Introduction to Culture Process Improvement

Introduction to Culture Process Improvement

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Make Process Improvement Stick by Re-Thinking “Change Management”

Culture Process Improvement - featured

There is a distinct difference between change management and change leadership.

We often hear stories from organizations who have embraced process improvement (and we certainly have our own), and many of the stories follow the same plot line: upper management sees how identifying and eliminating waste will benefit their people, their customers, and their bottom line.

They teach their staff the 8 Deadly Wastes and explain how process improvement will make people’s lives easier. Employees are willing to give this “lean” approach a try, and small efforts start to produce wins in some areas. Everyone pats each other on the back, and 4 months later those wins have evaporated and it’s back to square one.

Implementing actual change in any organization – whether it’s your business, your family, your community – takes prolonged effort and commitment from the people who have influence.  In other words, change takes leadership, and we often make the mistake that managing change and leading change are the same thing. They aren’t, and here’s how they’re different:

Change Management vs Change Leadership chart

 

Here’s the takeaway: implementing process improvement or lean management techniques needs to be a systemic change if it’s going to stick, and that means that change leadership, not change management, will be what’s required.

business handshake

Here are 4 key questions you need to (clearly and articulately) answer to start establishing yourself as a process improvement leader:

1)  What will process improvement do for my organization?
2)  What 3 things will I need to do differently in order to get better in my role as a change leader?
3)  In 3 areas of my organization, how will process improvement actually look once it’s implemented?
4)  What difference will improving processes make in the lives of employees and customers?

 

“For companies to change, we need to stop thinking like mechanics and to start acting like gardeners.”

— Alan M. Webber

How to Reduce Deadly Waste in Professional Services: Motion

How to Reduce Deadly Waste in Professional Services: Motion

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Nurse wearing rubber gloves, surgical mask and protective glasses

Healthcare is a famously motion-intense industry, with entire spin-off industries of comfortable shoes springing up to service the nurses, doctors, and support staff who are always on the move. Your clinic may not be as big as a hospital, but the same rules of motion apply.

Like all process improvement, communication is key. Ask your people their ideas and genuinely listen when they offer them. Their idea could save you money and, even if it doesn’t, the fact that they’re taking the effort to tell you is a sign that you’re on the right track.

 

Where’s your Equipment:

Motion waste is infuriating because it’s so preventable and often comes down to sloppily misplaced items. While the most commonly used items, like tongue depressors, are typically kept in every room, less common items are stored centrally.

Make sure your storage is centralized and organized. For example, if the only pencil available is misplaced or left in an examination room, it could take staff a lot of wandering time to find it. On top of motion waste, this also compounds waiting waste for the other involved staff and the patient, and potentially for subsequent patients.

 

Everything in its Place:

5S is the pillar of Lean best designed to tackle motion waste. It’s a disciplined approach to making sure there’s a place for everything and everything in its place. It also stresses cleanliness and ongoing equipment maintenance, which is universally helpful, even in clinics wherein there are strict best practices.

 

Procedure Prep:

A little motion waste in a process is multiplied by the number of times per day, per week, and per year, repetitively. When you start your process improvement strategy, the most common processes are the lowest hanging fruit to look at for waste.

Clinics perform multiple minor surgeries a day, and each of them requires equipment assembly. This typically can take around 10 minutes, which can then trickle down into waiting waste for patients and other staff.

If your clinic reliably performs that same surgery, consider preparing sterile packs of the most basic items ahead of time. This can save time for the procedure and help eliminate staff congestion at the main storage room.

 

surgery tools, stethoscope

Spaghetti Charts:

Clinic staff are always moving. Doctors are hustling between rooms, front end staff are to and from printers, and nurses are pretty much everywhere.

With all the movement happening, motion waste should be low-hanging-fruit if you know where to find it. A Spaghetti chart is a Lean tool that helps pinpoint motion waste. It works like this:

  • Handout out floor maps of the clinic to every staff member, along with a pen and have them write their names on them.
  • Ask them to scribble down everywhere they walk throughout the day, with a line connecting the “here” and “there.”
  • Afterward, take some time to sit down with each staff member and chat openly about their travels throughout the day.
  • Look for routes that are repeated often and are longer than they should be. Are desk staff having to walk 100 feet repeatedly to the only printer? Is the only store room on the far side of the clinic?

