Ford’s system did not provide for the management of a large differentiated organization and the integration of diverse and complex functions. The General Motors system added this capability by creating accounting and control systems that enabled the design of a diverse range of cars, sharing many parts, and utilizing shared engineering and production facilities. GM developed a superior system of administration and this is why GM overtook Ford and became the leading manufacturer of automobiles. It wasn’t until Ford hired Robert McNamara and “the Wiz Kids” after World War II that Ford developed its own system of management.

General Motors not only developed a system of integrated organization, but they promoted and developed professional managers. An entire hierarchy and departments of professional managers emerged. Power and decision making shifted from the engineers to the professional managers, accountants and strategic planners. However, just as happened at Ford, excess pride in their system led to the assumption that all things could be solved by professional accounting and strategic planning systems. Unfortunately for GM, none of those systems of “modern management” as Womack calls them, could engineer a superior car or produce one with few defects. Both GM and Ford grew to place excess faith in their accounting and administrative systems and failed to focus on the core skills of engineering and manufacturing.

This historical context is important because each management theory or system has its day and makes its contribution. And then, their methods tend to become mechanical, bureaucratic, a set of standardized and unthinking procedures that blind their followers to new methods. And are there no signs of the same in lean implementation? Is 5S, standard work, and other methods becoming bureaucratized? Are lean practitioners a little too certain about what they think they know?

Pride and arrogance always precede the fall, whether in civilizations, companies or management methods. Lean practitioners beware!

The Miracle of the Lean Management System

The miracle of lean organizations is the achievement of both economic efficiency and social intimacy. This can truly be labeled “the high performing organization” because it not only serves the needs of customers but also the needs of the people within the organization. It achieves not only business performance, but it enables the realization of human potential. It is not only a technical system, but a social system.

The power of well functioning teams, at every level, is that they are the key to creating unity of social intimacy and economic efficiency. Teams are the family unit of modern organization. Having done some work at both Ford and General Motors I can tell you that the psychological isolation was not only symptomatic on the factory floor, but in senior management ranks as well. They were not safe environments. Isolation, whether a worker at one machine in the factory, or within the confining walls of an executive office, leads to fear and distrust. The elimination of walls and silos must be both horizontal, between departments, as well as between levels of management and employees. Disunity must be replaced by social unity.

At this same time I was involved at Honda in Marysville and the social unity between leaders and led was obvious and in stark contrast to the alienation at GM and Ford. The arrogance of “professional management” was gone and replaced by a deep respect for those who did the value adding work on-the-spot.

I am seeing lean implementations that address front line work processes, but fail to recognize the social illnesses that have been created over many years of fragmented organization, the dead carcass of so-called modern management. The principles of lean management that Womack articulates can heal that illness.

Is Lean a Change Methodology or an End State?

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Is lean where we are going or how we are getting there?

Let me suggest that lean, like the term implies for the human body, is the absence of waste (fat), continuous flow of materials without interruption, and total engagement of people, resulting in high customer satisfaction. Without getting into a debate as to whether that is complete definition or not, (see previous posts) lets accept it just for the sake of the real point I want to make in this post.

But just as a lean body is a condition or state we would all like to achieve, it in no way describes a methodology for achieving that state. To achieve a lean body you could have liposuction, exercise every day, become a vegetarian, or just have good genes. I am sure we would not confuse the end state with the method of change or achieving that end state.

Change management methods are something completely separate from lean. The absence of sound change methodology is a major weakness in many lean implementations. Now, let me suggest that there is micro-change and macro-change; or, continuous improvement and what I like to call whole-system architecture. Both may be right at different times.

I spoke at a Toyota suppliers conference some years ago and the president of a supplier company got up and described the process of Toyota’s consulting group coming into his plant and completely redesigning everything. They sent all the workers home and told the president he had to stand by and not interfere. They ripped all the equipment out of the floor, moved everything around, completely reworked the flow, redesigned the jobs of both workers and managers, and then instructed them when they returned to the plant. This young president described it as a rather traumatic experience.

I sat with the Toyota consultants at lunch and asked them why they didn’t ask the workers to participate in designing the future state. Their answer was simple and direct. “We know and they do not know. Why would we ask them?” Not exactly the model of participation.

This was obviously not continuous improvement, but this was an implementation of  Toyota Production System. It was revolution not evolution. It was not gradual experimentation by those on-the-spot, it was a whole-system change.

