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

We can use social media to build bridges and to establish connections with others in ways that we never imagined.  Many of us tend to gravitate towards "birds of a feather" - people that are doing similar work nearby.  Sometimes we expand our networks by getting to know others doing the same sort of work in other locations.. However, building an network of colleagues who do work that is different from yours can help you become far more effective.Dr. James Rawson shared with me the concept of "randomized coffee trials" - a play on the term "randomized clinical trials".  Randomized coffee trials, or "RCTs" for short, represent a cool way to facilitate connections between people in an organization or ecosystem that don't know one another especially when the people are separated by distance and time.

Here's how it works. People who want to expand their network express interest to a facilitator. The facilitator pairs up participants randomly and provides contact information to the pairs. It could be a colleague doing the same sort of work but in a different place. Or a colleague that does very different work.  Next, the pairs agree to "meet for coffee" using technology like Skype, FaceTime, Lync, etc. During their virtual meeting, the paired up individuals discuss topics of mutual interest.  You can read more about RCT's at:

http://www.gurteen.com/gurteen/gurteen.nsf/id/randomised-coffee-trials

Have you participated in RCT's? I would enjoy hearing about your experiences and the connections you've made.

   

I often hear people saying the explosion of social media in the 21st century is, in fact "anti-social" ,and causes us to become more "isolated" rather than more "social".  I wanted to share a TEDxTalk on this very topic presented by Dr. James Rawson.  He argues that social media can build a virtual community in which to transform the sharing of ideas into real life endeavors. Social media can be used to build connections and relationships to have impact on the world.

What do you think? Is social media isolating or bridge-building. Here is the link to Dr. Rawson's TEDxTalk

https://youtu.be/5txst5mOywM

To improve almost anything, one has to diagnose what needs improving and then make the improvement.  The other day, I became engaged in a discussion regarding the relative importance of the "diagnose" vs. "make the improvement" activities.  From one perspective, you could argue that diagnosing and implementing are like your right foot and left foot - which foot is more important in the walking process. Of course, both feet are equally important.

When it comes to diagnosis and implementing an improvement (or treatment of the problem), the answer is not so clear.  Some of my colleagues argued that implementing the improvement is more important. Others argued that if you don't diagnose the problem and get to root cause, all attempts to improve are futile because you will only improve by accident.  

Where do you weigh in on this matter?

Some people describe "culture" as the "unwritten rules about how we do things in our organization."  The other day, driving home from the airport, I saw a large billboard promoting the corporate culture  of a company, Delta Air Lines. The gist of the billboard was that the Delta culture made a difference for its customers.  The billboard had a URL for further information.  When I got home (I promised I didn't do this while I was driving), I visited the URL and read about Delta's culture.  There were several things that intrigued me.  First - that Delta was marketing its culture to its customers. Second, the manner in which they had taken the "unwritten rules about how we do things around here" and turned them into a written articulation of their culture called "Rules of the Road."  

www.delta.com/c...of-the-road.pdf

This leads to several questions for you:

1. Could your organization write down its "Rules of the Road?"

2. Could your organization write its "Rules of the Road" in a way that you would be proud to share them with uour customers?

3. Can an organization's culture be promoted to its customers as a differentiator?

I recently read an article in Harvard Business Review titled Help Your Overwhelmed, Stressed-Out Team (source: https://hbr.org/2015/01/help-your-overwhelmed-stressed-out-team?)

Helping teams cope with and remove excessive stress most definitely can help improve organizations.  After reading the article, I found myself thinking about the work of Steven Covey. Many years ago (late 1980s and early 1990s), Covey, author of the "Seven Habits" series of books posited that all our time falls into one of four quadrants delimited by columns labeled not-urgent and urgent and rows labeled not-important and important.

Covey argued that we tend to spend too much of our time in the "urgent but "not important" quadrant and too little of our time in the "not-urgent but important" quadrant.  Yet, it is in the "not urgent but important" quadrant where great and meaningful things are accomplished professionally and in our personal lives.  

Covey also noted that time management practices focused on prioritizing and calendarizing (allocating time for) tasks principally based upon urgency.  Covey argued that people needed to shift their planning timeframe from "today" to a far longer perspective so that we changed our perspective of "priority" to include the "important but not urgent" matters. 

I recall a carton that depicts several "cave men" pulling a wagon with four square stone wheels. As you can imagine this required a lot of effort.  Following the wagon was another cave man carrying a "round" wheel. This cave man is saying "try this new wheel, it will make your job pulling the wagon much easier."  The cave men pulling the wagon responded "we don't have time try anything new because we are busy pulling this wagon.

Ironically, despite Covey having "discovered" these important points about making time for the important but not urgent matters (and having made a lot of money teaching others about this) decades ago, I wonder why these principles haven't gained traction? Is it a lack of time? A lack of interest? Or are the ideas simply flawed?

Any ideas on why these ideas didn’t gain traction and what we could do differently today in order to feel comfortable allocating time to the important-but-not-urgent?