From the Spaghetti chart, and from honest dialogue with your staff, you should be able to pick some low-hanging motion fruit that will build staff confidence and morale in the process improvement journey.

Spaghetti Chart example

An example of a Spaghetti Chart that helps to reduce the waste on transportation, motion and waiting time.

Let’s Talk Spaghetti from Hahn & Houle LLP on Vimeo.

How to Reduce Deadly Waste in Construction: Motion

How to Reduce Deadly Waste in Construction: Motion

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Motion is the unnecessary movement of people, and construction sites are full of it. With so much activity, some Motion Waste is unavoidable, but too much can quickly become costly and downright dangerous.

 

Safety:

The most dangerous Motion Waste happens without moving our feet. When a worker needs to bend, reach, or stretch beyond his or her comfort level to perform routine tasks, muscles pull, tendons strain, and balance becomes precarious.

Every year thousands are injured and hundreds die on construction sites and Motion Waste plays a significant part. If workers must routinely pick up something heavy, build an impromptu shelf to keep it at a comfortable level. Listen when people say their required movements are causing discomfort. Ask yourself if there’s a way to fix it and make the necessary adjustments to save the hassle later.

 

Site Congestion:

       Job sites are busy places. Multiple trades-people, inspectors, and managers are all vying for space. Whether it’s dodging each other, bumping into each other, or skipping a portion of a job because it’s too busy, saying they’ll come back later, it’s all Waste.

Try to space people out across the site. If everyone is on the North end, move some to the South. It sounds like common sense, but when deadlines loom and our heads are in the job, it’s easy to miss the small stuff.

 

Where Are the Tools?:

How often does a worker spend wandering around, looking for a tool that should be at hand? Or worse, going back to the truck or shop for something missing?

5S, the pillar of Lean emphasizing proper equipment care and placement, offers excellent guidance for businesses who can’t find the hammer. It sounds laughable, but those 3-minute stretches looking, really start to matter when they accumulate by the dozens and hundreds.

construction motion waste

Tips:

       Here are some low-hanging Motion Waste fruit that can add up to big savings:

  • Don’t Park in the Mud: Dirty tires driving across a worksite means someone needs to clean it up at the end of the day. Keeping a clean site means less time cleaning the site.
  • Organize the Permit Box: When papers are all stuffed in, you risk the next person pulling them all out. Create slots and require people to take an extra second not to “stuff-and-crinkle.”
  • Don’t Be a Litterbug: When people leave wood scraps, nails, bits of pipe, water bottles, and lunch wrappers lying around, it often means that someone needs to clean up after you. Clean up after yourself.
  • Start With What You Need: Make sure the starting packet that goes to your team is complete. If it’s not, people will be running around, assembling documents, instead of getting to work.
  • Blueprints and Vital Documents: Most projects have a few key documents that everything hinges on, like blueprints, which are vital to the job’s success. They’re also the same pages we spill coffee on, leave in the sun to fade, the rain to get soaked, and stuff behind the seat of the truck. When we can’t read them anymore, we need to print new ones, leading to a few different Wastes, stacking up into a real headache. Take care of your blueprints!
How to Reduce Deadly Waste in Manufacturing: Motion

How to Reduce Deadly Waste in Manufacturing: Motion

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Your job is to create. You get a set price for what you create and how much of that goes into the bank is up to you.

Motion Waste is the unnecessary movement of people (as opposed to products, which is Transportation Waste). This Waste’s most obvious casualty is time, but it can lead to serious health concerns, as well.

 

Motion Waste Origins:

In the late 1880s, a young bricklayer’s helper, named Frank Gilbreth, noticed something that bugged him. Having to bend over repeatedly during the day to pick up bricks, the layers were suffering from sore backs, which reduced productivity over time.

Gilbreth developed a multi-layer scaffold so bricks were always in easy reach. Productivity increased, and he become an efficiency expert who’s still being studied today.

 

Count your Steps:

Every smartphone comes with a built-in pedometer, so let’s use it. Walk through your assembly process step-by-step, recording how long each part of your process takes. Like all process improvement, this isn’t something you can do from the corner office. Change happens on “the floor.”

