Develop capabilities by asking the right questions
Lean beyond the factory floor is still a new frontier in many organizations. For manufacturing leadership exploring potential organization-wide lean improvements, Dan Jones’ recent keynote presentation at the Association for Manufacturing Excellence (AME) annual conference in Toronto provided abundant “lessons learned” about lean healthcare – and tweaked listeners to spark dialog needed for future success.
The Hospital of Santa Maria Nuova in Florence, Italy has transformed itself to a lean healthcare system, noted Jones. The hospital redesigned patient flows, trimming patient wait times and improving the quality of care as line managers capably streamlined traditional processes. Flow management was transferred from the doctors to engineers, giving the doctors an opportunity to deepen their medical skills as others assumed what had been time-consuming tasks. This hospital’s non-traditional approach to process management complements its rich history. It was founded in 1288 by Folco Portinari. One of the oldest welfare institutions, it is home to many works by well-known Florentine artists.
What triggers your organization to step back and reevaluate how processes are managed, asked Jones. He added that healthcare organizations use the scientific approach to diagnosing and treating patients, as lean practitioners do in manufacturing and other arenas. “Science is about asking the right questions, not just testing hypotheses and taking responsibility for solving our problems and others’ problems,” said Jones. “We develop capabilities by asking questions. Everyone has to be involved in managing flow. How are you taking responsibility for developing capabilities?”
Igniting a Fire, Taking the Customer’s Perspective
Passionate involvement in the healthcare sector also thrives in Saskatchewan, as reported by Jones. He shared comments by Dan Florizone, who served as Saskatchewan deputy minister of health and deputy minister for lean across government: “We’ve ignited a fire in civil service that we haven’t seen in decades.” Viewing service and waste from the patient’s perspective has yielded improvements in patient care, including ventures upstream to prevention services and downstream to recovery programs, according to Florizone. Embedding patients in process improvement teams contributes to progress.
Working within complex healthcare systems, leadership can bring together people from various functions for more effective lean improvements, commented Jones. “We can achieve a higher level of improvement in this way,” he said. “We’ve emphasized the system for too long; we need to emphasize the customer.” Lean concepts are now taking hold in an increasing number of fields including corrections and government, Jones said.
The British healthcare system, beset with challenges ranging from budgets to lengthy queues, offers great opportunity for lean improvement. Jones cited initiatives and potential remedies such as mapping patient journeys, learning to see obstacles and delays and learning where to act to un-block the flow.
How best to build stable, flexible flows across departments, aligned with demand? Making work visible is a good place to start, Jones said. Hands-on, end-to-end oversight of flow also provides needed information and cues for needed change.
Too much time spent reviewing a lengthy list of projects distracts everyone from the tasks at hand. “Focus on the vital few projects to close performance gaps,” suggested Jones. “Learn how time drives quality and where to deploy for closing gaps, then uncover where you need to go next.” Ask yourself about what experiments can show what processes most urgently need your attention.
We can learn from the healthcare dialog that increasingly includes customers in the conversation, Jones said, adding that this increasingly inclusive approach has just begun. “How is your organization going to prepare for these changes?” Jones asked. Your next-generation success depends on how well you make this transition.
For a thought-provoking read about finding and testing information, Jones suggested Stuart Finestein’s Ignorance: How It Drives Science. Finestein asserts, among other things, that a failure can be as interesting as a success, and it can drive learning just as effectively.
For More Information:
Visit www.leanuk.org for more insights by Dan Jones.
Lea Tonkin, owner of Lea Tonkin Communications, is the former editor-in-chief of Target magazine and the Target Online newsletter published by the Association for Manufacturing Excellence (AME).