I don't often do a “cranky blog post” but Ive got a head cold (as I write this on 9/30) and I've gotten sucked into watching some free online “lean healthcare white belt” training that just makes me want to blog.
I get good feedback that these “cranky” posts make for good reading, so here goes. If I say anything stupid, I'll blame cold medicine for an unclear head. I'm typing as I watch, occasionally pausing the video… so this is pretty unfiltered…. OK, somewhat filtered.
I've debated back and forth about this and I think I'll purposefully NOT link to the site in question to avoid giving them the traffic. The training is more L.A.M.E. (“Lean as Mistakenly Explained) than Lean. Do you like terrible photoshopping of a white belt onto my L.A.M.E. symbol?
Intro Module
The video I watched is wrong, first, in referring to Six Sigma as a “problem solving methodology” while Lean described as just a bunch of tools. Lean and TPS provide a number of robust problem solving methodologies, like the “5 Whys” and the A3 problem solving process. When people separate Lean and Six Sigma like that, it could be because they want to sell you both sets of training.
Another straw man is the idea (said by some, not in this video) that “Lean is for efficiency but you need Six Sigma for quality.” That's again just absolutely false, as the two pillars of TPS are “just-in-time” and “jidoka” (quality at the source). One could more correctly argue that Lean is a quality system that also improves flow (they go hand in hand). Maybe that's still coming in the video (since I'm typing this as I watch).
The next place the video was wrong was in laying out a situation where different production operators were each doing the job differently. To me, that sounds like a scenario that calls for the operators to work on “standardized work, a core Lean concept, but the presenter says that you need “process control tools” to “get the process more standardized” or else you'd be using Lean to “simply make errors at a faster rate.” WHAT??? That shows such a fundamental misunderstanding of Lean, the creators of the video shouldn't be doing training. Sorry. They should have their training license revoked if there were such a thing.
Buyer of Lean education, beware! The LEI does NOT have FTC-style authority to shut this bad training website down, nor does Toyota.
I cringe at the phrase “pull some Lean tools out of your toolbox” each time it's used here in the video. Lean's not just a set of tools –it's a management system, a culture, and a philosophy. Lean is not a bunch of projects to be executed by “belts” – it requires the engagement of all employees and the transformation of how we manage.
Six Sigma Module
The training breaks it down into white belt, yellow belt, green belt, and black belt. Oh, and master black belt. I've heard of one healthcare organization that also has blue belts. Too many belts! I like to refer people to Mike Micklewright's article “Black Belt for Sale” that calls this whole setup “elitist.” The training I'm watching says “these belts enhance the workplace.” Those “belts” (really, they are people) can also drive people crazy if they're trying to change the process without involving everyone.
In the “Control” phase, the thing I don't like is the idea of “we hand the process back to the process owner.” Why was the “process owner” ever out of the loop??? I think the Lean methodology does a much better job of getting the process owner involved to better understand their process and to know how to better manage it.
I don't want management trained as “champions” who get to “sponsor” a project and then run away — managers just lead improvement and learn how to do Kaizen – that's an important lesson from Toyota. Leadership requires more than what's pitched here in the Six Sigma training “create budgets and hold people accountable.” That's old-fashioned top-down command-and-control style management and it's not effective.
Speaking of “control.” I've always thought the “C” should stand for “Continuously Improve” not “Control” but that's a different blog post altogether (and I'll point you to my buddy Ron's). Do traditional managers (command-and-control types) like Six Sigma because of the word ‘Control' in DMAIC? It speaks to them?
Note: The guy who did this training has a Six Sigma background, he's a “Master Black Belt.” No more hints or clues about the trainer is or what his web address is. I'm not feeling that sick, or that mean.
The Lean Module
I don't know if I have the strength to watch the full-blown Lean module. Before it starts, I'm wondering if there will be three outright untruths or L.A.M.E. moments or more? Will the module mention quality? Will it mention “respect for people”?
OK, so quality is shown in a diagram. It's mentioned. “Highest Quality Patient Care” is a good goal of Lean healthcare.
The main problem he lays out is “too many tasks aren't standardized.” Wait, I thought that was the “process control” module that provided answers to that, now it's “Lean?”
Again, it's portrayed and draw as just a collection “of Lean tools.” No mention of management system or culture.
OK, +1 for encouraging people (the lowly white belts) to “learn by doing.” The trainer says the “higher level belts will be pleased.” Good grief. Elitism. -1 for using the same Chinese proverb twice in 20 minutes.
-100 for the the trainer saying we should use all of our senses for learning, including “tasting.” Um, probably not a good idea to use “tasting” in a hospital or any workplace!
+1 for “Lean is not about workforce reductions and eliminating people.” +1 for saying that Lean can be a growth strategy to create new opportunities.
+1 for saying lack of employee engagement is the 8th type of waste.
Process Control Module
Meh, I don't feel like watching this after the first modules. Diving into the details of Attributes and Variable data…
The Quiz
There is a 10-question multiple choice quiz, which I think they give you three chances to pass. The quiz is free, so I took it.
Question three nearly made me vomit (do I have the flu instead of a cold, I wonder?)
I'm sorry, I'm trying to keep my “respect for people” hat on, but that's just terrible. That's a really bad quiz to give those as the two choices for a definition of Lean. How can you get 100% on a test when the answer choices are incorrect?
