A trip to the Doctor--A case study

So here's an exercise for you and your team to liven up your next process-excellence gathering. 


The story below comes from a colleague of mine, who gave me permission to use it as written.  On the one hand, we could read it and go "tsk, tsk, why don't medical facilities improve?"  That does us no good, however.


Try this instead.  Distribute this story to your team.  Then ask one person or sub-team to take the role of the physician, another one the role of the office administrator, another the role of the patient, another the unseen director of the clinic.  Then make some proposals; how would you improve this?  How would you communicate it?  What principles would you employ?  How would you measure it?  Who would you involve in the discussion?  How would change happen in this setting? 


By looking at others we learn about ourselves.  


*********************

Went to the dr's this week for a simple dermatologic procedure. My appointment was set at 11 and I was told to expect to be there for an hour. I presumed the procedure would take about 30 minutes, and maybe prep work and post work would be the remainder. Not so.

I arrived and was promptly taken to the procedure room by my nurse. She said the procedure indeed would take 15 to 30 minutes, but I should sit tight so she could find the dr so I could meet him. Odd, I thought, I figured we could break the ice before or after my procedure. She asked that I try not to be intimidated when I meet him, because he was "a real doctor, busy busy busy, lots of patients to see". 


And then came the real kicker, she listed the questions he would ask me and indicated I should "think about the answers because he needs to move on to his next appointment quickly".  She left and returned 20 minutes later, indicating that he had another procedure scheduled at 11 and it would be an hour and a half before he could meet me. I started towards the door and told her I would need to reschedule, I couldn't wait that long. She asked that I stay; she said that she was going to be doing my procedure anyways so we could get started immediately.

The following things struck me as odd:

- Why was the appointment made longer than procedure required?
-Why did the nurse have to "hunt down" the doctor for a quick meet and greet?

-Why not stagger appointment times if this is really important?

-Why did she feel compelled to warn me of his busy nature?

-Why didn't she just finish my procedure first and give me the option to meet him afterwards?

This clicked with me for a few reasons:

- I felt like a "part", something that needed processed and moved on, not a person that had questions or concerns with a medical procedure. 
- Do I make people feel this way?

- Do I respect the time of others, or make them wait on my own busy, busy, busy schedule?

For me, a fundamental of Lean is in gaining efficiency and respecting people. This doctor had attempted to gain efficiency, but perhaps inadvertently not respected the time of others. 

***************

Click here to subscribe to Learning about Lean by email.

Leadership and Same Page-ness

The National Basketball Association really doesn't interest me, I much more enjoy college hoops.  Yet, the story today of the sudden resignation of the coach of the New York Knicks NBA team caught my eye. 

The coach was caught in a bind.  The owner of the team meddled, selling and trading players with an eye to individual stars.  The former coach, in contrast, had a cohesive style of play which he was attempting to implement.  He needed players with the physical and mental skills to carry out that style of play.

When the Knick's highest paid superstar objected to this style, ostensibly because it deemphasized his own ability to show his individual skills, the atmosphere was simply too tough for the coach.  And he said "enough".

Having a common view of what success looks like and agreement on the core strategy to achieve it is essential.  Point speed vs system speed.  Do we agree?? 

Paying attention to that commonality is part of the role of a Lean leader. 


Click here to subscribe to Learning about Lean by email.

Coherence

Here's an excellent quote from an unusual source for me--a   musician at the South By Southwest Festival in Austin, Texas.  Describing his group's approach:

So a lot of themes are going to come back on the next record, I think, and they’ll always be there. On the one hand, maybe that might seem unoriginal, to keep recycling over and over again, but I also think novelty is overrated, and I think coherence is undervalued.

Coherence trumps novelty.  Even for a "creative" profession.  This band, anyway, wanted to have a recognizable theme, over time.  Some consistency.  A shape, a direction, something that hangs together, over time.

This is the same challenge for us as Lean leaders.  The principles really don't change.  Yet so many forces want the "new" thing...the new trick which will somehow make process excellence easier. 

The newness breeds the "flavor of the month" cynicism which tears apart excellence, however.  It's up to us to fight that trend, keep bringing the same theme back, over and over, yet in a fresh way, just like the band is trying to do. 

Coherence trumps novelty.

Also useful in raising children. 



Click here to subscribe to Learning about Lean by email.

Project Scheduling

Late last year we ordered a sizable (for us) piece of capital equipment.  Promised delivery date, from the start, was March 1.  Updates through January and most of February confimred the March 1 date.

Then, on February 25, we got this news:

All,

They are a bit behind…now on track to ship the week of March 12^th.

With a week to go, the schedule slid by two weeks. 

How does this happen? 

Managing projects is the stock-in-trade for most engineers and technical leaders.  And projects have common problems.  While some truly surprise, most we can anticipate.  Yet, repeatedly, I mess up project management.  And I know I'm not alone.

It's a subject by itself.  Tools play a role.  Clarity of thinking is more crucial.


Click here to subscribe to Learning about Lean by email.

Excellent new A3 resource

Jamie Flinchbaugh has done the Lean community yet another favor.  He recently released an ebook, A3 Problem Solving.   I've read it, twice, and found it very useful.

Of particular interest is his focus on clarity of thought as opposed to simply mechanically filling in pre-formed boxes.  Why do we use A3s??  It is to gain clarity on the nature of the problem, the complex problem; clarity on the root cause of that problem; clarity on what we will do about the problem; and clarity of evaluation on the effect we had on the problem.

In short, the purpose of A3s is to shape our thinking by shaping our doing.

Here's the link: http://leanpub.com/a3problemsolving

And a surprise!

