Hi, this is Mark Raven. Welcome to episode 249 of lean
blog audio. This is a post from February
2nd, 2018 titled, employee complaints about lean and
Healthcare, even at some of the best organizations.
Now, recently, I blogged about some employee complaints related
to rotating day and night shifts at the Toyota, San Antonio plant
in that post, I mentioned that employees who post on
glassdoor.com and other sites might not be a representative
sample of the full employee population.
So with that in mind though, what happens when we search the
glass door, surveys of some well-known lean hospitals, quote
unquote, I posted a few of those employee comments on LinkedIn.
The other day is a short post, that's received over 50,000
views and prompted, a lot of discussion.
One of the employee comments about a health system that many
would consider to be a long time in leader, in lean Healthcare
said, the employee complaint read.
Management needs to have a better understanding of the work
because this Health Systems lean culture changes are made on a
continual basis by people, not in the work and who don't
understand who is all impacted by the change and of quote, as I
said on LinkedIn in a lean culture.
Improvement is supposed to be done with people or by people,
it's not supposed to be done to them.
Here's another sad comment from a different well known lean
hospital. It says the hospital has gone
too far and it's attempt to cut costs, many behind the scenes.
Employees work in squalor and are treated like slaves, they
are encouraged to skip lunch and breaks and are in constant fear
of being fired. As a new employee.
It only takes a few days to realize that you will be asked
to commit hari-kari if you make an honest mistake, that is the
Japanese parentheses. Lean way and of quote.
Well no no I mean the lean way doesn't blame or punish
individuals for an honest mistake.
I don't understand how the leaders in these organizations
maybe misunderstand lean or or maybe didn't bother to learn.
If even one employee has this perception I guess perception is
the reality is they say we need to do better.
Another employee comment says there's so much focus on lean
and know. So focus on building better
managers. Well, that's sad to hear.
I mean lean is supposed to focus on developing people.
Including managers lean is a different way of leading and
managing not to set a set of tools or projects.
Now are those comments representative of what most
employees? Think?
Well, probably not, but even if even a handful of employees have
major and understandable issues with what they're experiencing
with lean, then that represents an opportunity for improvement.
Do these organizations need to be more consistent with what
lean really is. Do they need to invest in
additional or more capable coaches for those leaders who
are perhaps misunderstanding or Miss applying lean mean we're 20
years into the lean movement in healthcare but there are still
way too many organizations where lean is limited to relatively
trivial things, including straightening up, the workplace,
or having daily Huddle's at the Frontline.
I'd say a majority of those organizations that are quote
unquote. Eating lean don't have
Executives who are actively learning about lean yet alone,
teaching it or modeling. The behaviors would want to see
in an effectively in culture. So what health systems are these
employee comments about? Well, it kind of makes me harken
back to a scene from the movie Fight Club.
A major one is Ed Norton character set in the movie.
Actually, it's major ones here are some of the comments from
LinkedIn about my post and those employee.
Kevin pots. Wrote leader, should be the
teachers and developers of their direct reports in lean.
This can't happen if the leader is vacant or misinformed on lean
who was or where is the teacher of the leader, what is their
understanding of lien could questions.
Terrence T Burton wrote many of these and similar comments are
testimony to a failed lean approach in healthcare.
Many consultants simply ported over the tools and methodologies
for manufacturing and implemented lean as quote.
Unquote imposed Improvement program.
They did not take the time to understand the unique Health
Care industry and adapt continuous Improvement to a very
different organization and cultural environment.
I too have, heard many comments like we finished lean five years
ago, and I've heard about the silly lean demonstrations, like
setting up a pole system to replenish yogurt and putting on
the floors having nurses wear a rainbow of color, coded
bracelets, and many other things that have not impressed the
Listen, clinician, staff lean is viewed by many as getting, in
the way of patient care. I went for blood work a few
weeks ago, and talked to the nurse about the hospital's
previous lean initiative. She said, I'm glad it's over and
don't want anything to do with lean.
So the big question, how do you resurrect lean and CI and
Healthcare is the accepted daily cultural standard of thinking
and working the need for improvement.
Did not go away. It's greater than ever before
James C, Larson reporting, Wrote a big part of the problem is Six
Sigma and lean or often used as tools to the self aggrandizement
of an elite few. These people espoused values
like quality and patient centeredness but what they
really value is power and money the True Value creators and
Healthcare are the people who get the job done.
The doctors nurses Tech's housekeepers Cooks, AIDS billers
Etc, when Executives and managers value these people.
That's when the magic happens. Kenneth stem wrote the failures
of land are caused by the same reasons.
For the failure of tqm back in the 80s, a vast majority of
upper management views lean as a set of tools to be implemented,
Deming used to rail against the whole concept of implementing
quality management. The same thing is happening now,
sadly, most upper managers believe they already know all
there is to know and therefore fail to realize that their job
is to deliver value to the customer, develop people and
drive out waste throughout the Many would agree.
But what most managers do not understand is that there is no
known answer, how to specifically do each of those.
In other words, we must learn. I would add we must practice
lien, which is why number of us, wrote a book called practicing
lean, which you can find at www.pricescion.com by the way.
And his comment reminded me about.
I think a still relevant book from 1994 about tqm failures.
Something that I blogged about you can find a link to that blog
post. The parallels between tqm
failures and lean failures. You can go to lean blog dot org,
slash audio. 249 a few other comments here.
Todd McCann, wrote people who do the work should be the idea
generators to improve the work if they need help leaders, clear
the way not stand in the way or create barriers for patient
care, man. Even if change outside, the span
of control should be managed and leaders should be stepping up to
ensure, positive outcomes. Focus on the patient while set
final comment, Holly Barrett. She wrote as the leader of a
large Global organization. I became a lean student and
Zealot. The day, I participated in a
structured direct observation of work performed by some of my
more Junior Finance employees. I'll add a comment.
This was at Intel where Holly worked for a long time.
Tapping into those experts using Kaizen events to improve the
quality and efficiency of the work was invaluable their
results. Far exceeded those, a top-down
approach, would have delivered and with minimal resistance to
the changes because the buy-in was quote-unquote designed in.
So I'm curious to hear what your thoughts and reactions are and
you can go to lean blog dot org. Slash audio 249 to join the
conversation.