Archive for August, 2011
Shingo PrizeDid you ever have one of those chance encounters with an individual that makes you sit down and really think about what just happened? It happened to me recently.
Our Neurological Institute has a “go to gemba” process where each of our administrators spend at least a week each quarter, making daily rounds in our in-patient unit to talk with patients and determine if we are meeting their expectations for care. I have found the interaction with our patients some of the most gratifying work that I’ve done while working at the Clinic.
Last week, while connecting with our patients, I had a chance encounter with a very interesting man. He took the time to let me know where we had fallen short in our care of a loved one. He was not upset or angry, he felt the need to share his experience and I seemed open to listening, so we talked.
As we continued our conversation, a familiar language started to emerge and I found myself actively engaged in a discussion of root cause, errors, defects, visual management, standard work, etc. We were talking lean.
“I work with dairy farmers,” he said. “I focus on preventing the diseases that you detect and fix.” We continued for a little while until he had to leave. I told him I would be back in the morning. He handed me his business card and I saw his Guiding Principle – “In Pursuit of Parlor Perfection for healthy, comfortable, well fed, pregnant cows.”
Being a student of lean, I recognized the principle of “Pursuit of Perfection” and wanted to learn more about how this principle has been applied in the dairy business. Over the next two days, we spent a total of nearly three hours discussing the opportunities he saw for us to improve our patient care processes and he shared with me the details of his consulting business where he helps dairy farmers focus on quality at the source and increase milk production through the reduction of disease.
Without a college degree or a lean certification or any formal lean training, he has mastered the application of lean principles, systems and tools as described in the Shingo Prize for Operational Excellence.
His simple philosophy – listen to the cows.
He told me about how milking parlors are built for the efficiency of the farmer; however, their design results in decreased milk production from the cows (workers). Automation and technology take the farmer away from the cows and is creating a whole host of quality problems – from diseases, passed on through their milk and beef to humans, to increased costs due to inefficient milk collection techniques that cause cows to produce less milk.
We talked about the backwards way our current health care system places its emphasis on treating diseases, rather than preventing them. He told me about his application of lean principles such as lead with humility, respect for every “cow”, flow, scientific thinking, constancy of purpose, systems thinking, and value for the customer.
My head was spinning. I was drawing parallels with the tools of lean such as visual management, standard work, quick changeover, error-proofing, preventive maintenance, etc. Could the humble cow be the start of the Healthcare value stream?
I’ve made the transition from manufacturing to healthcare and have seen how the principles of lean apply across multiple, diverse industries, including lean dentists and lean government. This was the first time I was really exposed to the potential of lean – at the source – in the supply chain of the food and farming industries – before the production or processing stages – and recognized the connection to the healthcare industry – a strange customer of the current food processing business.
We traded contact information and vowed to continue our discussion. We’ve asked him to serve on our Patient Advisory Council and he’s asked me to help spread his message on disease prevention. It sounds like a good deal so far.
As my father once told me, “The more you know, the more you find out you don’t know”. I learned a lot last week and recognize that I have a lot more to learn.
Stephen R. Covey‘s “7 Habits of Highly Effective People“, first published over 20 years ago continues to influence many people and help us all become more effective. In 2010, Covey formed a partnership with the Shingo Prize for Operational Excellence strengthening the awareness of successful principles-based organizations
“I have great respect and interest in what The Shingo Prize has been doing and in the transformational work underway at the Huntsman School of Business,” Covey said. “Companies that have implemented principles taught by The Shingo Prize have made dramatic and measurable progress in achieving operational excellence.”
Of the 7 habits mentioned in the book, perhaps the one that resonates most with me is number 5 – “Seek first to understand, then to be understood.” To a lean thinker, this habit forms the basis for following the principles of “Lead with Humility” and “Respect for every Individual”. This is not a sign of weakness or lack of knowledge.
To “Lead with Humility” means we must admit that we don’t know it all. My father told me long ago, “the more you learn, the more you’ll find out you don’t know.”
Did you ever go from feeling like a genius one moment, to feeling like you just don’t get it in the next moment? When talking with a group of like-minded thinkers, the discussion just seems to flow and everyone is nodding their heads in agreement – sometimes jumping in to finish each other’s thoughts.
