“Just to show you that I have been listening, Curmudge, may I start this session with a question?”
“You’ve got the floor, Jaded Julie.”
“Is Hoshin Kanri a part of Lean? The workplace, gemba, is the focus of Lean, but Hoshin Kanri is an initiative that goes from the top down.”
“Good observation, Julie. I see them as complementary, and here at Affinity Hoshin Kanri is an extremely important adjunct to Lean. A Lean cultural transformation is a major change, and change must have the vocal, enthusiastic, and unwavering support of the organization’s leadership. Without their involvement, the people farther down in the organization will ignore the change.”
“Curmudge, this sounds just like in medieval times when the knights would sound the charge and lead their followers from in front. If the leaders were not always there, the troops would lose heart and go home. They would probably say that this was just another conquest of the month.”
“Great analogy! At Affinity, Hoshin Kanri is the means by which top management provides their support for the Lean transformation. With Lean as a corporate strategy and Lean tools needed for many of the hoshins, Hoshin Kanri cascades the Lean transformation all the way down to gemba. So to answer your question, Julie, Lean and Hoshin Kanri go together like love and marriage.”
“You sound old fashioned, Curmudge, but what would I expect? So maybe we should call this whole thing the Hoshin Kanri/Gemba Kaizen Transformation.”
“That’s good Japanese, Julie, but it sounds like the name of the solution to a problem in advanced mathematics.”
“Well, can we just give it a home-grown name, like the Affinity Performance Excellence System?”
“That name has already been taken. But perhaps we can consider it to have been kaizened and subjected to continuous improvement. Then we’ll call it Jaded Julie’s Affinity Performance Excellence System.”
“Wow! Does that mean that you regard me as somebody special?”
“As a nurse, Julie, you always were.”
Affinity’s Kaizen Curmudgeon
Monday, October 15, 2007
Friday, October 12, 2007
Hoshin Kanri is More than Diagrams
“Jaded Julie, now that you have learned what PD and PM matrices look like, should we learn how they are used to guide our actions?”
“Well, Curmudge, what else can a captive audience say but ‘yes’?”
“I appreciate your enthusiasm. Did you know that in the world of Hoshin Kanri there are two kinds of time, Discretionary Time and Ready-to-Serve (RTS) Time?”
“At least I understand discretionary time. That’s the five minutes left in the day after I get home from work, feed the family, and put the kids to bed. Does ready-to-serve time apply to me? I’m a nurse, not a waitress.”
“It’s only a term, Julie. Remember that tackling isn’t the job of an offensive tackle. Actually, most of your shift would be considered ready-to-serve time. It’s the time you devote to your daily required processes like patient care and compliance-required recordkeeping. Duties performed during RTS time are those required for the hospital to stay in business; they can’t be put aside in favor of another activity. Two- or three-day process-improvement events that don’t require resources from outside your department would also be RTS.”
“So what does RTS time have to do with Hoshin Kanri?”
“RTS and discretionary time are complementary. They add up to one’s whole working day. People with significant discretionary time are managers, directors, and members of corporate departments like Information Systems, Marketing, and the Kaizen Promotion Office (KPO).”
“I presume, Curmudge, that those folks shouldn’t use their discretionary time standing around talking about the Badgers and the Packers.”
“They would do so at their peril, Julie. Their discretionary time, also called ‘deployable time,’ should be used to work on the projects shown on Hoshin Kanri PM and PD2 matrices. Ideally, everyone should try to make their RTS activities more efficient—perhaps using Lean tools—so that their RTS time decreases and their discretionary time expands.”
“These days, IS and KPO staff members must be in great demand for Hoshin Kanri projects. Seems as if they might need to have 20 hours per day of discretionary time.”
“Fortunately, prioritization and allocation of resources are central features of Hoshin Kanri. Corporate hoshins and the projects supporting them have highest priority; then business unit hoshins and finally department hoshins at the low end of the priority list. If a given person’s discretionary time is fully committed to a project supporting a corporate hoshin, he/she is not available to work on business unit or department projects.”
“But what if that person is absolutely essential for the lower-priority project?”
“In that case, Julie, the project—and possibly the hoshin if the project is essential to the hoshin’s success—is put in the ‘parking lot.’ In Hoshin Kanri language, the project is said to have been ‘deselected.’ It can be recovered from the parking lot and worked on after the higher priority project is completed.”
“And what if the staff person’s discretionary time is needed in two projects at the same priority level?”
