DailyKaizen

I was fortunate to catch up with Lee over the phone today, myself in Logan Circle, him in Seattle somewhere….I can tell that our experiences are bifurcating, in a very complimentary way. As he’s going to discuss, he’ll be involved in an organizational-level transformation to LEAN. I’m involved a journey of breadth, rather than depth, connecting with health care organizations that are very different than ours - the 97% of health care that is provided outside of model systems like ours. Instead of ready access to sensei, an Intranet with downloadable tools, and visual displays all around me, I’ll be self-teaching, searching for answers, and trying a bunch of new things that may or may not work in the majority of US Health Care. Hopefully, we’ll then meet in the middle, with enough breadth and depth to appeal to every patient and care provider in every health system. Only 5 months to do this, and if 5 months isn’t enough, then I’ll just think of a month being equal to 5 years. With an extra 5 year buffer.

One little self-teach for me surrounded the definition of “Plan” in “PDCA,” which I had to ask Lee about. Yesterday, I convened an advisory group for the work I’m doing here and was asked a great question. It was (I’m paraphrasing), “Ted, if you say that 80% of time in a Toyota Model is spent on Planning, and this is the majority of your PDCA cycle, you’ll be challenged to have relevance in policy, because without anything to point to as actually happening, your work will be less compelling.” I left the discussion with a discrepancy - diligent planning is good, PDCA cycles are good. Which is it?

Lee talked me off the ledge on this one by explaining that for senior leaders, Planning is actually a cycle, which includes the strategy, checking on the strategy, and adjusting it, continually. Within this, PDCA cycles are running, so that product is being created and improved. The point is that leaders in a LEAN world do not create a plan and then send it off to be acted on and check on it way down the line. They stay attached to it and adjust it, even if they aren’t “do”-ing the work. So “P” from “PDCA” is not the same as “P” from “Planning Cycle.” For my work then, I should be checking and adjusting frequently, and not keep doing things the same way based on a plan we created several months ago. Given the cadence of what I’m doing, 30 days is actually a good term. Comments on this question/dilemma are welcome of course.

In the course of writing this post, I also realized that I shouldn’t lament the lack of visual systems around me - I should create them for my project and put them up now. As it is said, “If you don’t like the news, go out and make your own.”

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