For many years before anyone heard of the term lean, I was a practitioner of socio-technical system design, or what we called Whole-System Architecture. Simple idea: in every organization there is a technical system – the work flow, equipment, job definitions, etc.; and there is a social system – who knows, who cares, who decides, who is informed, how are people organized into teams, what is the job of managers, etc.? The theory is simple – change is optimized by designing both the social and the technical system together and creating alignment. This theory comes fromm Eric Trist and Fred Emery at the Tavistock Institute and its early proponents in the U.S. were Bill Walton at Harvard, William Passmore, Lou Davis at UCLA and others. All the early self-directed team plants were created through socio-technical system design. These included Gaines Topeka and all the Proctor and Gamble plants. Ironically, it was Norman Bodek, who brought Shingo and others to the U.S. and translated their work, who introduced me to socio-tech.

I just completed a whole-system redesign of a home health care delivery organization in Canada. They had previously created a central planning/scheduling center (think central hotel reservations) where they both standardized and centralized the scheduling process.  The nurses and managers out in the districts around the country had no control of the scheduling process because of this centralization. We formed a design team and in ten weeks redesigned the entire work flow from the time a customer calls needing a service provider to the time they get paid. Long story short: the time required to schedule a nurse declined from an average of five hours to an average of five minutes. A pre-survey of customers had indicated that 84% were either “very dissatisfied” or “somewhat dissatisfied” with the level of service. Two months after implementation ZERO
customers reported being either somewhat or very dissatisfied. Before the implementation nurse managers reported that they spent 80% of their time fighting fires, rework, etc. Now that has been eliminated. Now, every nurse is a member of a “primary care team” and the person doing the scheduling is part of their team. Now, the nurses do their own “load leveling” by adjusting their schedules to help each other, eliminate missed visits, etc.

This could not have been achieved through continuous improvement. It required a complete redefinition of the flow of the work, where people were located, the definition of jobs, the decision processes, etc., etc. It was a whole-system change and it eliminated a huge amount of waste. Now, they can and need to engage in continuous improvement. Now every team feels empowered to conduct experiments and find small improvements. They could not have done that in the old system.

Whole-System Architecture or socio-technical systems design is a high participation process of redesigning the system of the organization. It is not “lean.” It is a change methodology for achieving a lean end state. Just talking about lean or just implementing small improvement teams will never achieve the dramatic changes needed in many organizational systems. You must have a methodology for redesigning the whole-system.

The following, in very simple terms, describes the process of Whole-System Architecture. See the linked article in the Papers section for a more complete description of the process.

So, whether we call them Macro Kaizen events and micro Kaizen events, or continuous improvement and whole-system change, revolution vs. evolution, I don’t care. But, we should recognize the time and place for each. When people are not receiving the data, when they are not formed into teams, when their work is controlled by standard operating procedures defined by some distant person, and when the manager thinks it is his job to make all the decisions, continuous improvement is virtually impossible.



Lean Management and Culture in Health Care

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HealthCare Lean is now available from Amazon

If you examine each of the characteristics of a lean organization in the previous post you will find that it is not hard to apply them to a hospital or other health care organization.

