Lean Blog Audio

I was happy to see an engineer (Chemical Engineering) and a General Motors leader, Alicia Boler Davis, on the cover of the Northwestern University alumni magazine.See this profile and story: "DRIVING GM" http://www.leanblog.org/audio161

In the Lean approach, we don't call people idiots or dummies. We don't say, or shouldn't say, things like "idiot proofing" or "dummy proofing."There's an old Toyota story about how the term "fool proofing" upset an employee, they switched to using the equivalent of "mistake proofing" or "error proofing." Read more about the story in a comment on an old blog post of mine. Terms like mistake proofing help us focus on the process and the system instead of blaming individuals. Instead of labeling people as idiots, we have to focus on improving the system so it's easier to do the right thing and harder for errors to occur.

http://www.leanblog.org/audio159 I do a lot of work across the U.S., but I've also been very fortunate to work with hospitals, clinics, and health systems around the world over the past 11 years.It started with a few trips to Canada to conduct some hospital lab assessments and Lean leadership training when I worked for a J&hospital consulting group. Then, came an opportunity to spend about eight weeks working with a hospital north of London in 2008, a fascinating opportunity.In recent years, I've visited and/or coached hospitals in The Netherlands, Sweden, Finland, Japan, China, and Thailand. These are very different countries in their national cultures, of course. Their high-level, big-picture healthcare systems are designed differently (including the level of universal coverage, or lack thereof, and who pays). But, when you look at the details of how the work is done... how healthcare is delivered... how people manage... things are more the same than they are different. In England, they said, "Same problems, different accent." The same has been true in my most recent stop here in Thailand - except it's same problems, different language.

A few weeks ago, I saw this announcement about Dean Gruner, MD, the second CEO to lead ThedaCare during their Lean journey:Dr. Dean Gruner, ThedaCare President and CEO, Announces Retirement "Dean Gruner, MD, president and CEO of ThedaCare since April 2008, today announced his plans to retire. Dr. Gruner began in healthcare 40 years ago, has served this community for 33 years, and has served as President and CEO of ThedaCare since April 2008." Congratulations and best wishes to Dean on his retirement! He has been a great leader and advocate for healthcare improvement.

I was happy to see this announcement the other day:UCSF to Train Residents in Lean Management and Process Improvement From the announcement: “UC San Francisco will train medical residents and fellows in Lean management principles, as part of a broader institutional commitment to continuous quality improvement. The effort is being supported inpart with a grant from the Accreditation Council for Graduate Medical Education (ACGME) through its Pursuing Excellence in Clinical Learning Environments initiative. UCSF was one of eight medical training sites nationally to receive the competitive grant.”

You might remember the hubbub (a kerfuffle?) over the NEJM opinion piece written by Dr. Jerome Groopman and Dr. Pamela Hartzband. See my first post about their article. There are more links at the bottom of this postNow, the "Perspective" section of the New England Journal of Medicine has published a piece titled "The Hard Work of Health Care Transformation" by Dr. Richard Bohmer. Check it out. Dr. Bohmer says "government and regulators influence" (or attempt to influence, I'd add) healthcare organizations through financial rewards and penalties, regulatory constraints, and attempts to encourage "performance-improvement activities through education, research, and measurement programs." These approaches might help, but aren't sufficient.

More notes and discussion about my trip to China. http://leanblog.org/audio155

http://leanblog.org/audio154 Continuing from Part 1 of my post about my first day of my first China trip, I'd like to share more about the Lean healthcare conference and presentations that took place.In the next presentation from a Chinese hospital, the speaker started talking about the need to "improve [patient and employee] satisfaction through Lean management" and that "we have the same goals and purpose" as I expressed in my presentation... namely safety, quality, waiting times, cost, andemployee morale (SQDCM). I had showed a "spaghetti diagram" in my talk, shown below, of a podiatrist running around an Illinois clinic searching for supplies (this was the walking required for ONE patient... 10 minutes of waste):

Audio courtesy of Quality Digest Live -- see www.QualityDigest.com for more info and http://www.leanblog.org/audio153 for the link to the article referenced.

We'll probably also talk about this article that was published yesterday on QualityDigest.com:"Lean Is About Quality, Not Just Speed or Efficiency... in Factories or in Hospitals" It might ruffle some feathers, but oh well. I'll stand by what I say here as factual, not just opinion: http://leanblog.org/audio152