Leaving this familiar place and go into areas where our subject matter knowledge isn’t as developed can sometimes feel over-whelming. Change always comes with an anxious dilemma. How do I share what I know without coming across as a know-it-all, yet still influence the direction of a group when they are struggling to find their way? Welcome to the world of continuous improvement.
As lean practitioners know, the hardest part of our job is to balance our desire to just do it, versus our desire to teach others how to do it. We are sought out for our expertise, yet it is the lean leaders job to leverage the expertise of the people currently doing the job. To be able to lead people to where they need to be by asking questions, rather than providing answers is one of the most satisfying aspects of the change management process.
Transitioning from manufacturing to healthcare has been a great learning experience for me. There has been a lot of observing, listening, asking questions and where appropriate some talking. I’ve had the opportunity to lead some great teams that have yielded very good results. I’ve also been disappointed when I’ve transitioned off of projects and the team’s old behaviors resurface and the initial gains slowly start to evaporate. This is usually because not enough work took place upfront to understand the culture of the team. The work required to change the culture of a group by leading them out of their comfort zone to one of continuous improvement is always harder than changing a work process itself.
As I continue to seek to understand the field of healthcare and lend my expertise to making things better, there is a constant balancing act. A thought shared by fellow bloggers, Matt Wyre and Tim McMahon . At times it is exhilarating, others times, totally frustrating. In times of frustration, I often turn to this poem that I first came across in one of my MBA text books on organizational development.
He is quick, thinking in clear images;
I am slow, thinking in broken images.
He becomes dull, trusting to his clear images;
I become sharp, mistrusting my broken images.
Trusting his images, he assumes their relevance;
Mistrusting my images, I question their relevance.
Assuming their relevance, he assumes the fact;
Questioning their relevance, I question the fact.
When the fact fails him, he questions his senses;
When the fact fails me, I approve my senses.
He continues quick and dull in his clear images;
I continue slow and clear in my broken images.
He, in a new confusion of his understanding;
I, in a new understanding of my confusion.
Follow me on Twitter: @valuesstreamldr
I think she understood what I meant, but her raised eyebrow leads me to believe I have some ‘splainin ” to do.
The short-lived tagline of this blog used to say, “Where values are not aligned, it is there you will find waste.” My intent was to use a clever take-off from the Value Stream mapping process that allows you to see waste in processes by observing where the flow of products or services and information stop flowing. Many lean practitioners will tell you that Value Stream mapping is a valuable tool in their continuous improvement toolbox. It looks at work from the point of view of the customer and asks if the customer is willing to pay for the activity. If not, then the work is viewed as “Non-value added” and you should strive to reduce or eliminate the activity. A focus on process improvement, through the elimination of waste will result in a higher Value-add / Non-value add ratio of work, shorten the overall lead time from order to delivery, and improve the quality and productivity of a process. This ultimately leads to lower costs and higher value to the customer.
Experienced lean practitioners will also tell you that having the right culture in place makes a huge difference in how quickly and easily process changes can occur. Creating the proper culture is a key responsibility of leaders. As I discussed in a previous post, The Excellence Experience, leaders should first exude, then expect, then recognize and reward desired behaviors in order to build the foundation for an organization seeking to attain Operational Excellence.
So this morning, my wife told me that she didn’t like my tagline. “It focuses on the negative. You should never, ever, ever, link your work to a negative.” she said. After a brief pause, I acknowledged that she was right. She then didn’t tell me what it should be, rather, she gave me the first part of the tagline, “When values align…” and challenged me to fill in the blank with a positive statement. After some thought, and picturing the blog’s logo, I realized that culture has a multiplying effect on an organization’s improvement efforts, thus my new and improved tagline, “When values align…value multiplies!” I like this much better. What do you think?
If process improvement leads to added value, I submit that organizational alignment leads to multiplied value.
Critics can provide the best opportunities for improvement. Moving forward requires friction. Embrace critics and thank them for challenging your viewpoint and creating a learning opportunity for both of you. Just be sure to take some time to ‘splain yourself. Thanks, Lisa!
There’s a reality show on NBC that showcases a variety of performers who compete for viewers’ votes to keep moving forward. Weekly winners advance towards the grand prize of landing a headline show in Las Vegas. I have to admit that mixed in with some really goofy acts, there are some real diamonds in the rough who are really talented and discovered through their appearance on the show. This post isn’t about them.
