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

My first trip to China...

http://leanblog.org/audio151

http://leanblog.org/audio150

Thanks to those of you who pre-ordered the 3rd edition of my book Lean Hospitals.Click below to read a free preview from the book, the start of the chapter on leading and engaging employees (arguably, it's all about leadership).

Improving the Way We Manage [Preview of "Lean Hospitals" 3rd Ed.]

And if you post a comment sharing some of your reflections on your Lean journey, you might receive a free copy of the the book. Also, you still have a chance for me to send your CEO a free copy.

For decades, manufacturers have been tripped up by the simplistic idea that Lean is about "zero inventories." It probably didn't help that one of the earliest and most prominent books about what many used to call "Japanese manufacturing practices" had that exact title: Zero Inventories. It was published in 1983, well before "Lean" was a term used for this.Not even Toyota has zero inventories. They don't have zero raw materials. They have non-zero buffer inventories in between parts of their assembly lines. And it's not hard to see INVENTORY of unsold cars at Toyota dealers (realizing those are independent businesses and the inventory's not on Toyota's book, but still...)

Thanks to this post by Bruce Hamilton (aka "Toast Guy" or "Old Lean Dude"), I was reminded of the old General Motors effort, spearheaded by then-CEO Roger Smith (of "Roger&Me" fame), to fully automate car factories. Their concept was the "lights-out factory" that could run without people (other than a security guard).GM invested $90 BILLION dollars over 10 years in this quixotic (if not foolhardy) quest. The robots often famously painted each other instead of painting cars, as described in this book:

http://leanblog.org/audio148