  • Continuous Improvement: Health care, more than any other field of work or knowledge, has practiced and developed through a process of continuous improvement. Imagine if doctor or nurses were doing their job today the same way it was done ten, twenty or fifty years ago. Every day there is improvement in health care services. It is the job of everyone, every team member and every manager, to participate in continuous improvement.
  • Experimentation: Health care, in all its forms, has emerged from the scientific method of controlled experimentation. Applying the principles of experimentation to daily work practices in a hospital, long term care facility, or home care, should be a natural process for those who are trained in any health or healing profession.
  • Respect for People: Most of those who enter the health and healing professions do so, not for selfish reasons, but to do something noble, to be of service to others. You have probably learned that there is no more reliable source of information about the health of an individual than their own voice, the voice of the customer. The best health care organizations demonstrate respect for the expertise and the spirit of those who chose to work in this profession.
  • The Elimination of Waste: Everyone knows that health care organizations are experiencing tremendous pressure to reduce costs, from the university where we are educated to end-of-life services. What lean implementation has proven is that costs can be reduced while at the same time providing improved service to clients. If one form can be completed on a computer and be maintained by the client, rather than filling out multiple forms that provide the same information and consume the time of patient and staff, fill filing cabinets, and represent a source of error, costs can be reduced while at the same time reducing the frustration of patients. There are many forms of waste that can be eliminated in most health care organizations.
  • Assure Quality and Safety, First! In healthcare we know that our first responsibility is to do no harm. Unfortunately, too often harm is done. That harm may be in the spread of infection in the hospital. It may be in a failure of diagnosis. It may be a delay in diagnosis or treatment. Quality and safety must be the first priority of any lean initiative. As in manufacturing, quality and safety cannot be achieved through a special committee or individual. It must be the responsibility of every single associate. This is accomplished by every team being clear of their area of responsibility and their measures of quality and safety.
  • Blame the Process, not the People: A culture of blame and shame destroys motivation and creates fear. This destroys the capacity for experimentation and learning. Dr. Deming said that 95% of the problems are in the process, but more often we blame the people and fail to fix the process. Too often in health care organizations there is a tendency to search for the “guilty party” when the real blame lies in a process that is too confusing, too difficult, or that leads to errors. Every manager and every team of clinicians and service providers must become experts in their processes and focus on process improvement.
  • A Culture of Teamwork: The Mayo Clinic, ThedaCare, VON Canada and other organizations that are demonstrating superior results are doing so through a culture of teamwork. Clinicians are organized into teams to provide the best possible care, as are service providers from those in the cafeteria to those who assure clean facilities.
  • Joy at Work: You only go around once in life. Why not get all the joy you can? What is “joy?” Joy is the happiness that is derived by putting your strengths to work for a worthy purpose. You joined the health care field because you intuitively felt that you would derive joy from your work. Every time you see a patient get well it brings you joy. Every time you see a client that needed home nursing or support become independent it brings you joy. Unfortunately, that joy is often countered by bureaucratic procedures, sources of frustration to your clients, and fear created by management practices and behavior that are based on faulty assumptions about human nature.
  • Lean is Interruption Free Flow: Several times in factories I have had teams take incoming material off the delivery truck and then stand there as the box stands there. When it is opened and stored, they move to the warehouse or storage area and wait. Then they move from production station to production station and stand there and wait as long as the actual part stands there and waits. This can be an incredibly frustrating experience. I ask them to imagine that the material never stopped moving, but continually flowed from beginning to end. Now follow the patient who feels a pain in her stomach. Where does she go? Stand there with her. Follow her to the next office, the next form, the next professional, the next phone call, the next waiting room, etc. How long does it take? Every second during which she is not receiving direct care for her illness, is an interruption and is non-value adding waste. It is more than waste. It is a source of risk.

Health Care Lean

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I haven’t been posting much lately because I have been extremely busy working with a healthcare client and revising my team manual to be focused entirely on the health care sector.

Like many who have developed some knowledge in the area of lean management, the majority of my background has been working in manufacturing. But, recently, my focus has been on health care, and home nursing and health care delivery in Canada, in particular. At some point I will share more details about that effort, but it has been a great success, in my humble opinion.

Based on that success and some previous experiences with in health care, I wrote (edited is more exact) HealthCare Lean which will be available within the next month. If anyone reads this who is working in health care, please contact me. I am going to offer free copies for review and I would love to get your feedback.

More details to follow soon.

Action-Learning: Cycles of Learning are the Key to Developing a Culture of Continuous Improvement

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The following article was published today in Industry Week’s Continuous Improvement blog/website today. (Note: this is available for download on the “Papers” page of this blog and you are welcome to use it in your work.)

The best methods and the best of intentions can easily fail unless we take into account how adults learn in our organizations. During World War II a process that has become known as Training Within Industry (TWI) and its component Job Instruction (JI) was developed and was then adopted by Toyota as it developed its system of production. For management development Toyota and other Japanese companies added the role of the sensei or coach. These methods are effective because they are consistent with action-learning that recognizes the reality of how adults learn.

Malcom Knowles who pioneered the field of adult learning identified the following principles as critical to adult learning:

  • Adults are autonomous and self-directed. They need to be free to direct themselves. Their teachers must actively involve adult participants in the learning process and serve as facilitators for them. They must show participants how the learning experience will help them reach their goals.
  • Adults have accumulated a foundation of life experiences and knowledge that may include work-related activities, family responsibilities, and previous education. They need to connect learning to this knowledge/experience base.
  • Adults are goal-oriented. Instructors must show participants how this class will help them attain their goals.
  • Adults are relevancy-oriented. They must see a reason for learning something. Learning has to be applicable to their work or other responsibilities to be of value to them.
  • Adults are practical, focusing on the aspects of a lesson most useful to them in their work. They may not be interested in knowledge for its own sake. Instructors must tell participants explicitly how the lesson will be useful to them on the job.
  • As do all learners, adults need to be shown respect. Instructors must acknowledge the wealth of experiences that adult participants bring to the classroom. These adults should be treated as equals in experience and knowledge and allowed to voice their opinions freely.