“Then the appropriate directors negotiate the relative priorities of their projects. The Japanese call this process ‘playing catch ball’.”
“The words are English, Curmudge, but I bet they are pronounced with a Japanese accent.”
“That’s okay. Hoshin Kanri is their game; perhaps they anticipated that we would be using it. Now, Julie, I believe that we have covered most of the organizational elements of Hoshin Kanri, but we need to spend a moment discussing Hoshin Kanri management.”
“If you say so, Curmudge. This part is going to be easier, right?”
“Right. The PM’s and PD2’s that we have learned about are Hoshin Kanri’s visual management tools. They are posted in each team area and reviewed weekly by the hoshin leader. Problems are marked in red and are addressed immediately. This process will soon be possible electronically using QuickBase®”
“It seems that there are no hiding places in Hoshin Kanri.”
“There sure aren’t. Hoshin Kanri provides transparency, which is an essential feature of good modern management. Then every month or every other week the business unit leadership does a walk-around review of the status of local and corporate hoshins. Finally, every quarter the top management devotes a meeting to hoshin reporting and coordination. This provides company-wide accountability for all initiatives and how they drive strategies leading to achievement of organizational goals.”
“What happens if a hoshin leader’s planning matrix shows a lot of red? I understand that hoshins are described as ‘must-do, can’t-fail’ initiatives.”
“That’s true, Julie, but that means that the organization can’t fail to accomplish the hoshin. Red in the PM simply signals the need for assistance as soon as the need is apparent. That’s the beauty of Hoshin Kanri’s real-time visual management.”
“Curmudge, it also signals the need to take a break from filling my brain with Hoshin Kanri.”
“See you soon, Julie.”
Affinity’s Kaizen Curmudgeon
“Well, Curmudge, what else can a captive audience say but ‘yes’?”
“I appreciate your enthusiasm. Did you know that in the world of Hoshin Kanri there are two kinds of time, Discretionary Time and Ready-to-Serve (RTS) Time?”
“At least I understand discretionary time. That’s the five minutes left in the day after I get home from work, feed the family, and put the kids to bed. Does ready-to-serve time apply to me? I’m a nurse, not a waitress.”
“It’s only a term, Julie. Remember that tackling isn’t the job of an offensive tackle. Actually, most of your shift would be considered ready-to-serve time. It’s the time you devote to your daily required processes like patient care and compliance-required recordkeeping. Duties performed during RTS time are those required for the hospital to stay in business; they can’t be put aside in favor of another activity. Two- or three-day process-improvement events that don’t require resources from outside your department would also be RTS.”
“So what does RTS time have to do with Hoshin Kanri?”
“RTS and discretionary time are complementary. They add up to one’s whole working day. People with significant discretionary time are managers, directors, and members of corporate departments like Information Systems, Marketing, and the Kaizen Promotion Office (KPO).”
“I presume, Curmudge, that those folks shouldn’t use their discretionary time standing around talking about the Badgers and the Packers.”
“They would do so at their peril, Julie. Their discretionary time, also called ‘deployable time,’ should be used to work on the projects shown on Hoshin Kanri PM and PD2 matrices. Ideally, everyone should try to make their RTS activities more efficient—perhaps using Lean tools—so that their RTS time decreases and their discretionary time expands.”
“These days, IS and KPO staff members must be in great demand for Hoshin Kanri projects. Seems as if they might need to have 20 hours per day of discretionary time.”
“Fortunately, prioritization and allocation of resources are central features of Hoshin Kanri. Corporate hoshins and the projects supporting them have highest priority; then business unit hoshins and finally department hoshins at the low end of the priority list. If a given person’s discretionary time is fully committed to a project supporting a corporate hoshin, he/she is not available to work on business unit or department projects.”
“But what if that person is absolutely essential for the lower-priority project?”
“In that case, Julie, the project—and possibly the hoshin if the project is essential to the hoshin’s success—is put in the ‘parking lot.’ In Hoshin Kanri language, the project is said to have been ‘deselected.’ It can be recovered from the parking lot and worked on after the higher priority project is completed.”
“And what if the staff person’s discretionary time is needed in two projects at the same priority level?”
“Then the appropriate directors negotiate the relative priorities of their projects. The Japanese call this process ‘playing catch ball’.”
“The words are English, Curmudge, but I bet they are pronounced with a Japanese accent.”