Now, which steps could be removed? When did you have to walk to get something, turn something on, reset something, or move a material into position? Think outside the box on how to make it more efficient. Move the worker to a better spot, create some at-hand storage, or revisit procedures so everyone is performing tasks closest to their area.

motion waste is also known as transportation waste

Lifting and Bending:

The most insidious Motion Waste happens when our feet aren’t moving. Fetching heavy objects from high or low shelves, having to reach repeatedly beyond our comfort, or needing to bend and contort as part of an everyday process are all long term drains on our physical resources.

Back pain, soreness, and other bodily ailments will lead to decreased productivity at best and lawsuits at worst. They drain morale and make people think less of working for you, but are often easily avoided.

If the process involves a heavy product, put it on an arm-height shelf to avoid bending. If the product is light and needs no extra effort to be lifted, put it on the floor.

The Equation:

Yes, there’s math involved. The more repetitive a process is, the more each saved step is worth. McDonalds invests big money to save a step in their Big Mac Combo process because it’s repeated umpteen times a day.

If you haven’t focused on Motion Waste before, there will be plenty of low-hanging fruit to start with. Chances are, with little searching, you’ll be able to tighten up a lot of processes before you have to start thinking about moving machinery around and changing production floor workflows.

5S:

When you walk into a shop and see an outline on the wall where a hammer should be: that’s 5S. It’s a pillar of Lean that’s invaluable in tightening Motion Waste.

The premise is simple: keep equipment clean, in good order, and its place. One thing that your step-counter won’t tell you is how much time per day your team spends wandering around looking for that very hammer.

How to Reduce Deadly Waste in Professional Services: Talent

How to Reduce Deadly Waste in Professional Services: Talent

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Talent waste happens when your team isn’t engaged enough in their jobs to give you their creative best. When your doctors, nurses, and front-end staff feel empowered enough to stop you in the hallway with a “what about this,” the win goes to the patient and, by extension, your clinic.

Process improvement can’t happen without your staff. In healthcare, however, burnout poses an exponential threat to medical professionals, heightening not just Talent waste, but increasing risk of misdiagnosis.

 

What is Burnout?

Although not as prevalent in clinics as in hospitals, fatigue and burnout still loom large. Consider that some of your team may have a hospital position or be part of an intensive training program as well as their clinic shifts.

Burnout happens when doctors and nurses become so fatigued that exhaustion becomes emotional. They’ll feel detached from their job and will find it hard to locate any sense of personal accomplishment throughout the day, regardless that they heal people for a living.

At its worst, burnout can lead to difficulty focusing and may even affect meaningful interpersonal relationships. Here’s what you can do about it:

  • Communicate: Be accessible for a few words around the coffee machine or in the hallway. Informal, friendly dialogue has the dual advantage of giving you a read on how they’re feeling and potentially offering one of their few non-medical, social interactions in their work day.
  • Be Respectful: Doctors and nurses know when burnout is happening. It’s up to you to create a culture wherein they feel comfortable reporting it. When they do, it becomes your responsibility to help them however you can. Respect like that can help stop potentially dangerous scenarios before they happen.
  • Prioritize Balance: Medical professionals report a lack of work/life balance more than any other profession. We all need time to detach from workplace pressures. As an extension of the culture of openness you create, try to make time for your doctors and nurses to go to personal events like a wedding, a child’s play, or a weekend away.
  • Facilitate Community: Medical professionals often feel very lonely in their jobs, even when surrounded by patients all day. Encourage social connections where peers can have dinner, grab a drink after shift, or enjoy social interactions that aren’t clinical, and that connect them with people who are probably facing the same work/life issues they are.
  • Audit Barriers: Do your staff face internal obstacles? Look at the forms they’re filling out, the reports they’re writing, and the behind-the-scenes processes that they’re doing daily. While much of that is regulatory and untouchable, some of it is probably just “how you’ve always done it” and potentially wasting time that they could be spending with patients or learning more about their speciality.

hard working medical staff

Lean Thinking

Think about your team one by one. Are there any individuals who, if they felt exhausted, emotionally drained, or frustrated at encountering administrative roadblocks, wouldn’t feel comfortable coming to you or another manager about it?

You’re not making widgets or houses. Healthcare’s product is well being. Lean thinking focuses on how to improve value to the patients across the entire industry.