This past weekend, my wife, Lisa and I did something we haven’t done since we’ve been married; we spent six hours together – just us, no kids, at the fair, enjoying the sights, sounds and food. It was a fun day, and we re-discovered the real talent developing in our future leaders.
We started our day with a trip to the 4-H booth building that I wrote about last week. The theme for this year’s fair was “Pride”. Some clubs exhibited pride in the projects they worked on and included quotes from club members on what they were most proud of. Other clubs interpreted the Pride theme by referring to their clubs as a Pride of lions.
There were so many references to key #lean leadership principles evident throughout the booths. Here are a few of my favorites.
Next, we went over to the livestock show barn where the annual auction of animals takes place. Kids who have spent the last year caring for cattle, pigs, sheep, turkeys, and other varieties of livestock, learn one of the toughest lessons in life and leadership – letting go. The reward for their hard work is a nice payoff for their investment of time and effort. My son’s girlfriend and her family have been raising cattle and turkeys for years and this year, her younger sister’s cows won Champion County Born and Raised and Reserve Grand Champion carcass. Listening to the auctioneer is pure entertainment as he works the crowd to gain that extra nickel per pound for the 4-H’er. This represents college tuition to many of the kids. They work hard for it and earn a nice reward.
Next up, the open class still exhibits where my daughter, Sara, (who only started knitting a little over a year ago), proudly displayed articles of clothing she has knit for her children. Sara’s projects earned her a First place and several other second and third place ribbons. She can now proudly call herself an award-winning knitter. Actually, one of her projects won a ribbon at last year’s fair, so she was already an award winner. You can see some of her work here and make a purchase if you’re interested.
While we were looking at the still exhibits, the Dock Dog competition started. You may have seen these competitions on television, where dogs leap 20 feet through the air off of a dock and into a pool of water chasing after their favorite toy. These dogs are fun to watch.
By this time we had worked up an appetite and there is no better food than fair food. My doctors at the Cleveland Clinic might think otherwise and I know that I will have some explaining to do at my Weight Watchers meeting this week, but the “Porktato” that we shared was a real treat. It starts with a large baked potato, topped with butter, sour cream and finally smothered with smoked pulled pork and barbecue sauce.
A lemonade to wash it down was welcomed on a hot, muggy day in Northeast Ohio.
After getting re-fueled, we visited the memorial site for the victims of the steam engine explosion I wrote about last week. It was touching to see how nicely the community has pitched in to keep the memory of these neighbors and friends alive.
Next up, the animals. Every year, there are two mother pigs with their litters of about 10 baby piglets nursing and playing in their pens. Stayed tuned for a future post on how my favorite bedtime story to read to my kids as they were growing up – Charlotte’s Web, played a big part in my understanding of lean. Sheep, goats, pigs, horses, dairy cattle, rabbits and poultry were all on display for everyone to see up close and personal.
The agriculture building is where we saw one of our favorite displays, the Medina County Beekeepers booth. A plexiglass display case houses a demonstration beehive, enabling fair-goers the opportunity to watch the bees work and challenges them to “find the queen”. Many years ago, I got started in beekeeping while helping my son’s with their 4-H beekeeping project.
A.I. Root developed many of the hive technologies that are currently used by beekeepers. While learning about bees, I discovered the secret to their success in keeping their hives vibrant and productive. They have clearly defined roles and responsibilities for each bee in the hive (standard work) and their communication systems are outstanding. While working at Ford, a swarm of bees found their way to the back of our building. I assisted a co-worker who was also a beekeeper in capturing the swarm and then wrote an article for our monthly newsletter about the teamwork displayed by bees. I’ll post that here soon.
Finally, after getting some kettle corn and a milkshake (strawberry) from the 4-H milkshake stand, we settled in to watch and listen to a fiddling competition. Contestants competed in four categories – Youth, Junior, Senior and Open classes. Kids and seniors all played well, but it was the open class where some very good fiddle players showed off their talent. It was a real treat to sit and listen to them under the shelter of a pavilion when the skies opened up with a deluge of rain. The highlight came at the end of the competition when all of the players got together onstage for a jam session.
Yes, there are troubles in the world where competing values struggle to find alignment. This past weekend, however, we experienced a place where values aligned, talent was showcased and we confirmed that America does have talent!