“That’s okay. Hoshin Kanri is their game; perhaps they anticipated that we would be using it. Now, Julie, I believe that we have covered most of the organizational elements of Hoshin Kanri, but we need to spend a moment discussing Hoshin Kanri management.”
“If you say so, Curmudge. This part is going to be easier, right?”
“Right. The PM’s and PD2’s that we have learned about are Hoshin Kanri’s visual management tools. They are posted in each team area and reviewed weekly by the hoshin leader. Problems are marked in red and are addressed immediately. This process will soon be possible electronically using QuickBase®”
“It seems that there are no hiding places in Hoshin Kanri.”
“There sure aren’t. Hoshin Kanri provides transparency, which is an essential feature of good modern management. Then every month or every other week the business unit leadership does a walk-around review of the status of local and corporate hoshins. Finally, every quarter the top management devotes a meeting to hoshin reporting and coordination. This provides company-wide accountability for all initiatives and how they drive strategies leading to achievement of organizational goals.”
“What happens if a hoshin leader’s planning matrix shows a lot of red? I understand that hoshins are described as ‘must-do, can’t-fail’ initiatives.”
“That’s true, Julie, but that means that the organization can’t fail to accomplish the hoshin. Red in the PM simply signals the need for assistance as soon as the need is apparent. That’s the beauty of Hoshin Kanri’s real-time visual management.”
“Curmudge, it also signals the need to take a break from filling my brain with Hoshin Kanri.”
“See you soon, Julie.”
Affinity’s Kaizen Curmudgeon
Tuesday, October 2, 2007
Jaded Julie Learns about Policy Deployment Matrices
“Okay, Julie, sometimes one has to grab the bull by the tail and look the problem right in the eye. So here’s the policy deployment (PD1) matrix for the Curmudgeon Company.”
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“Wow, Curmudge! That’s an information-filled matrix. Where do I start?”
“First, let’s read it like a map, with north at the top. Start at the west with Goals, then Strategies in the north, and Hoshins in the east. Strategies are linked to goals by the big dots, called ‘meatballs’, in the northwest; Hoshins are linked to Strategies by the meatballs in the northeast. The Team Support and the meatballs in the southeast show the organizations that are going to accomplish the hoshins.”
“If I look at the PD1 matrix long enough—maybe for a week—it will all soak in. I fear, however, that you already have another type matrix to dump on me.”
“I do have another one, Julie, but its concept is a lot simpler than its sticker shock. It’s just a PD1 rolled onto its side, that is, rotated a quarter turn counterclockwise. Here it is.”
.JPG)
“Hey, the goals went away!”
“No, they’re still there, Julie, but they are hidden from view and hopefully imbedded in your mind. Unless, of course, you want us to make this thing three-dimensional.”
“No thanks. I see now that the Strategies are in the west, and the Hoshins in the north. But you’ve added Projects in the east. I remember those from the planning matrix (PM). At least the projects supporting the ‘Improve yard’ hoshin were on the planning matrix we looked at.”
“That’s right, Julie. The ‘Remodel bathroom’ hoshin would have its own PM. If the Curmudgeon Company were bigger, like Affinity, each department would have a PD2 showing its projects; and individual people assigned to the projects would be shown under Support on the south side of the matrix.”
“These matrices are informative, Curmudge; they do require concentration. My head is spinning, but it has only gone a quarter turn counterclockwise. Is there more to Hoshin Kanri than diagrams that have to be read sideways?”
“There certainly is, Julie, and we’ll talk about that next time.”
“Bye, Curmudge.”
Affinity’s Kaizen Curmudgeon
.JPG)
“Wow, Curmudge! That’s an information-filled matrix. Where do I start?”“First, let’s read it like a map, with north at the top. Start at the west with Goals, then Strategies in the north, and Hoshins in the east. Strategies are linked to goals by the big dots, called ‘meatballs’, in the northwest; Hoshins are linked to Strategies by the meatballs in the northeast. The Team Support and the meatballs in the southeast show the organizations that are going to accomplish the hoshins.”
“If I look at the PD1 matrix long enough—maybe for a week—it will all soak in. I fear, however, that you already have another type matrix to dump on me.”
“I do have another one, Julie, but its concept is a lot simpler than its sticker shock. It’s just a PD1 rolled onto its side, that is, rotated a quarter turn counterclockwise. Here it is.”
