The Sensei is Concerned

“Curmudge, you look worried.”

“Perhaps, Jaded Julie, I’m just reflecting Jim Womack’s concerns about the future of Lean. If a person of his stature in the Lean movement is wondering what lies ahead, the rest of us should also.”

“Okay, Mr. Prognosticator, what do you and Womack see coming at us?”

“Womack reminds us that the process improvement programs of the past, like Total Quality Management, have emerged as waves that crested and then declined. Might this happen to Lean, and if it does, why? Then he answers himself by asserting that while we have been improving our core (production) processes, we have not similarly improved the management processes. He implies that an organization’s persistence in using traditional management will be Lean’s downfall.”

“I shudder at the thought. So what countermeasures does Womack propose?”

“He suggests that senior managers be engaged as a team to evaluate the current state of the organization’s management system. They need to consider how to identify the most important problems, how to evaluate proposals originating in gemba, how to implement standardized work and management, and how to create the current and next generations of lean managers.”

“Womack’s comments were for everybody. How do they apply to health care?”

“Actually, Julie, in this blog we addressed some of Womack’s issues long ago. We talked about hoshin kanri to prioritize problems (September-October 2007), and the development of manager/leaders and servant leaders (from May 8 through June 5, 2008). Although neither hoshin kanri nor servant leadership is an integral part of Lean, they both are essential adjuncts. And in addition, we talked about things an organization must do to prevent Lean’s early demise (October 29, 2007).”

“Curmudge, I recall your mentioning something about the differences in the nature of competition between manufacturers and hospitals.”

“Confidentiality is a critical issue with manufacturers of similar products. When husband and wife work for competing companies, there is great concern that company-confidential information might get mentioned in ‘pillow talk.’ It seems to be different in health care. In metropolitan areas with several hospitals in close proximity, the interchange of employees is common. Although the hospitals compete for patients, they do so by openly advertising their advances in service and how the advances were achieved.”

“So what does this have to do with the longevity of Lean programs in health care?”

“The folks in Hospital A know that if they allow their Lean efforts to lag and their waste and inefficiency to increase, it will inevitably be recognized in the community. As a result, Hospital B will become dominant in attracting providers as well as patients. Self-preservation will be a powerful motivator for Hospital A to maintain their Lean culture.”

“I suspect what you are saying, Curmudge, is that of necessity Lean will evolve and grow in health care; and even if its name is changed, the reincarnation will contain the best features of Lean.”

Affinity’s Kaizen Curmudgeon