Another way of saying this is simply to say that adults aren’t good at sitting at a desk and obediently following instructions and learning theories or abstractions. Learning has to make a difference to them and they have to put it into action. I think the same could be said for children, but we don’t need to argue that point.

Much of my own training is focused on the development of both work and management teams to engage in effective continuous improvement, problem solving, and to become a high performing teams. What has proven most effective is to apply this action learning model to team development. The eight steps illustrated here constitute a cycle of learning and continuous improvement. In many ways they correspond to the PDCA cycle of improvement. However, they are a bit more specific to the actions required for effective learning and incorporate the role of sensei or coach.

The steps illustrated in yellow are primarily knowing/gaining knowledge steps. The steps in purple are more experiential and have more impact on how the learner feels. Knowledge and emotions are equally important in gaining sustained change in individual behavior or in the culture of the organization. Too often our training methods focus more on knowing, and too little on the emotive aspect of learning which is more likely to occur from experience. Often we assume that “if they know, they will do” and this is a false assumption.

1. Build A Case for Action:

It is essential that team members understand the business case for action. Why do we need to do this? What difference will it make to our performance, to customer satisfaction, and to my own work?

As management embarks on a process of continuous improvement they need to point to competitors, best practices, financial benchmarks and the voice of the customers who are telling us that we need to improve. And, it helps to make clear that learning and practicing the new skills will be a component of everyone’s appraisal process. In other words, it is the job of managers and coaches to make change matter!

2. Gain Knowledge:

Transferring knowledge is what most corporate trainers do best. It is what classrooms are best designed to accomplish. It is why we have books and websites. However, knowledge very often does not result in behavioral change. It is the difference between taking a history course in which knowledge acquisition is the goal in itself; as opposed to learning to play the guitar. The former is primarily about cognition/knowledge, the latter is about habits or changes in behavior gained through experience and feelings of comfort with that new behavior.

If we are training teams to solve problems effectively, knowing the steps in a problem solving model is important, but it is only the beginning of employing that knowledge for continuous improvement. Knowledge without action will not change habits or culture.

3. Agree on New Behavior:

Intention is the beginning of change. The guitar instructor may teach a chord position or scale on the fret board. By itself, that is useless knowledge. It only becomes useful when practiced. The student must agree to practice the chords or scales.

The way I have designed my own training manual is so that each chapter is a training module and each training module corresponds to a deliverable – a desired performance or behavior. For example, the second chapter is on writing the team’s charter. The deliverable or action step is to actually go through the steps in writing the charter and gain approval of the sponsoring manager. Another chapter is on defining customer requirements. Of course, the team then brainstorms customer requirements, interviews customers, and agrees on customer requirements. So, each bit of knowledge and training then asks for a new behavior to be performed the team agrees on the behavior and then takes action.

4.      Apply & Practice New Behavior:

Imagine learning to play a musical instrument. How much knowledge of the keyboard or fret board is useful without then putting your hands on the instrument and practicing? The answer is very little. The important learning comes from playing the instrument, hearing the sounds, trying out different positions and chords and experiencing their difference. At one point I had the idea that I would learn to play the banjo and I bought a lesson book by Pete Seeger. When asked how often you should practice his answer was “Never. Just play!” What he understood was that the learning will come from the joy of playing, not from doing exercises or turning the experience into a painful task.

Learning any new skill is much the same way. Teams need to practice problem solving and experiment. It is OK to fail as long as every effort is recognized as a learning experience.

Practicing, evaluating, improving becomes a way of life. A Fast Company article (6/2/2009) on Toyota’s Georgetown, KY plant described the reflection of one worker in the plant: “Artrip has been at Georgetown for 19 years. The way he does his work is so compelling it has become part of his personal life. ‘When I’m mowing the grass, I’m thinking about the best way to do it. I’m trying different turns to see if I can do it faster,’ he says.” This is a clear sign that continuous improvement has become ingrained in the culture.

