The Crystal Ball 1

“Today we’re going to play one of our ‘Curmudge-and-Julie-make-believe’ games.”

“Ooh, Curmudge, the last time we did that I was seriously ill.”

“Don’t worry, Jaded Julie. This time the outcome will be better. Your role is to be a middle manager in a health care organization—one whose operating philosophy is command-and-control and where everything is done the way it has always been done.”

“Hey, that outfit is suffering from organizational obsolescence. They are really behind the 8-ball. Don’t they read or use computers? They must think that Google is a character (Barney Google) in a silly song. But say, Curmudge, I thought we were going to explore the future, and here we are talking about an organization living in the past.”

“We have to start somewhere, and even today there are probably command-and-control organizations out there. It wouldn’t be proper to just blow right by them. Their first need is to realize that employees are more productive when they are respected and that problems are best solved by the people in gemba…”

“…and that traditional hospitals tend to be wasteful, and that systems are best understood and improved after they are mapped. I’ve got it, Curmudge. Making these improvements is just common sense. Understanding this is where a traditional organization has to start if they want to join the rapidly changing world of health care.”

“One problem, Julie. People have their own, unique concept of common sense. We would have chaos if every person went his own way making improvements. People’s creative energies need to be harnessed and focused by using a structured program like Lean. We’ve talked about Lean in this blog for the past four years. However, for the total neophyte’s remedial reading we recommend a review of similar programs in the April 14, 2011 posting in Curmudgeon’s Wastebasket. ”

“People use lots of names for their improvement program, including those that are unique to their organization. Most of them are based on the principles of the Toyota Production System. But tell me, Curmudge, how should the wayward outfit whose role I am playing get their culture change under way?”

“Since Affinity began their Lean journey several years ago, a ton of books have been written and an army of consultants have come out of the woodwork. However, the absolute least expensive way to learn about Lean is to read Kaizen Curmudgeon. You’ll also want to benchmark organizations that have been describing their Lean successes at meetings. At some point you will probably want to contract with a sensei (honored teacher) for guidance. The best way to find such a person is to talk with people who have been where you want to go.”

“After I have done a lot of reading and become a dedicated change agent, what’s my next step?”

“Julie, leading from the middle of an organization is like pushing a rope. Nevertheless, it’s essential that those higher in the organization—especially at the top—become emotional, vocal, and physical supporters of the proposed new culture. However, your task should not be impossible if these (paraphrased) comments from a recent meeting of the American College of Healthcare Executives are valid: ‘They have heard, and hopefully understand, that they are going to have to change their organizations in major, cataclysmic ways especially if they haven’t started to do so already. Leaders in general are now much more knowledgeable about the steps they will have to take. They understand they have to adopt Toyota and Lean manufacturing strategies.’ “

“Whew! That helps. Let’s assume that I am successful and that the organization has set sail on its Lean journey. Can I sit back and relax?”

“No way! It may have taken herculean efforts to get the flywheel turning, but it is not frictionless. Maintaining a Lean program requires dogged determination and almost religious dedication. And ideally, it never ends.”

“Perhaps it’s a bit like marriage, Curmudge. You’d better hardwire the whole concept, because it’s going to be your partner for a long time.”

“In addition, Julie, as the resident futurist you will want to expand your horizon. Instead of thinking how better to organize a supply closet, you’ll want to know what’s coming down the pike that will impact your organization.”

“Wow! That’s a gigantic expansion. I assume we’ll talk about that next time. By the way, Curmudge, are you a futurist?”

“Of course I am, but for me the future is tomorrow. That’s why if I wake up in the morning, every day is a beautiful day.”

Affinity’s Kaizen Curmudgeon