Hi, this is Mark Raven. Welcome to episode 280 of Liam
blog audio. This is going back to a post
that was published on. May 31st 2019.
It's titled. When having a process
Improvement idea means you're weak the question mark, so I
guess I'm wired for improvement or it's just become a habit or
it's both. I mean I celebrate moments when
I can identify an opportunity for improvement in my work.
I tend to be pretty transparent about problems and Even
mistakes. Like the time, I forgot my socks
and that's something. I something I blogged about.
I haven't made that mistake since if you want to read that
blog post or seed links to other stuff I mentioned here you can
go to lean blog dot org slash 280.
I'm sorry. That's lean blog dot org.
Slash audio 280. There's a mistake.
I didn't plan on doing that. It just happened.
But if you're a regular listener to this podcast, you know, the
link is always lean blog Dot. Org slash audio and then the
episode number. So anyway, back to the post, the
Toyota ISM of no problems as a problem.
That's that really resonates with me.
I mean, identifying a problem, shouldn't bring blame and shame.
It's the first step in improving the way work is done.
Now. I'm fortunate that we've built a
culture at Connexus where problems and opportunities or
celebrated. It's safe for people to speak up
and problems lead to Improvement.
Not punishment. Our book Healthcare Kaizen that
I wrote with Joe schwarcz that book, share, stories and
examples from organizations that have built a strong and
sustained culture of continuous Improvement.
Like his self Health System, Franciscan Saint Francis.
And by the way, I'll interrupt and mention you can come and
visit Franciscan in October. We do this great site.
Visit. This is the fourth time.
We're doing it. You can learn more by going to
www.hsn live.com. So anyway, you know, with that
culture. A Franciscan and other places.
I almost take it for. Granted that Improvement is a
positive thing. But I sometimes get reminders of
the challenges that people face when working in an organization
that is not a culture of continuous Improvement twice.
Now, in recent weeks. I've heard a story from
Healthcare professionals, one American and one on another
continent, one of them a nurse, you know, she's the type who
seems wired for improvement. She tries speaking up.
She aims to be constructive and pointing out the ways.
As the work of patient care could be easier, but she gets
told things like, well, this is nursing.
The implication is that she needs to toughen up and get
better at dealing with the waste.
This mindset is really hard for me to wrap my head around.
I mean, I think nursing should include the opportunity to
improve the nursing work. So there's a small real example
from a different organizations. Let's say a nurse notices that
patients ask for ginger ale to drink when they're nauseous and
there's no ginger ale on the Unit.
So the nurse has to go upstairs to a different unit to go get
ginger ale, or the patient's request, maybe doesn't get met.
If the nurse is too busy. It would be easy to say we don't
have any sorry, the nurse points this out to the manager and
suggest it would be nice to stock ginger ale on their unit.
The manager could say things like well, you know, suck it up.
That's the job. Go get the ginger ale even if
that means walking. I mean, nurses today.
I want to have it so easy. Good grief.
And don't you dare say you're too.
Busy to do it. It's part of your job.
That's the end of the made-up lecture there.
But in a culture of continuous Improvement that manager thinks
the nurse for pointing this out without saying things like,
well, why didn't you mention that before?
The manager might contact dietary services to change?
What beverages are delivered to the unit or the manager might
teach staff how to contact dietary Services as needed but
not every organization. Truly Embraces continuous
Improvement. It's sad, you know, it's really
sad to hear a health care. Professional have an idea that
could be implemented right now at little cost only to be told
things like you have to understand.
This is how Healthcare works but it doesn't have to be that way.
The work could be easier. The culture could be better, the
implications of comments like these from managers include how
dare you point out a problem that's offensive or you need to
toughen up or you should be more resilient or Out with that waste
when I was a nurse. So why can't you handle it?
It almost reminds me of the cycles of hazing that happened
in organizations. People say, well, I survive
this. So I'm going to make the Next
Generation suffer through it too.
So again, this is all very puzzling to me.
I'm curious. Have you experienced similar
situations? I mean, how can we help change
this? So if you want to read the post,
if you'd like to share comments, you can go to lean blog dot org,
slash audio 280. There.
I did it right. This time.
So there's a lot of comments and discussion on the post already.
Baba Milian e wrote in part. That hazing is a wonderful way
to express the problem. I've experienced the blame and
shame for identifying problems and multiple contexts past and
present a beat eight wrote in part.
Thank you for shining a light. On this issue.
I've worked in healthcare for 15 years, as a bedside caregiver,
and now in performance Improvement.
I believe the only way this problem can be solved as An
executive team Who quotes from quote-unquote gets it and is
committed to instilling these Concepts into existing
leadership and only hiring new people who already get it or are
willing to learn it. In addition, the executive team
must actively demonstrate the desired behaviors and hold
accountable. Those who don't?
I agree with all of that. Very strongly, Joe Lopez wrote
in part. There's clearly a generational
component here as well, working in a flawed system, for a
lifetime making do in perfecting workarounds.
It gets worn as a personal can do badge, and change can be,
especially difficult for those who have had to work this way.
And then, Dan route from a patient perspective.
He posted a comment. Says, he was in a room for 10
days to get a heart attack. I overheard nurses talking about
having no time to enter patient info into the computer.
They walk 9 to 12 hours per shift.
They told him that's half their time walking to get things and
deliver things, but nobody knew how to do anything to fix it.
And then he Said he shared some observations and the doctor and
nurse team were shocked about his observations.
And he said, it's as if time has stood still 50 years regarding
Improvement, waste teams Etc there what he experienced in
healthcare so we can do better. It is possible to create this
culture. They've done it at Franciscan
st. Francis Health.
And again, if you want to come, visit them with me and Joe
Schwartz and other hosts, there you can learn more by going to
Zen live.com.