5.      Receive Feedback from Coach

The role of the sensei has become understood as an element of Toyota culture. A sensei is, essentially, a personal coach and mentor. Someone who can guide, observes, and gives feedback and encouragement. It is worth noting that in every sport, whether the emphasis is on team performance or individual performance, there is always a coach. And coaches are not reserved for children or new learners. The best professional quarterbacks, tennis stars, professional golfers and opera singers all have personal coaches even though they are at the top of their game.

In a May, 2004 Harvard Business Review article (Learning to Lead at Toyota) Steven J. Spear does an excellent job of describing how a new manager is hired and trained at Toyota. His coach introduces him to the organization with structured observation and debriefing on what he sees. He is asked to find improvements, many each day, just from observing. Then he is asked to work on the line with an assembly team. He is asked to find improvements and work with the team implementing them. He is then taken to Japan to again work with a frontline team and implement improvements, even in the very plant where the Toyota Production System began its development. At each step the sensei is encouraging him, guiding, and debriefing with him on the lessons he is learning. It is intensely personal and direct training and coaching. But, the sensei does little instructing in the traditional sense. Rather, he is creating experiences, asking questions, encouraging reflection.

Now consider how you develop teams in your own organization. Do they have a coach? Do they follow a structured learning process? Do they receive guidance, encouragement and feedback from a coach? Let me suggest that this is a necessity for the development of teams at every level of the organization.

6.      Gain More Knowledge:

And now, the cycle becomes obvious. After each lesson learned, action or deliverable completed, the team receives feedback from the coach and then goes on to learn the next element of development: how to develop a balanced scorecard; how to map their work process; how to recognize variances of common versus special cause; how to reduce waste and cycle time, etc. And again this leads to practicing those skills.

7.      More Practice:

The team and their coach should map out a series of ten to twenty steps that the team or individual will learn then do, then gain feedback and reflection. These steps should be those that lead to the complete set of behaviors you want a team to perform.

8.   Positive Reinforcement from Coach and the Natural Environment:

As teams practice the skills of continuous improvement they begin to have an impact on actual performance. They should be able to see this impact on measured performance, on graphs. This is in itself, positive reinforcement and strengthens the learned behavior. It is the job of both the coach and the manager to assure that new skills and desired behavior lead to good outcomes for both individuals and teams. These outcomes can be as simple a certification that you are a High Performing Team, or the opportunity to present the results of your efforts to senior managers. There are a hundred ways to “make it matter” to strengthen the behavior of continuous improvement and this reinforcement should be part of the designed learning process.

While there is nothing entirely new about the eight steps of this action-learning cycle, it is a key to establishing lean management and culture that is too often overlooked.

 

Straight Talk: Avoid the Con of Quick and Easy Lean

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Lean is a strategic initiative that will require at least three to five years for any organization of size. It is a lifestyle change, not a diet.

(The following was published earlier today in Industry Week’s Continuous Improvement newsletter)

I recently spoke to the head of lean implementation at a large European-based manufacturing and engineering organization. He is discouraged. Contrary to his advice, the senior executives just agreed to purchase the services of a major consulting firm to implement lean.

What they bought were a series of quick and simple kaizen events in which the participants would do A3 problem-solving, and the consultants guaranteed quick financial results. The executives were assured that it would require no burden on their part, just verbal and financial support (for the consultants) and the consultants would handle everything else.

Simple. No problem.

These executives were led to believe that they would then be “doing lean,” Toyota Production System and all that good stuff. There is one thing I can absolutely guarantee you, in addition to the sun rising tomorrow. They will NOT be doing lean or TPS!!

Quick and easy solution = quick and easy sell. Unfortunately, more and more executives are being duped into what is essentially a scam.

Let’s be honest about this problem. Many senior executives suffer ADD (attention deficit disorder) and lack the tenacity, vision or as Dr. Deming would say, the “constancy of purpose,” to implement significant change in the culture and processes of their organizations. Feeding them quick and easy solutions is like selling dope to a drug addict.

Here are some clues to avoiding the scam:

  • If you want to achieve short-term financial gains by just cutting head count, don’t pretend it’s anything associated with lean. And don’t imagine you need a consulting firm to help you. Just do it! Then work on the important stuff.
  • If someone comes into your office and promises you short-term financial results and claims it’s “lean management,” throw him out of your office and tell him never to come back! Check to see that your watch is still on your wrist, first.
  • If someone claims that lean is doing 5S, an A3 or A4 problem-solving sheet or PDCA, they do not know lean and are appealing to your ADD. Tell them to stop insulting you, you have already taken your Ritalin for the day!
  • If someone tells you that you can implement lean “down there,” while you and other senior managers remain unscathed, avoiding effort or pain, tell them you have seen enough late-night cable-TV commercials telling you how to lose 50 pounds without breaking a sweat! It ain’t gonna happen!

