Jaded Julie learns that to succeed, Lean must follow a plan.

“Hi, Curmudge. We’ve been reading the books you recommended last time, but the kids wish they had more pictures of animals. However, they do like the sketches in the book by Pascal Dennis.”

“We’ll use an observation from Dennis’s book in a moment, Julie. First let’s return to our discussion from last time on Jeffrey Liker’s ‘4 P’ pyramid that depicts the Toyota production system. At the base of the pyramid is the first P, which stands for Toyota’s philosophy. We ‘Affinitized’ philosophy to mean the corporate goals of Affinity Health System. The second P up the pyramid stands for Processes. Toyota uses tools like one-piece flow, pull systems, and load leveling to remove waste from their processes.”

“And in health care we should be using Lean tools like 5S, value stream maps, and standard work. See, Curmudge, I’ve been reading the books.”

“Great, Julie! Keep it up. The important point is that most ‘Lean’ organizations in the U.S. never achieve a sustainable Lean culture despite their use of Lean tools. Do you have any idea why they don’t?”

“Is it because they don’t get to the third and fourth P’s of the pyramid?”

“Why don’t they?”

“Does someone in the organization’s administration pull the plug on Lean?”

“Right. But why would they do that?”

“Could it be that Lean did not meet their expectations?”

“Correct. But why didn’t it?”

“Perhaps they didn’t use Lean tools efficiently.”

“Why didn’t they? What was missing?”

“I’ve got it, Curmudge. It was because they didn’t follow a plan. We know that most anyone can hammer a nail, but you have to have a plan in order to build a house. By the way, Curmudge, we just did the ‘Five Why’s’ to find the root cause of our problem.”

“Congrats, Julie. I knew you could do it. For our answer, let’s paraphrase Mr. Dennis: The organizations that didn’t get beyond the second P did not use strategy deployment as their guidance and delivery system to focus their Lean tools on their business needs.”

“Strategy Deployment! Isn’t that one of the English translations of Hoshin Kanri planning? You and I spent much of September and October talking about that. If Affinity Health System is successful in deploying Hoshin Kanri, we should be able to move up the Toyota pyramid toward achieving a Lean culture.”

“And that’s what we are going to talk about next time. Meanwhile, keep reading those bedtime stories. I’ll try to find some of my grandson’s books with pictures of animals.”

“You realize, Curmudge, that we used a reverse translation in this lesson. We converted Strategy Deployment into Hoshin Kanri because the Japanese term is more familiar to our Affinity colleagues.”

“Good catch, Julie. Sometimes a foreign term is more meaningful than its English translation. In that case, we’ll use it.”

“Bye, Curmudge.”

“Ciao, Julie.”

Affinity’s Kaizen Curmudgeon