The most fundamental issue in management is how to think horizontally in our inherently vertical organizations, according to management expert Jim Womack, founder and senior advisor at the nonprofit Lean Enterprise Institute (LEI).
“Senior managers must keep in mind that there is often a disconnect between the needs of processes, which run horizontally across the company to customers to create value, and the needs of vertical silos which are how organizations are put together,” Womack said.
Womack made his remarks in a podcast interview with Mark Graban, founder and lead contributor of LeanBlog.org . Graban also is a senior fellow at LEI and is the author of Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction, winner of a 2009 Shingo Research and Professional Publication Award.
Walking Value Streams
Making the switch from vertical to horizontal thinking requires a big change in the way managers and executives think, but especially in what they do, said Womack. He urged managers, especially senior managers, to take “gemba walks” in order to reorient their thinking from vertical to horizontal.
The Japanese term gemba or “actual place” denotes the location, such as a shop floor, where value is created for customers. Womack’s latest book, Gemba Walks (LEI, 2011), describes the lessons he learned during 30 years of walking a wide variety of value streams at manufacturing and service organizations, such as healthcare.
Just as important as taking a gemba walk is how you take it. “Most senior managers when they do go [gemba walking] think their job is to solve problems,” Womack said. That’s impossible because they are too far removed from the process they are observing. Instead, executives and managers should be guided by the saying, “go see, ask why, show respect.”
Womack said he typically begins at a value stream’s beginning, which could be processing raw materials in an industrial value stream or data in an office or service process. “I always want to talk to the people who are doing the actual work; look at what’s really happening right now; ask people about the purpose of the work; look at each step in the process. And, as you talk to people, you begin to see whether they are engaged or not, whether they have a way to deal with problems or not, whether they are being trained in a way that will help them make a better process or not, and whether there is a process for creating the next generation of process managers or not. By the time you get to the end, what you’ve seen probably is indicative of what’s going on in the rest of the organization.”
You don’t have to look at everything, Womack noted. Looking closely at one value stream will tell you a lot about an organization’s ability to create value.
One of his most unusual gemba walks was along the remains of a value stream at Ford’s Highland Park, MI, plant.
“Between 1908 and 1915 it was the most creative site probably in the history of industry in terms of rethinking product development, rethinking production, rethinking supplier relations,” Womack said. Today it’s empty except for some old car parts and records. “It’s the brilliant process that time forgot.”
Womack said his most “haunting” walks were along healthcare value streams. He saw people in operating rooms and other critical processes “working incredibly hard in very difficult conditions right at the edge of science in many process that are out of control.”
While the image of healthcare is one of a science, “it is the most craft-focused business there is,” Womack observed. “You see doctors doing things because their teacher, Larry or Biff or Sally back when they were residents taught them to do it that way.” Data on the effectiveness of methods often is lacking.
Womack said the growing application of lean principles in healthcare value streams was “fraught with positive potential” but he wasn’t ready to declare victory. “We just don’t know how effective we’re going to be. But I will say that lean thinking is about the last drug left in the arsenal between what we got right now that is not sustainable and a grim scene of de-contenting [healthcare], taking things out, denying, and saying no.”