When trying to solve a problem, you want to identify underlying causes, which will help you to prevent fires rather than just extinguish them. By identifying the underlying causes down to the root causes, you can reduce the likelihood that a given problem will recur.

The most common root-cause analysis technique in lean is the "Five Why's." This is practice of asking why repeatedly whenever a problem is encountered in order to get beyond the obvious symptoms to discover the root cause.

For instance, Taiichi Ohno gives this example about a machine that stopped working (Ohno 1988, p. 17):

1. Why did the machine stop? There was an overload and the fuse blew.
2. Why was there an overload? The bearing was not sufficiently lubricated.
3. Why was it not lubricated? The lubrication pump was not pumping sufficiently.
4. Why was it not pumping sufficiently? The shaft of the pump was worn and rattling.
5. Why was the shaft worn out? There was no strainer attached and metal scraps got in.

Without repeatedly asking why, managers would simply replace the fuse or pump and the failure would recur. The specific number five is not the point. Rather it is to keep asking until the root cause is reached and eliminated.

This template gives you space to record the problem as well as the direct causes and underlying causes.

Doctors and administrators from nine healthcare organizations in The Netherlands toured VIBCO Vibrators plant in Wyoming, RI, to better understand lean principles in action. A visit by Rhode Island Governor Lincoln Chafee highlighted the visit. The Netherlands teams also attended the Lean Healthcare Transformation Summit in Orlando, FL, and visit other organizations including Beth Israel Deaconess Medical Center, and Accurounds.

The Jacksonville Lean Consortium (JLC or LeanJax), which counts approximately 40 companies and two hospitals as members, offers advice for launching sustaining a successful consortium.

Dear Gemba Coach,

I’m a lean consultant, and have been hired by a large service organization to develop an A3 problem solving training program for their middle-management. Why is it so hard to engage middle-managers in rigorous analysis? It’s not that they don’t understand the concepts or that they don’t feel it could help. They often just don’t seem to get it. How can I do my work here?

Perfecting Patient Journeys co-author Beau Keyte talks with The Leaning Edge host Debra Levantrosser about the central role of collaborative learning in improving continuous improvement.

Dear Gemba Coach,

I’m a lean consultant, and have been hired by a large service organization to develop an A3 problem solving training program for their middle-management. Why is it so hard to engage middle-managers in rigorous analysis? It’s not that they don’t understand the concepts or that they don’t feel it could help. They often just don’t seem to get it. How can I do my work here?

When the Ambulatory Surgery & Critical Care Tower opens in 2015, it will represent a three-year lean design and construction collaboration among builders, architects, trade contractors, healthcare provides, patients, and patient families. The design of both the facility and future operations is being shaped directly by patients and those who care for them. Input from nurses, doctors, therapists, technicians, and patient parents heavily influenced design decisions—from incorporating emergency room hallways that protect the privacy of abused children to the number of electrical outlets in each neonatal intensive care room.

Writing in the Huffington Post, Karl Ohaus, a co-author of Perfecting Patient Journeys, poses 7 questions to ask at the start of fixing a healthcare process.

LEI Chairman and CEO John Shook explains management PDCA: improving the way we align people with process to achieve purpose, connecting macro level business objectives with micro levels of value creation throughout the organization.

LeanCor CEO Robert Martichenko believes many Lean Thinkers consider the term “lean warehousing” an oxymoron.

“Let’s face it,” he tells journalist Tonya Vinas, “most lean purists believe that all transportation and warehousing functions are pure waste. Considering my entire career has been in logistics, I’ve become a little defensive at this notion.”

In an interview that includes a diagram with elements of a lean warehouse, Martichenko notes that global supply chains with extended lead times are causing many companies to view logistics – and warehousing -- as ways to gain competitive advantage and deliver more value to customers. The interview covers such issues and questions as:

• Is the term “lean warehousing” an oxymoron?
• Is warehousing a commodity?
• How do lean and warehousing come together?
• What are the main things supply-chain professionals should focus on for “strategic lean warehousing”?
• What should they focus on for “tactical lean warehousing?
• Is there a specific toolkit or approach for implementing the lean warehouse?
• What must a leader do to drive lean warehousing?

 After reading the story, consider these next steps ...

 Supply chain professionals will learn how to apply lean principles in logistics and warehouses at two special workshops being run by the Lean Enterprise Institute at LeanCor’s working operations center:

• Go and See the Lean Supply Chain, June 25-26. 2013
• Lean Warehousing and Distribution Operations, June 27-28, 2013