.JPG)
“Hey, the goals went away!”“No, they’re still there, Julie, but they are hidden from view and hopefully imbedded in your mind. Unless, of course, you want us to make this thing three-dimensional.”
“No thanks. I see now that the Strategies are in the west, and the Hoshins in the north. But you’ve added Projects in the east. I remember those from the planning matrix (PM). At least the projects supporting the ‘Improve yard’ hoshin were on the planning matrix we looked at.”
“That’s right, Julie. The ‘Remodel bathroom’ hoshin would have its own PM. If the Curmudgeon Company were bigger, like Affinity, each department would have a PD2 showing its projects; and individual people assigned to the projects would be shown under Support on the south side of the matrix.”
“These matrices are informative, Curmudge; they do require concentration. My head is spinning, but it has only gone a quarter turn counterclockwise. Is there more to Hoshin Kanri than diagrams that have to be read sideways?”
“There certainly is, Julie, and we’ll talk about that next time.”
“Bye, Curmudge.”
Affinity’s Kaizen Curmudgeon
Tuesday, September 25, 2007
Jaded Julie Learns the Language of Hoshin Kanri
"Time for a vocabulary lesson, Julie. Then we’ll learn how the words are used.”
“Okay, Curmudge, but I sure hope that when a new word goes into my brain, an old word doesn’t come popping out.”
“Don’t worry, Julie. That only happens to senior citizens. Let’s start by talking about matrices, which is the plural of matrix.”
“So what is a matrix?”
“I don’t think you want me to say that a matrix is a rectangular array of numbers, so why don’t we just use an example. A calendar is a simple matrix; it shows days of the week across the top and weeks of the month down the side. If you go out for fish every Friday, you’ll be doing it on October 5, 12, 19, and 26 in 2007. That’s pretty important information, don’t you agree?”
“I’m getting hungry already. Go on, Curmudge.”
“In Hoshin Kanri Planning there are several types of matrices. Each one has a name, and each name has an abbreviation.”
“I sense that this conversation is going down hill, but I haven’t bailed out yet.”
“Good! These are the names and abbreviations of the two main types of matrices: Policy Deployment (PD), and Planning Matrix (PM). Note that when ‘P’ is followed by ‘D’ it stands for Policy, and when ‘P’ is followed by ‘M’ it stands for Planning.”
“That sounds a bit inconsiderate of students, but at least it’s in English.”
“Don’t complain. There are similar idiosyncrasies in Arabic, and they have been learned by millions of children. Let’s gain an understanding of these terms by devising a simple scenario. Call the company the Curmudgeon Company with my wife and me the co-CEO’s.”
“I presume that you each make some of the important corporate decisions.”
“Right. She decides where we live and how the house is furnished, and I decide what color shirt to wear to work every day. Anyway, back to the scenario. We have developed two long-term goals, Move to a Warmer Climate and Sell the House. Our strategies for selling the house include Remodel the Interior and Upgrade the Exterior to Improve Curb Appeal. One of our hoshins (short-term essential achievements) to further the ‘Upgrade the Exterior’ strategy is to Improve the Appearance of the Yard. Although this is all hypothetical, I hope it helps clarify the terms we introduced last time, Goals, Strategies, and Hoshins.”
“It’s not bad, Curmudge. Whenever I get discouraged, I think of little children trying to learn Arabic.”
“Remember, Julie, the reason for the scenario is to help us understand the two main types of matrices used in hoshin kanri planning, the Policy Deployment Matrix (PD), and the Planning Matrix (PM). The Planning Matrix is simpler, so we’ll start with that one. Every hoshin has a planning matrix that shows the hoshin’s measure of success, the individual projects undertaken to support the hoshin, and the progress of those projects. Shown below is the planning matrix (PM) for our ‘Improve the Appearance of the Yard’ hoshin.”
a.jpg)
"Well, Julie, I hope our example makes the Hoshin Planning Matrix appear straightforward. Next time we’ll tackle Policy Deployment Matrices.”“I agree, Curmudge. Sometimes you do make complex topics easier to learn.”
“When do you want to hear my lectures on thermodynamics, Julie?”
“How about in ten years?”
“Bye, Julie.”
Affinity’s Kaizen Curmudgeon
Jaded Julie Begins to Learn about Hoshin Kanri Planning
“I’m sorry, Jaded Julie, but we’re going to have to deviate from our Lean transformation theme. The new topic is Hoshin Kanri Planning.”
