Tag: Culture

Mark's Note: I asked my firiend Sam Selay to write a blog post on this topic after some private discussions that we had. He agreed and shared this post. I've talked to many others who have run into similar roadblocks and frustrations when trying, with the best of intentions, to bring their Lean skills and experience into healthcare. Sam was one of the contributing authors to the anthology "Practicing Lean," which is now available through Apple iBooks, in addition to Amazon (Kindle and paperback), and Leanpub (eBook and audiobook). Here is his post: In June, I was informed by my employer that the company had decided to go in a new direction. They said they would now build lean into their processes and enable process owners to be responsible for all continuous improvement functions. To date, I don’t know many organizations that have been able to successfully embed lean into everyone’s work and sustain it.

My guest for Episode 311 is Jess Orr, a continuous improvement practitioner at WestRock, a large paper and packaging company, where she helps plants foster a culture of continuous improvement and employee engagement. \Her experience includes working directly for Toyota Motor Manufacturing Kentucky. She is particularly passionate about sharing best practices across industries, which motivated her to found Yokoten Learning. In today's episode, we talk about her path from Six Sigma Black Belt to a Lean-thinking engineer at Toyota. How did she progress from solving problems herself to developing others? We'll talk about a blog post that she wrote for this blog earlier this year, Lean and ROI, leadership and culture, and much more. What is it like working outside of Toyota again? I hope you enjoy the discussion.

Joining me again for Episode 310 is Stephen M. Shortell Ph.D., MPH, MBA. He is Blue Cross of California Distinguished Professorship, HPM and is a Professor of Organizational Behavior at the University of California, Berkeley School of Public Health.  He was previously a guest on Episode 267 talking about the establishment of the Center for Lean Engagement and Research (CLEAR) at the University of California, Berkeley, where he is the director.  In this episode, we talk about some initial research that they released in a paper that was published in The Joint Commision Journal on Quality and Patient Safety: "Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results From a National Survey"

For a long time, I've been an advocate for the parallels between Lean and an approach called "Just Culture." See previous blog posts on this topic. Here's a good overview of Just Culture, which says, in part: "A just culture recognizes that individual practitioners should not be held accountable for system failings over which they have no control. A just culture also recognizes that many individual or active errors represent predictable interactions between human operators and the system in which they work. However, in contrast to a culture that touts no blame as its governing principle, a just culture does not tolerate conscious disregard of clear risks to patients or gross misconduct, such as falsifying a record, performing professional duties while intoxicated, etc."

The first thing that prompted me to write this post is an interesting article about Toyota and their Georgetown, Kentucky plant that's known as TMMK (via Ward's Auto): "New Lexus Big Test for Toyota’s Georgetown Plant and Its New Manager" How does their approach and mindset seem to differ from Tesla?

I'm often reminded of three challenging questions that are asked by Paul O'Neill, former CEO of Alcoa and former US Treasury Secretary.  I've mentioned the questions before, in this blog post about Eric Ries and an employee's bill of rights. See more blog posts and my podcast with Mr. O'Neill. Sadly, I'm reminded of the questions when I'm around people who cannot answer "yes" to them in healthcare workplaces. This is a widespread problem.

Tesla CEO Elon Musk has been quoted as saying he will "school Toyota on Lean manufacturing." OK, let's take inspiration and lessons from the apparent Tesla Way management system. What would happen if hospitals and other organizations tried emulating Tesla instead of Toyota? What are the methods and mindsets? The behaviors and principles? What's the management approach and culture?

Recently, I blogged about a quality catastrophe that I lived through at GM just over 20 years ago, at the now-closed GM Livonia Engine Plant. Bluntly, the quality problems were caused by poor management and the side effects of their decisions. Even though they constantly blamed workers, management directly interfered with workers and engineers being able to do the right thing for quality. Here is Part 2 of that story... the first quality "spill" took place in April 1996. As I wrote about last time, Angry high-horse memos were sent out by management. Workers were told to have pride and to pay closer attention to quality (as if those had been the problems).

When surgeons have no better options than complaining about process problems on LinkedIn, are their leaders and organizations really properly supporting them? In this post, we'll explore questions of blame, accountability, and engaging people in process improvement... being of better service to them.

After I kicked off the Lean Six Sigma World Conference this week, I had the fantastic opportunity to hear the now-legendary Captain Chesley "Sully" Sullenberger...

Joining me for Episode #303 is Craig Deao, a senior leader with Studer Group. Today, we're talking about his book The E-Factor: How Engaged Patients, Clinicians, Leaders, and Employees Will Transform Healthcare. We'll talk about the differences between satisfaction and engagement, how to tell if people are engaged in their work, and how to engage various stakeholders, including employees, clinicians, and executives. We'll also talk about how Studer Group became a recipient of the Malcolm Baldridge National Quality Award in 2010.

Last week, a nurse manager downloaded the free first chapter of my book Lean Hospitals and wrote this message in the contact form: "Interested to see how the disconnect between management and the staff supervised can be helped. Too many managers refuse to help those they supervise. A growing number have never done the work that they are in charge of getting done. Patients and residents feel it, not healthy. Poor PR. It does get back to the consumer. Difficult to fix at that point." In my experience working with many hospitals, her comments resonate with me. Identifying problems like these doesn't mean Lean provides easy solutions for organizational transformation.