1.Who are you, what organization are you with, and what are your current lean-oriented activities?
I am a Senior Consultant with ValuMetrix Services, a Johnson & Johnson organization that provides “Process Excellence” (Lean and Six Sigma) consulting to hospitals and healthcare organizations. In this role, I train, coach, and mentor hospital staff in their Lean Transformation efforts. Unlike the kaizen event approach, this work is done through continuous 12 to 16 week projects, where we’re teaching the hospital how to implement Lean as an ongoing process and how to manage in a Lean way. In the past year, I’ve led projects in the U.S. and U.K., in laboratory, radiology, primary care, and inpatient care settings. I also do a fair amount of executive training, speaking, and workshops.
I am also the founder of the site www.leanblog.org, where I blog and podcast. I am also the author of the book, Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction, published in 2008 by Productivity Press.
2. How, when, and why did you get introduced to lean and what fueled and fuels the passion?
A few pivotal moments in my life: First was my dad (a 40-year GM employee) attending Dr. Deming’s four-day seminar back in 1987 when I was in high school. He came home talking about Dr. Deming and my interest was piqued. I read “Out of Crisis” on my own in college and was hooked (I’m a bit of a nerd, I guess).
In college, I learned from Mark Spearman and his “Factory Physics” class that Lean was better than MRP, from a production planning standpoint. When I joined the working world, I started at a GM Powertrain factory in the Detroit area that claimed to be governed by the Deming Philosophy. This turned out to be wishful thinking, a bunch of posters on the wall (ironically enough). This plant was performing very poorly, but I had a chance to learn from some internal consultants that GM had hired from Toyota suppliers and Nissan. This was my first real exposure to Lean concepts and our efforts to implement them in a very traditionally managed non-Lean environment.
I saw how miserable people were in the workplace and how quality suffered – all because of bad management, as Dr. Deming had preached. So a lot of my passion for implementing Lean comes from a passion for making sure people can enjoy their work and not be miserable every day. I also saw that change was possible when we got a new plant manager, Larry Spiegel, who had been one of the first GM people at the NUMMI plant. He was an incredible mentor and role model.
3. In your opinion what is the most powerful aspect of lean?
Ultimately, it’s about people development. When a workplace starts to shift from the old “check your brain at the door” model to one where employees are fully engaged in “kaizen” and improvement, everybody wins. Yes, “check your brain at the door” can sometimes be found in healthcare, as well as manufacturing. I’ve heard phrases like “nobody ever asks me what I think about anything” in both settings. It’s particularly sad to hear this in healthcare, where you have such highly skilled and intrinsically-motivated individuals. Bad management systems drain the life out of people – and patients suffer. We can’t afford that in this country (or anywhere in the world).
4. In your opinion what is the most misunderstood or unrecognized aspect of lean?
I really dislike it when people claim that “Lean is about efficiency and Six Sigma is about quality.” That’s completely not true. Lean, from its roots in the Toyota Production System, is clearly about both quality and efficiency. They go hand in hand. Error proofing (poka yoke) is a Toyota method for ensuring perfect quality (zero defects per million opportunities, not just the vaunted 3.4 level). When quality improves in a process, flow improves. When flow improves, quality tends to improve. This is true in hospitals, as well. For example, when there are “defects” in a pre-surgical process (required testing or paperwork didn’t get done), that delays flow (and harms the quality of care, in some cases). In a hospital lab, when the flow is improved (by reduced batching), quality of test results tends to improve (the quality of the results and the quality of service in terms of faster test results). Six Sigma can play a role in an organization, but you can certainly improve quality with Lean methods.
5. In your opinion what is the biggest opportunity for lean in today's world? How can that be accomplished?
Healthcare, healthcare, healthcare. Of the over $2 trillion a year spent for healthcare in the U.S., it is estimated that $1 trillion of that is waste. Much of that waste can be reduced and eliminated through Lean methods and Lean thinking. Rather than rationing and denying care, we need to use our healthcare dollars more efficiency. Also, too many people are harmed by preventable errors in healthcare. We need to use Lean methods to improve quality and patient safety so lives aren’t ended prematurely due to process problems and systemic errors (we have to stop blaming individuals).
So my message to the experienced, skilled Lean implementers out there is – get into healthcare! Now! There’s so much waste (and therefore, so much opportunity to make a big impact). Our society needs it, badly.