“That’s okay, Curmudge. As Yogi Berra said, ‘If you come to a fork in the road, take it.’ But it sounds as if I’m going to have to learn two new Japanese words. You know that I’m not very good at foreign languages.”
“There’s nothing to fear, Julie. There are only two Japanese words that we’ll be learning; everything else is in English. Besides, every trade and profession has its own language. You have already learned the language of nursing. If someone says ‘Foley catheter’ to you, you immediately know what they mean. Those words mean nothing to the average person on the street, and those folks who recognize them simply shudder.”
“So you’re saying that learning Hoshin Kanri is essentially the same as learning a foreign language or the specialized English vocabulary of a profession?”
“Exactly. Learn the most essential words and the rules for their usage; then practice, practice, practice. Soon you’ll be thinking in Hoshin Kanri.”
“I’m shivering with anticipation. By the way, Curmudge, why are we doing this?”
“Every corporation needs to plan how it will improve its performance. Affinity has determined that Hoshin Kanri is the best planning process. It can be translated as policy deployment, goal deployment, or policy management, but Affinity has adopted the Japanese terms. In this process, the leadership team identifies goals for the corporation, develops strategies for achieving the goals, and then specifies essential achievements needed to further the strategies. In this context, the essential achievements are called ‘hoshins’. Sorry about the additional Japanese, but it’s just a rule of the game—sort of like learning to roll your ‘r’s to be understood in a foreign country.”
“It seems reasonable so far, but it sounds as if it involves only management. So why do I have to learn this?”
“You’re right in that the folks most directly involved with Hoshin Kanri are those from top management on down to directors and managers. But you might be called on to help. As I’ll point out later, Hoshin Kanri will permeate all of Affinity; and you will want to understand what is going on around you. Furthermore, achieving a Lean transformation is one of our corporate strategies. Hoshin Kanri is the means by which the Lean transformation that you have been studying will be accomplished.”
“So it will relate to me. I was about to lose interest. Proceed, Curmudge, but go slowly.”
“Let’s wrap up this session by mentioning that the business units—each hospital, Affinity Medical Group, etc.—commit to hoshins (remember—essential achievements) that further the corporate strategies that are within their purview. They also develop their own business unit strategies and hoshins. The result of this is that everyone is focused long term on achieving the corporate goals.”
“Whew! Are we finished for the day?”
“Yes. We’ll tackle more Hoshin Kanri Planning next time. Meanwhile, think how easy it was to learn the special terminology of sports, like ’first down’ and ‘offside’ in football…”
“…and throwing a ‘Hail Mary’ pass from your own 10-yard line.”
“You’ve got the idea, Julie. And I’ll make sure that learning Hoshin Kanri is not ‘unnecessary roughness’.”
Affinity’s Kaizen Curmudgeon
“That’s okay, Curmudge. As Yogi Berra said, ‘If you come to a fork in the road, take it.’ But it sounds as if I’m going to have to learn two new Japanese words. You know that I’m not very good at foreign languages.”
“There’s nothing to fear, Julie. There are only two Japanese words that we’ll be learning; everything else is in English. Besides, every trade and profession has its own language. You have already learned the language of nursing. If someone says ‘Foley catheter’ to you, you immediately know what they mean. Those words mean nothing to the average person on the street, and those folks who recognize them simply shudder.”
“So you’re saying that learning Hoshin Kanri is essentially the same as learning a foreign language or the specialized English vocabulary of a profession?”
“Exactly. Learn the most essential words and the rules for their usage; then practice, practice, practice. Soon you’ll be thinking in Hoshin Kanri.”
“I’m shivering with anticipation. By the way, Curmudge, why are we doing this?”
“Every corporation needs to plan how it will improve its performance. Affinity has determined that Hoshin Kanri is the best planning process. It can be translated as policy deployment, goal deployment, or policy management, but Affinity has adopted the Japanese terms. In this process, the leadership team identifies goals for the corporation, develops strategies for achieving the goals, and then specifies essential achievements needed to further the strategies. In this context, the essential achievements are called ‘hoshins’. Sorry about the additional Japanese, but it’s just a rule of the game—sort of like learning to roll your ‘r’s to be understood in a foreign country.”
“It seems reasonable so far, but it sounds as if it involves only management. So why do I have to learn this?”
