I am not convinced that facilitating kaizen events will produce a Lean culture. I am also not convinced that value stream mapping, balanced scorecards, A3 problem solving, 5S, visual management, standard work, Poka yoke, statistical process control, quality function deployment, failure modes and effects analysis, control charts, process leveling and andon will lead to a Lean culture. In more than 20 years of coaching Lean and applying these tools in various industries around the world, I have yet to see a Lean culture emerge from only implementing Lean tools.
It is true that organizations can apply the right Lean tools in the right location and can achieve great results. Processes can be changed for the good and waste can be greatly reduced or eliminated by simply using the right tool and involving the right people. However, in the long run, sustainability under that sole philosophy will always be a recurring issue. Many organizations that exhibit this behavior tend to cycle – they are quick to jump to the next improvement tool or methodology because of an article someone read or an industry buzz word that is currently in vogue.
This is not Lean Healthcare. The eventual result of this behavior is an organizational culture that suffers from what I call leadership salad. Leaders pour on a little bit of this technique and a little bit of that tool and top it all off with a non-unified philosophy and pretty soon very few in the organization know where they are being led. In the end, those that are still motivated to improve often suffer from nomenclature fatigue and are overburdened because so many new things are added to their plate that they do not know what to call it or what to eat first.
Here are some requirements for creating a Lean Healthcare culture:
- Leadership must adopt Lean as an operating philosophy.
- Leadership must detach from the conference room and go to where the work is done and where value is being created for the patient or the customer and learn from them.
- Leadership must learn to apply the tools of Lean.
- Leadership must learn to standardize and improve their own work.
- Leadership must embrace learning in light of continuous change.
- Leadership must be willing to learn from a Lean coach.
- Leadership must learn to be a coach.
- Leadership must be willing to invest in organizational development and learning.
- Leadership must be willing to break down hierarchical barriers and enable safe communication and feedback across the organization.
- Leadership must be willing to weather the storm. Lean is a philosophy in method and thinking, long term forbearance must persevere to realize the sustainable gains.
The Lean philosophy is not for everyone. Not every organization has the stomach for all that is required to fully embrace the philosophy. Our patients, our customers and our associates deserve our best regardless of what we may call it – Lean, continuous improvement, process improvement; they deserve value and satisfaction which are chief for organizational success and long term profitability.
I say either embrace it or enjoy your salad.
Ronnie has more than 25 years of professional leadership and management experience deploying Lean and Six Sigma principles and concepts in a variety of environments ranging from healthcare to manufacturing and service industries. Ronnie’s diverse and well-rounded background brings a unique perspective to the healthcare industry where he has consulted and led lean transformation efforts with some of the nation’s leading healthcare systems and hospitals.
Ronnie holds a Master’s in Management and Organizational Development with concentration in Total Quality Management and a Bachelor’s degree from Trevecca Nazarene University.