To say Lean is just “speed and efficiency”, again, is factually incorrect. You don't need “Six Sigma” to fill in the quality piece – Lean is both quality AND efficiency (or, better, “effectiveness”).
As I completed the quiz form, I pulled my favorite “Homer Simpson filling out a form” moment (he did this in an episode filling out a job application or something):
Summary
This whole white experience reminds me of the MasterCard commercials:
- Online training course, free.
- Lean healthcare white belt test, $20.
- Lean healthcare white belt certificate? Priceless? Nope, worthless.
Seriously, they claim “the white belt certification is recognized throughout the world.” Not really. Please don't waste your money on training like this.
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Awesome share! Thank you very much
Mark,
Thanks for keeping it real. When we get past the politics and ego (easier said than done), then we can get into what really makes a difference for people. I think pseudo-quality jargon professing lean or six sigma people are even more dangerous than the executives we are so quick to blame as not leading by doing, but trying to delegate. The lean practitioners are supposed to know better, that is supposed to be their JOB!!!! I am not letting the execs off the hook by the way…just a different learning curve, we have to be better teachers.
I shared the link/video with a friend who reviewed it and he said (with permission to share):
“After reviewing the first training video, I think that you were actually being kind in some of your comments. It is important that people are aware of the LAME training that is out there and you did a great job at making your readers aware of this fact. I would also highlight some of the good lean training programs (i.e. LEI, PRHI, University of Michigan, etc.).”
Agree the teaching is pretty poor, but I wouldn’t get so anti Six Sigma.
Six Sigma solves a specific problem (excessive variation against a customer spec) but it only solves one problem – hence Lean which is a better approach for long term cultural change. Both are needed in their respective places.
Do we really think Motorola, having discovered its pagers were so crap that they would be out of business in months, would have said “Let’s do it Toyota style and build up a decentralised approach over years?”
Lean suffers the weakness that the only ‘eyes’ on whether problems are actually being addressed are the human eyes on the gemba.
That’s great, but who picks up whether differences actually are real?
A lot of Lean practitioners have a dangerous lack of understanding of statistical concepts like random, significance or trend, for example. So a little bit of Six Sigma can keep Lean on its toes too, which helps.
As for belts (and yes, I have one) it’s something I wish the industry didn’t have – but it’s there now. I like Michael Balle’s quote “there is no expertise in Lean, only experience” – but what do you do when you change jobs? The perception from a lot of outsiders to Toyota is that it’s a happy family, so happy you wouldn’t want to leave – but how do they support themselves when they do leave the family?
Why do Shook, Womack and co adopt terms like Sensei, if they are not as concerned as Six Sigma people are about status.
Message – Lean is great, and probably better in the long run for sustainable improvement, but don’t lose the key lessons of
Richard-
I’m not really anti Six Sigma. I have a good statistics education (formal and workplace-based) and I see value. I know Six Sigma gets a bad rap from some of the excesses or bad behavior, as happens with Lean.
Six Sigma has a good role to play for the right problems. I agree with you that Lean is more of a long-term culture play.
I just think the belt business, in particular, verges on self parody when companies start inventing blue belts and 7 different levels.
Thanks for the comment.
Mark
I also like to build my understanding of both Lean and Six Sigma within Dave Snowdon’s Cynefin framework – within the four domains of simple, complicated, complex and chaotic, neither Lean nor Six Sigma are appropriate within the complex and chaotic domains. Cause and effect are visible in the complex domain, but only in hindsight, so therefore Lean by definition can’t work. Nor will Six Sigma.
And the DMAIC system may help in the chaotic domain, if it gives senior management the ability to throw off the garbage (the things the organisation shouldn’t be doing at all) and focus efforts and what is known for certain and can be dealt with versus the other things that can’t.
People in the private sector might not be used to concepts like complexity or chaos but in government, healthcare or military they will understand all too well.
Toyota has made TPS work well in a complicated but not complex environment – but you wouldn’t want to stretch it past breaking point.
Thanks for your comment Mark and I always appreciate reading your blog.
On the belt issue, interestingly while the concept comes from Japan, its application was by Americans; while Lean comes from Japan and the Lean/TPS originators did not see fit to use belts.
I hate saying business differences are cultural – but I’m sure that is an example of one.
Why do Americans have to be so competitive – I’m better than you – rather than cooperative – how can we all work together to make ALL our businesses better?
As my brain ages and I start getting systems thinking more – and start falling for The Matrix type explanations – I wonder if the USA “doesn’t get it” that individuals are just ‘loci’ of activity and thought phenomena – and that people aren’t actually ‘in control’ over their own outcomes as much as they think they are.
If they actually accepted a form of enlightened self-interest that everyone’s welfare is improved by cooperation rather than conflict…[/rant].
I actually went through this intro program and found the basics to be sound. Unfortunately I have yet to find another program that brings an introductory level of training, such as this. Within an hour my staff was able to get a good understanding and with the certification being optional, they were under no obligation to pay the fee.
The author mentions speed and efficiency as well as variation reduction as part of lean. The focus of lean was on waste and inefficiencies, while process control was on variation reduction. Complimentary tools that can be used for both.
Lastly, kudos for the HOSPITAL acronym. Healthcare needs more tools such as these. I found the examples to be spot on.
Fake email address, I smell a shill for the company offering the bad training.