Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement

I had a chance to visit one of their community hospitals, Hillcrest Hospital, as well as the main campus. It was a very stimulating visit and it was great to see the progress they were making in building a "culture of improvement."

http://www.leanblog.org/audio167

"Making mistakes is better than faking perfection."I saw this quote the other day and tweeted it. It seemed like food for thought and something to reflect on for a new year. A Google search doesn’t lead to a clear creator of this quote… it’s a common thought that has been around a long time, I guess.

http://www.leanblog.org/audio165

I get annoyed by corporate euphemisms, such as referring to people as "resources," the term "right-sizing" for layoffs, and the type of jargon and babble parodied in the Weird Al song "Mission Statement."Using unclear language can intentionally mask and hide reality, or sometimes it's just another form of incompetence.

You might know about the recent Wells Fargo scandal (as I blogged about here).

The bank is trying to make amends for customers being harmed by unnecessary fees and the hit to their credit score that resulted from accounts being opened in their name without authorization (because employees were under pressure to hit unrealistic goals).

I can't find the commercial online, but Wells Fargo has been running ads that sort of apologize and promise to make things right (better latethan never).

The ad says something like:

"... customers who were impacted..."

They don't say WHAT the customers were impacted by. They make it sound like a tornado or some other natural disaster impacted those customers.

It's a bit of a modern management cliché to say "Don't bring problems! Bring me solutions!"

I think what that means is "Don't just complain! Think about improving things!"

It's good to think about improvement, but sometimes (if not often!) that improvement process starts by identifying problems.

In a "Kaizen" process in a team, I encourage people to bring problems forward even if they do NOT have a solution or "countermeasure" in mind. When somebody points out a problem, that can prompt discussion or brainstorming (with the manager and colleagues) about what solutions could be tested.

Here's an article from Harvard Business Review that delves into this same topic:

"Don't Bring Me Problems--Bring Me Solutions!"

I first blogged about this article back in 2009 and it's still online:"Keen to Be Lean"

The sub headline talks about hospitals being "desperate to cut costs." Has that changed?

I wish the motivation was more often about hospitals being "desperate to improve patient safety and quality." Lean can address that too and should be mentioned, even in a publication for CFOs.

http://www.leanblog.org/audio162

Dr. W. Edwards Deming used to warn against replacing intrinsic motivation with extrinsic rewards and incentives.Brian Joiner (author of Fourth Generation Management), who worked with Deming, warned that setting targets and quotas can lead to three things: improving the system, distorting the system, or distorting the numbers.

It’s often easier to distort the system or the numbers than it is to actually improve. We’ve seen that happen (gaming the numbers) in situations ranging from the VA waiting time scandal and the recent Wells Fargo scandal.

It’s predictable human behavior for managers to try to entice people to perform better through promises of rewards or threats of punishment...

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.