The answer to that question depends on the philosophy that drives them and the activities that surround them.

Lean Healthcare Kaizen events are without question transformational activities that fundamentally improve the performance of any process.  Yet, one of the nagging questions in Lean transformation is why do so few of these improvements sustain over time? To answer this question we have to look closely at what happens around and between these events.  I will illustrate this concept with an example regarding the health and well-being of two fictitious individuals:

Our first person, let’s call him Bob, lives his life without much thought to a healthy lifestyle.  Bob’s philosophy in life is to get through the day and pay the bills.  His primary measures of a successful life are financial.  He generally eats and drinks what is available and rarely exercises, making excuses that there is no time because he is too busy working hard. Physical stress from an unhealthy lifestyle leads to mental stress, compromising Bob’s ability to think clearly and maintain the high energy level that is required to work smarter.  In time he begins to gain weight and tax functions of his body requiring frequent medical intervention.  These medical procedures, while they greatly improve his current condition, only hope to restore Bob to a functioning state.  After the procedure he resumes normal lifestyle only to repeat the vicious cycle of decline recovery.  His physical condition translates into a poor disposition, decreasing performance, and frequent absenteeism, all of which end up interfering with his primary goal of earning money.  Bob’s overall quality of life gets increasingly worse with time.

Our second person, “Kate,” has chosen a healthy lifestyle. Kate’s philosophy is to continuously improve her mind and body to assure a long term healthy existence. She watches what she eats and regularly exercises.  She monitors key indicators such as weight, blood pressure and cholesterol, making enhancements to diet and exercise if these indicators go outside healthy control limits.  Kate always finds time for her healthy routine by working smarter, and in turn her healthy lifestyle provides her with clear focus, energy and a positive disposition to help her work smart.  She even has energy at the end of the day to stay current on career-related journals to continually sharpen her mind.  Kate’s step function improvements come in the form of reaching major milestones like running a marathon or taking on new, challenging projects at work.  These feats not only push Kate to new levels of performance, but they motivate and inspire her to reach for even higher levels of performance that were once thought unachievable.  Her energy, mental sharpness, and positive can-do attitude lead to a long and a prosperous career and healthy quality of life.

Let’s now translate the human metaphors to an organizational perspective.  These fictional characters’ philosophies in life can be translated to an organization’s operating philosophy and management system.  Bob has chosen a traditional philosophy of simply making money with little thought to the most effective and efficient means by which to do so.  This short-term operating philosophy leads to mediocre, non-competitive performance of both an individual and an organization.  On the other hand, Kate has chosen a philosophy of continuous improvement. She believes that a healthy mind and body will lead to long-term success.  She uses process indicators to determine if her routine is achieving the goals of her healthy lifestyle and uses this information to continually improve her routine and performance. Keeping current with the latest knowledge represents the “learning organization” we associate with leading Lean Healthcare companies.

Both individuals experience transformational events in their lives.  From an organizational perspective this translates to Kaizen event type transformation. In the first case, these improvement events serve to bring Bob back to — at best — normal operating performance, only to suffer continued deterioration after each intervention because nothing changes in his life’s operating philosophy.  In the second case, Kate trains and prepares for these transformational events through daily improvement activities.  This could be compared to performing daily Kaizen to keep improvement skills sharp, readying the organization for major step function improvement.  She leverages the momentum from these transformational events, to not just maintain, but to continually improve toward the goal of becoming a world class performer.  Her commitment to her healthy lifestyle is holistic, translating into everything she does. 

The physical bodies of Bob and Kate could well represent the value added workforce in an organization.  In the first example, Bob’s body/workforce is not treated with respect, rarely exercised and thus its performance and general disposition worsen overtime.  In the second example, Kate’s body/workforce is treated with great respect and regularly exercised (involved in improvement).  In this case we have a high performance, high energy, fit and flexible body with a positive disposition, much like we see in the workforce of Lean Healthcare organizations. 

While both individuals experience transformational events in their lives, it is easy to see which one has adopted a Lean philosophy that translates into sustainable improvement.  The important question is does your organization more closely resemble Bob, or Kate?

This week’s blog was written by Gary Bergmiller, Ph.D. Gary brings 25 years of experience directing Lean system design, implementation and cultural transformation  Gary has served as the senior official leading lean transformations for world class companies such as GE, Philips, and Cox corporations. Prior to joining HPP Gary worked with Toyota Way series author Dr. Jeffrey Liker to develop a Toyota Way academy healthcare workshop. Additionally, Gary was hand selected by Dr. Liker to lead the implementation of the Toyota way for the entire western US and Canada Hertz operations. Gary’s expertise is in developing sustainable improvement cultures, lean strategy deployment, executive training, lean management systems, value stream based organizational structures, designing corporate wide lean programs, building teams of lean facilitators, and integrating lean and green systems for a holistic approach to waste elimination. He has authored a series of articles based on his research that have been cited in the EPA’s current research effort Lean and Environment: Next generation and Jeffrey Liker’s book Toyota Culture. Gary holds a Bachelors degree in Electrical Engineering from Northeastern University, a Masters in Engineering Management from University of South Florida and a Ph.D. in Industrial Engineering from the University of South Florida.

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