On the other hand, here is some straight talk about implementing lean:

  • Lean is a strategic initiative that will require at least three to five years for any organization of size. It is a lifestyle change, not a diet.
  • It requires active leadership. Mr. Toyoda and Mr. Honda were both directly involved in shaping the culture, driving what was important in the organization and recognizing success. They did the gemba walk, were on the spot, where the value-adding work gets done, learning from those who are expert in the work.

Ray Kroc did it too. Ray Kroc spent half of his time visiting McDonald’s locations, and when he did, if the bathroom was dirty, he grabbed the bucket and mop and cleaned it. That was when he was chairman, with tens of thousands of stores. You may think he was crazy, but he did it. He built one of the most significant corporations in the world around a few core values (quick, clean and courteous), and he demonstrated their importance through his own behavior.

You need to do it!

  • Knowledge of lean is more important at the top than at the bottom. The cost of waste is far higher in the poor decisions made by managers and executives than it is on the front lines. Time and again I have seen senior executives making multi-million-dollar decisions without following any disciplined decision process — little fact finding, little brainstorming of root causes of problems, little brainstorming of potential solutions, etc. Adopting lean management means continuous improvement in management processes and behavior, as well as the processes and behavior on the front lines.
  • Consultants cannot do it for you. Use experienced consultants to develop internal capacity and competence among internal change agents and then work themselves out of a job at your company. You need to own the capability to continuously improve. You do not need to continuously employ consulting firms. Consultants should also be willing to deliver straight talk to senior managers. It is hard for internals to look you in the eye and tell you that you need to change! But, that is often the truth, and an external consultant must be a truth teller.
  • Lean is a culture, not an acronym or a workshop. Certainly 5S, A3s, etc., may be part of lean implementation, but they can also be an excuse for not doing the really important things like knocking down significant walls in the flow of work through the organization. Those walls are management walls. Lean requires the development a healthy value system in the organization, and that cannot happen in the short term. It can start tomorrow, but it must be pursued continuously by the leaders of the organization.
  • Lean management is both a social and a technical system, and both need to change together.Yes, lean is just-in-time inventory management, continuous-flow or interruption-free processes, the adoption of IT solutions that enable the process flow, etc. That is the technical system. But it only works if the social system — the trust in employees, the empowerment to make decisions and improve processes at the first level, teamwork, the respect for those who are on the spot, and the recognition and reinforcement of positive behavior — are all aligned to the new work processes. One without the other is likely to lead to short lived success.

And, one more thing: Straight talk, absolutely honest, frank and open conversation about both problems and successes, is a necessity of developing a lean culture. In fact, it is an absolute necessity of any healthy organization, family, community or country. It requires straight talk both to and from leaders.

Comment:

If you detect a note (or a shout!) of sarcastic annoyance in the above you are right. That is a response to a pattern I have seen over and over again from the most prestigious and largest consulting firms. During the TQM days I was working at Inland Steel and one of these prestigious firms was employed there claiming they were implementing TQM. They formed teams of employees to do little more than identify how many heads could be cut. That was their goal, not any change in process or culture. It didn’t take long for employees to catch on. And, they called it TQM. It was nothing of the kind. Now I am seeing that exact same pattern from that same firm and others. I am frankly sick of this exploitation. It needs to stop and someone needs to call them on it. If they really want to implement lean or TQM then they should learn what it really is and have the intellectual honesty to confront the executives of their clients with the real commitment and change in behavior that it will require of those executives. And, that will not appeal to those addicted to quick and easy solutions. It is a fundamental of consulting ethics that you do not simply sell a client what they think they want. You have a moral obligation to tell them what they need, which is often much more difficult and a harder sell.

Also, this is not a condemnation of consultants in general. After all, I am one. And, I know and would recommend many other consultants who have integrity and skill and are not appealing to this quick and easy addiction.

Well, I am glad I got that off my chest!

Have a great day!