“You’re right in that the folks most directly involved with Hoshin Kanri are those from top management on down to directors and managers. But you might be called on to help. As I’ll point out later, Hoshin Kanri will permeate all of Affinity; and you will want to understand what is going on around you. Furthermore, achieving a Lean transformation is one of our corporate strategies. Hoshin Kanri is the means by which the Lean transformation that you have been studying will be accomplished.”
“So it will relate to me. I was about to lose interest. Proceed, Curmudge, but go slowly.”
“Let’s wrap up this session by mentioning that the business units—each hospital, Affinity Medical Group, etc.—commit to hoshins (remember—essential achievements) that further the corporate strategies that are within their purview. They also develop their own business unit strategies and hoshins. The result of this is that everyone is focused long term on achieving the corporate goals.”
“Whew! Are we finished for the day?”
“Yes. We’ll tackle more Hoshin Kanri Planning next time. Meanwhile, think how easy it was to learn the special terminology of sports, like ’first down’ and ‘offside’ in football…”
“…and throwing a ‘Hail Mary’ pass from your own 10-yard line.”
“You’ve got the idea, Julie. And I’ll make sure that learning Hoshin Kanri is not ‘unnecessary roughness’.”
Affinity’s Kaizen Curmudgeon
Tuesday, August 28, 2007
Jaded Julie Learns More about a Lean Transformation
“Hey, Jaded Julie, my shadowing you for a day last month certainly convinced me of the potential value of Lean for nursing.”
“No problem, Curmudge. You were not in the way, and you seemed to have a lot in common with the older patients.”
“But remember the critical difference, Julie. I was standing up.”
“I’d like to learn more about Lean, Curmudge, especially the Lean tools that you mentioned.”
“Let’s not get ahead of ourselves. The tools and techniques used in Lean are only half the story. We first need to learn the basics of a Lean transformation. Using Lean tools without knowing the basic philosophy would be like putting you to work on Four South without first learning physiology.”
“Go ahead and teach, Curmudge, as long as it’s not biochemistry.”
“Lean has two basic principles. We have already learned about the first one, Continuous Improvement or Kaizen. The second principle is Respect for People.”
“That’s easy. We already show respect for our patients in our caring for them.”
“There’s more to it than that, Julie. In a Lean transformation the organization respects all of its people, including everyone in gemba. I’m sure you recall that gemba is everywhere in the hospital where services are performed for our customers, the patients. Remember the upside-down organizational pyramid. A major focus of Lean is to help workers realize their full potential. This is very different from traditional management systems.”
“I hesitate to ask, Curmudge, but is there more to Respect for People than professional fulfillment?”
“I’m glad you did ask. An essential part of a Lean transformation is a ‘no lay-off’ policy as a result of process improvement and standardization. That means if your unit becomes so efficient due to application of Lean that not everyone is needed, the extra person will have opportunities elsewhere with Affinity.”
“Wow! That sounds great. Is there anything else?”
“Eventually there will be. When there are gains to share, a ‘gainsharing’ program will be started. Gainsharing means that when the hospital exceeds predetermined performance levels, the monetary gains will be shared with everyone.”
“Curmudge, all of this Lean stuff sounds super, but I know there is no free lunch. What can go wrong?”
“As usual, Jaded Julie, you have keen perception. When we get together next time, we’ll chat about potential pitfalls. See you then, Julie.”
“Ciao, Curmudge.”
Affinity’s Kaizen Curmudgeon
“No problem, Curmudge. You were not in the way, and you seemed to have a lot in common with the older patients.”
“But remember the critical difference, Julie. I was standing up.”
“I’d like to learn more about Lean, Curmudge, especially the Lean tools that you mentioned.”
“Let’s not get ahead of ourselves. The tools and techniques used in Lean are only half the story. We first need to learn the basics of a Lean transformation. Using Lean tools without knowing the basic philosophy would be like putting you to work on Four South without first learning physiology.”
“Go ahead and teach, Curmudge, as long as it’s not biochemistry.”
“Lean has two basic principles. We have already learned about the first one, Continuous Improvement or Kaizen. The second principle is Respect for People.”
“That’s easy. We already show respect for our patients in our caring for them.”
“There’s more to it than that, Julie. In a Lean transformation the organization respects all of its people, including everyone in gemba. I’m sure you recall that gemba is everywhere in the hospital where services are performed for our customers, the patients. Remember the upside-down organizational pyramid. A major focus of Lean is to help workers realize their full potential. This is very different from traditional management systems.”
“I hesitate to ask, Curmudge, but is there more to Respect for People than professional fulfillment?”
