Fun day today. Healthcare, maybe more than other industries, is prone to tolerating and institutionalizing workarounds, as Steven Spear has written about.
As I'm teaching a hospital lab about lean, we're not just analyzing and documenting waste – we're working on fixing it. We identified some waste activity today – activity that is done to work around problems created upstream.
Using our lean eyes (the lab people's “new eyes”), we identified the activities as a workaround and started asking “why?” It turns out that the root causes were pretty easily fixed. It's just that nobody had the mindset to “fix” the workaround. Best of all, the fix didn't require getting managers or higher ups involved… the team just went and talked to some people and took them some labels… problem fixed. We also identified a way of fixing and eliminating one other workaround.
We're hoping that this behavior will become contagious. We need to stop tolerating our workarounds and start to go after the root causes that create the workaround activity. The less time we spend on workarounds, the more time we can spend on the Value Add. Neither of these examples we had today were huge on their own. But, there are hundreds of little problems to fix… plus we'll fix a few of the “big” problems, that should all demonstrate real lean value.
What workarounds can you destroy today?
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I think all the companies I have worked in have a binder full of workarounds that are informally trained to all employees. My company recently did a virtual wastewalk of our ERP system in a certain group of users. When we began asking the 5 Whys about their daily workarounds, the answer was almost always “If we could do it another way, we probably would be.”
It was a great highlight to a failure in management (of which I am part) to set the expectation of these folks. We spent time on brainstorming, not only to fixing the root cause of workarounds we found, but also to instill a sense that no one should be satisfied with a wasteful ssytem or process.
Truly fun stuff. We are chaging the expectations of everyone in the company.