 

Survey Results: Execution and Importance of Lean Culture and Leadership Factors

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I recently solicited the opinions of lean implementers regarding the progress they have made and the importance of what I felt were key factors when implementing lean culture or management. The individuals who responded were either those who read my own blog, those who participate on the NWLean Yahoo discussion forum, or members of the Lean/Six Sigma LinkedIn forum. It is safe to say that all of these individuals are engaged in the process of implementing lean, either as an internal change agent or an external consultant. A total of 82 individuals completed the survey.

To download the complete report please go to my “Papers, Etc.” page and click on the report to download a PDF file that presents my analysis of the data. You can also download the complete data set if you like.

How can you use this data? All of those who implement lean practices are in the business of influencing, convincing or changing the behavior of both managers and employees. I think this data can be helpful in making the case for changes in behavior and practices that are essential to lean implementation.

Who are the participants in the survey? 63% work in the manufacture of “things”; while 9.3% are in chemical or liquid manufacturing. Only 2 were in healthcare and only one was in sales or marketing. 25% were in service organizations.

All surveys simply report the perceptions of those taking the survey, rather than some absolute measure. The pursuit of “lean” is often described as a journey. I felt it was worthwhile to ask where these practitioners perceived their organizations to be on their journey.  It turns out that they have a fairly humble view of their progress. About sixty percent felt that they were no more than 25% of the way on that journey.

One of my own biases is to view the lean journey as containing two parallel tracks:  the technical track of modifying factory layout, inventory processes, and other technical aspects of the work; and, the social track – all of the issues around the engagement, motivation and management of people. I asked the participants whether they felt they had made more progress on the technical or social aspects of lean implementation. Thirty one percent reported that they “have made little progress on either.” Twenty seven percent said they had made significant progress on the technical side, but little progress on the culture, while only 12.5% felt that the reverse was true. Almost thirty percent felt that they had made equal progress on both the technical and social sides of lean.

Progress on Technical vs. Social

 

I then asked which would be most important in the coming year or two. Only 7.3% felt that progress on the technical side would be most important. 45% felt that progress on the social side would be most important and 50% said they would be equally important. (Note: I do realize that those percentages don’t exactly add up! But that is the way SurveyMonkey reported them.)

 

 

 

 

 

 

Which Factors Are Most Important?

Factor                                                                                    Importance               Execution

Creating a sense of purpose (5)                                                            89                    53.4
Managers have instilled a spirit of teamwork (53)                          84.4                 50
Promoting strong values  (7)                                                                83.8                 54
Leaders are effective at engaging team members (13)                    83.5                 49.4
Leaders have created employee empowerment (15)                       83.5                 47.2
High trust between employees and managers  (17)                        83.2                 44.8
Leaders act with urgency (9)                                                               82.7                 52.2
Managers focus on improving the process (31)                               80.6                 47.2

Which Factors Are Most Deficient in Execution?

Now let’s look at the items that got the lowest scores for how well they were executed or performed in the organization.  Again, this is entirely arbitrary, but we will take scores below 45 as a cutoff.

Factor                                                                                            Execution       Importance

Managers have defined leader standard work (63)                          30.8                 67.9
Most manager engage in disciplined problem solving (11)             36.6                 72.6
Managers are able to follow a disciplined PS model (61)                38.3                 76.6
Every employee is a member of a team (57)                                       39.9                 75.6
Managers can show a visual map of their processes (35)                40                    66.6
Managers are competent at motivating employees (21)                  41.8                 79.7
Feedback from customers to employees (25)                                    43.4                 70.4
Managers are competent at facilitating meetings (59)                    43.5                 73.7
Each team has defined their customers (27)                                      44.1                 71.6
There is high trust between employees and managers (17)            44.8                 83.2
Managers are good at motivating employees (47)                            44.9                 77.8

One of the more interesting set of factors, in my opinion were the comparison between performance and importance for the two items (19) “Managers are highly competent in the technical work for which they are responsible;” and (21) “Managers are well trained and competent at motivating and developing employees.”

Click on the following images for a better view.

There is a lot more data and analysis in the full report that you will find on the “Papers” page. You are welcome to download this and you may use the data as you wish, and do your own analysis.

For myself, it reinforces the need for managers to “be the change” by practicing the methods of lean culture personally. It also points to serious training needs in regard to problem solving and motivating employees. One of the greatest concerns in this data is the poor rating of trust between managers and employees. However, this may be explained by the other data. If managers are not practicing what they preach, this alone will lead to low trust.

I welcome any different interpretations or suggestions for future surveys of lean practitioners.