“I’m glad you did ask. An essential part of a Lean transformation is a ‘no lay-off’ policy as a result of process improvement and standardization. That means if your unit becomes so efficient due to application of Lean that not everyone is needed, the extra person will have opportunities elsewhere with Affinity.”
“Wow! That sounds great. Is there anything else?”
“Eventually there will be. When there are gains to share, a ‘gainsharing’ program will be started. Gainsharing means that when the hospital exceeds predetermined performance levels, the monetary gains will be shared with everyone.”
“Curmudge, all of this Lean stuff sounds super, but I know there is no free lunch. What can go wrong?”
“As usual, Jaded Julie, you have keen perception. When we get together next time, we’ll chat about potential pitfalls. See you then, Julie.”
“Ciao, Curmudge.”
Affinity’s Kaizen Curmudgeon
Thursday, July 26, 2007
The Curmudgeon Shadows Jaded Julie
“Thank you, Jaded Julie, for allowing me to shadow you last week. I learned a lot.”
“Well, you weren’t much trouble. You didn’t get in my way, and only a few patients asked, ‘Who is the old guy?’ Why did you need to shadow a nurse, anyway?”
“Remember last month’s saying from Gemba Kaizen about going to where the action is—‘Go to Gemba.’ If I hope to teach you anything useful, I need to know what a nurse does. So I took my own advice and went to gemba.”
“So what did you learn in my gemba?”
“Good things first. You do a great job of caring for your patients. Despite having a lot to do, you were always compassionate and responsive to the patients’ needs.”
“Thanks for the kind words. Did you see anything that we should improve?”
“I didn’t see, but I heard…a very noisy TV set in a patient room. In my opinion, that’s not a healing environment. If I were a patient, I’d want to get well quickly just to get away from the noise.”
“To live up to your name, Curmudge, I suppose you found other things to complain about.”
“Let’s call them opportunities, Julie, not complaints. Nurses spend too much time writing, and you do it by hand. And you are seemingly in constant motion. It might be good exercise, but I’ll bet that a lot of it isn’t value added.”
“Okay, Curmudge, but what can we do about all this writing and running?”
“Our need for better technology is dire, but you can’t do much about that personally. Ultimately, you’ll be able to use Lean tools to make your processes more efficient.”
“Lean tools? Is that like a skinny monkey wrench?”
“No, they are techniques you can use to remove waste from your processes. We’ll talk about them later. Meanwhile, keep up the good work. Perhaps I’ll even return for another visit.”
“If you do, I’ll warn everyone that ‘The Kaizen Curmudgeon Is Coming’.”
“At least the patients won’t wonder who the old guy is.”
Affinity’s Kaizen Curmudgeon
“Well, you weren’t much trouble. You didn’t get in my way, and only a few patients asked, ‘Who is the old guy?’ Why did you need to shadow a nurse, anyway?”
“Remember last month’s saying from Gemba Kaizen about going to where the action is—‘Go to Gemba.’ If I hope to teach you anything useful, I need to know what a nurse does. So I took my own advice and went to gemba.”
“So what did you learn in my gemba?”
“Good things first. You do a great job of caring for your patients. Despite having a lot to do, you were always compassionate and responsive to the patients’ needs.”
“Thanks for the kind words. Did you see anything that we should improve?”
“I didn’t see, but I heard…a very noisy TV set in a patient room. In my opinion, that’s not a healing environment. If I were a patient, I’d want to get well quickly just to get away from the noise.”
“To live up to your name, Curmudge, I suppose you found other things to complain about.”
“Let’s call them opportunities, Julie, not complaints. Nurses spend too much time writing, and you do it by hand. And you are seemingly in constant motion. It might be good exercise, but I’ll bet that a lot of it isn’t value added.”
“Okay, Curmudge, but what can we do about all this writing and running?”
“Our need for better technology is dire, but you can’t do much about that personally. Ultimately, you’ll be able to use Lean tools to make your processes more efficient.”
“Lean tools? Is that like a skinny monkey wrench?”
“No, they are techniques you can use to remove waste from your processes. We’ll talk about them later. Meanwhile, keep up the good work. Perhaps I’ll even return for another visit.”
“If you do, I’ll warn everyone that ‘The Kaizen Curmudgeon Is Coming’.”
“At least the patients won’t wonder who the old guy is.”
Affinity’s Kaizen Curmudgeon
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