This is not a free ebook.  But neither is there a set price.  Jamie allows YOU to set the price, based on what you think the value is to you!!  Very cool...walking the talk.

I recommend it.


Click here to subscribe to Learning about Lean by email.

An Automation Slogan

Met with a guy today who loves manufacturing and he threw out a wonderfully simple assessment of when to try to automate a process.

"Automate when it's dull, dirty or dangerous."

You could find way worse rationale.


Click here to subscribe to Learning about Lean by email.

How do we Notice?? Part 8

Some concluding thoughts, with personal illustrations about "things we notice", thanks to pal, Hal Macomber and his citation of Fernando Flores.

Flores explained this more effectively with the distinction "disclosive space." In short, what we see is governed by three concurrent aspects of our being.

1. We see what we can distinguish, hence the need to learn.
2. We see what we are concerned for, hence the importance to be clear for oneself and in social groups what concerns/goals we pursue.
3. And, we see in the midst of our everyday doing...the habitual way we engage in the world, hence we need to be deliberate to the point of choosing our habits to give us the opportunity to see.

Regarding #1.   I drive down the street with my wife.  I see trees.  She sees maples, oaks, ash trees.  She sees healthy trees, sick trees, ash trees at risk for the emerald ash bore, trees which will live for 30 years, trees which will tear up a sidewalk, trees which will best enhance our city.  She's on our town's Tree Commission and knows her stuff.  

I drive down the street with my wife.  She sees a jogger.  I see a young runner training for cross country.  I see a middle age lady who is a new runner.  I see someone nursing a sore left Achilles tendon.  I enjoy running.  She finds it an interesting hobby for others.  

We see what we can distinguish.  My wife can distinguish trees.  I can distinguish runners.  Both are learned skills.  But without learning, we can't distinguish. 

Regarding #2.  My youngest son is a US Army Officer.  He just informed us his unit will be deploying later this year for a 12 month tour at Bagram Airfield in Afghanistan.  We now listen to the news with new interest, our ears perking at mention of this airbase.  Our concern is for our son, thus we notice much more than we used to.  

Regarding #3.  Two years ago, at a Lean Enterprise annual conference, I heard the clearest description of standard management work I had ever heard.  Two weeks later, my chief co-worker and I began a disciplined daily walk-around of our operation.  We've only missed 3 work days in two years now.  We created a habit of going to see, in the work place, every day, in a way that was transparent and focused on things that matter.  We've chosen to form a habit of walking to gemba.  Looking for key parameters.  And often noticing other things we would not have seen otherwise.  

I hope this series has been helpful.  Please reflect a bit on it and find one thing you might change as a result.

Click here to subscribe to Learning about Lean by email.

"Things are a mess"

John Shook recently wrote on the occasion of Taiichi Ohno's 100th birthday:

As Ohno says in The Birth of Lean: "If you're going to do kaizen continuously, you've got to assume that things are a mess."

Brilliant.  If everything is OK, I have no need to improve.   

Why is this hard for us to do??  Is it our culture of self-esteem, holding "feeling good about ourselves" as a supreme value? Do we simply compare ourselves to ourselves, so we always look OK?  Are we all from Lake Wobegon, the ficticious Minnesota town where all of the children are above average?

A view of a zero-waste state will shake us out of this arrogant stupor.  With that perspective, things are indeed a mess.


Click here to subscribe to Learning about Lean by email.

How do we Notice?? Part 7

We've talked in recent days about how our commitments, concerns and habits affect what we notice.  And what we notice drives our behavior.  But what does this look like in business??

A recent Wall Street Journal article described this well.  Ever wonder what happens when you walk into a restaurant?  Many are trying to get a step up:  "How Waiters Read Your Table" 

Reading a table happens within seconds of a waiter coming to a table. By asking for a cocktail menu or smiling and making strong eye contact, "they are saying 'hey, I want to engage with you and I want you to make me feel really important,' " says Mark Maynard-Parisi, managing partner of Blue Smoke, a pair of barbecue restaurants in New York, owned by Union Square Hospitality Group. If people seem shy, "you want to put them at ease, say, 'take your time, look at the menu.' "

When an eatery has a commitment to customer service, they train their wait-staff to notice:

• Notice how the group handles (or doesn't) the menu
• Notice the relationship between the diners
• Notice the tone of voice of the patrons

And, with practice and habit, the server learns to make these assessments in seconds.  

But it all starts with a commitment to notice.  

Click here to subscribe to Learning about Lean by email.

How do we Notice?? Part 6

Hope you are hanging with me  and my pal, Hal Macomber about the things we notice.  We've both been influenced by Fernando Flores on this topic; Hal sumarized the critical elements in these three statements:

Flores explained this more effectively with the distinction "disclosive space." In short, what we see is governed by three concurrent aspects of our being.

1. We see what we can distinguish, hence the need to learn.
2. We see what we are concerned for, hence the importance to be clear for oneself and in social groups what concerns/goals we pursue.
3. And, we see in the midst of our everyday doing...the habitual way we engage in the world, hence we need to be deliberate to the point of choosing our habits to give us the opportunity to see.

The third point about noticing goes deep to our involuntary actions.  I notice things I'm used to noticing.  It is my habit.

Do I notice what people say about me?  Or do I notice other people?

Do I notice what the company is doing for me?  Or do I notice how I can contribute?

Do I notice what I notice? Or do I just kinda keep going on?

Hal uses, intentionally, the word "deliberate" regarding the choice of our habits.  Well said, pal.

Be deliberate.  Choose wisely.

More coming.



Click here to subscribe to Learning about Lean by email.