Again this week, I've been facilitating Lean Basics classes. The audience for each of these recent classes has been principally composed of nurses.  More than any other group for whom I've facilitated Lean Basic classes, I must say that nurses quickly pick up Lean Thinking and the methodical ways of solving problems we teach in Lean Basics.  Anyone have ideas on why this might be true?

During the class, we sought to differentiate between Lean Thinking and the tools that support Lean improvements.  We stress that a successful deployment of Lean requires changing your way of thinking - your frame of reference - your worldview - your mindset. To amplify upon that point, we spoke about a powerful Ted Talk by Simon Sinek in which he discusses the "Golden Circle" model of leadership.  A link to the video is below but the key point is that you have to believe before you act". In the context of Lean Thinking, you have to adopt the mindset "everything we do can be improved" before you begin using the tools

http://www.ted.com/talks/simon_sinek_how_great_leaders_inspire_action

One topic we covered at the end of class was where to find communities of people that are truly passionate about applying the art and science of process improvement, including Lean Thinking to healthcare delivery problems. I told the class about the Society for Health Systems, a global community of people, including nurses, engineers, physicians, scientists, and many others that all have a common passion in the improvement of healthcare delivery processes.  People interested in finding out more about this great organization can visit:

http://www.iise.org/shs/

I hope you are able to take advantage of the many networking and knowledge transfer activities the Society for Health Systems offers.

This week, I had the pleasure to facilitate a Lean Basics class to an audience of brilliant people that work with healthcare organizations every day to help those organizations improve clinical processes through the use of technology.  During the class, they raised some great questions about the basics of Lean that are worth repeating.

We spent time discussing the importance of standard work as an enabler for process improvement. A key teaching point is that the documentation of the steps to perform an activity is the foundation for improving the process.  A common concern is that "standardization" of the steps to perform an activity drives away innovation and is not suitable for the nature of work performed in clinical settings.   I found a great article on Standard Work by Mark Graban that seeks to address this concern.

http://www.leanblog.org/2010/02/my-thoughts-on-standardized-work/

Incidentally, Mark's blog is a worthwhile daily read.

Another topic we discussed was value stream mapping.  For people that want to learn more about value stream mapping, I recommend an excellent video on value stream mapping from Karen Martin

https://www.youtube.com/watch?v=5YJYMLaV9Uw

Yet another topic was the concept of daily management - in essence, establishing a cadence for paying attention to the critical few metrics that we can use to make "course corrections".  Here is a nice presentation on daily management:

http://asq.org/conferences/six-sigma/2009/pdf/proceedings/g5.pdf