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“But this isn’t an assembly line!”

When you start talking about standardizing processes in healthcare, people begin to perspire, lips clamp tightly and are pursed thin.  The declaration, “we don’t make widgets”  is oft proclaimed.  You see, “healthcare is different,” I am frequently told.  “We’re dealing with people’s lives and every patient is unique and most are complex….this isn’t an assembly line!”

When I left the automotive industry and joined healthcare, my response to such statements was that everything involves a process.  Whether you’re building cars or delivering life-saving patient care, it takes a sequence of highly coordinated tasks and processes to deliver the end result.  When this sequence of tasks is standardized, you’re well on your way to radically improving patient safety and eliminating significant sources of waste.

Standard work establishes the best method to perform a task with the least amount of waste while providing the best patient care.  It is an agreed-upon method and procedure for the best sequence and timing to perform a task.

Standard work is frequently misinterpreted and misunderstood.  Generally, people have a tendency to resist standard work until there is understanding of what it really means and how it impacts both themselves and the organization.  People don’t want to do their work the same way every time, nor do they think everyone should perform work the same way.  For this reason, it is not uncommon for healthcare providers to be cautious of jumping onto the standard work bandwagon. Medicine is a combination of art and science after all.  Surely, implementing a “standard” is comparable to throwing darts at the artistry that is needed to understand the nuances of medicine.  If standard work was rigid and unchanging, this point of view could indeed be valid.  However, it is important to understand that standard work is neither rigid nor inflexible.  Quite the contrary, standard work is alive and should change in response to changes in work conditions.

When standard work is consistently and uniformly adhered to, it drives continuous improvement by exposing problems within the process.  Making problems easier to see inspires planned experimentation to discover better ways to perform the work.  Standards are the foundation for continuous improvement.  Without them, you can’t effectively measure where you are.  Standards are the yardstick by which you analyze and test improvements that can then be systematically adopted by everyone.

When continuous improvement activity becomes part of your culture, creativity will flow from employees at all levels of the organization.  Problem solving at the front line often results in creative solutions never dreamed of in the boardroom.  Recognition for solving problems and making improvements builds self-esteem while skill levels increase through training to the standard work.  As the training becomes more effective and widespread, communication increases. People know what they’re supposed to do, when to do it, and how it should be done.

So, by all means, set up an environment of improvement activity that becomes part of daily work and see creativity skyrocket!   Once standard work is in place, creativity bubbles to the surface as people continuously improve their work.  This results in improved morale and job satisfaction, which can also lead to reduced turnover and, yes, improved creativity!

Needless to say, none of this happens overnight.  It’s a long process that requires a lot of determination and even more perseverance.

Does standard work destroy creativity or perpetuate it?

Let’s look back at past articles that discussed how standard work can be implemented in healthcare:


Today’s blog was written by Janet Dozier, Senior Manager with HPP.

Janet has twenty years of process improvement experience in healthcare and manufacturing.  She has led lean transformation efforts in clinical, non-clinical, and business operations of hospitals.  Prior to her work in the healthcare industry, Janet was in the automotive industry for ten years where she was a lead instructor of Lean Principles for the Ford Production System.

Janet received her Master’s Degree in Engineering from Case Western Reserve University and undergraduate degree in Industrial Engineering from North Carolina State University.  She is certified as a Six Sigma Black Belt.

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