DailyKaizen

Last week I wrote this quote down after seeing it on the wall at a Sushi Bar.  It was made for me.

“Tell me and I`ll forget, show me and I may remember, involve me and I`ll understand.”

As I mentioned earlier, I am currently working at our Capitol Hill specialty center, with our gastroenterology department. I am part of a cross functional team working on a specific patient care improvement project. We would like to automate a manual process using our sparkling electronic medical record. We’ve been steadily working at defining the triggers and workflow to make things happen. Then, the floor fell out from under us. A key assumption we made about how the system worked was not borne out in our testing.

I was rehearsing the discussion we would have with my specialty colleagues that we could not deliver the functionality we intended to. Depression started to set in, even on this sunny Seattle day.

Later in the day, I called our Team Lead. I asked how he was doing, he said, “Great, actually.” He sounded surprisingly optimistic. And he had reason to be. The team figured out how to make things work when they put their heads together.

What was this experience like for me? It was thrilling. I knew the impact of getting this done after having spent 2 weeks with our specialists. I knew what it meant to our team to figure this out. I knew the benefit of the confidence this will instill in all of us moving forward.

Eureka.

I am going to be speaking at a National Conference on Quality in early July to Health Care Quality Directors, Providers and Consultants on what Group Health has been doing “with this LEAN thing.” Last night I finished up my PowerPoint for the presentation. This gave me the opportunity to reflect on how far we have come in a year on our LEAN journey, and how far we still need to go. One year ago today we had only worked with two departments and only a handful of employees. In the last year we have worked with more then fifteen departments and touched hundred of employees. Our projects not only include clinical areas, but also administrative, sales, finance, and information systems.

In retrospect it seems like we have come a long way, but every morning on my way to work I feel a great urgency. With every improvement that we make we uncover ten more problems that we need to address. The potential is energizing, but the task is daunting. To be successful in our journey we need to energize all of our staff to own and lead improvement from where they work. We need to not only re-engineer our processes, but also change the behaviors that shape our culture.

I don’t know the answer here. But it’s an interesting question. Probably one worth asking the “five whys?” I assume that if employees worked together in cross functional teams, maybe water cooler chats would be unnecessary. From our experience to date, I feel like I have improved productivity and bonded with staff members far better by working on challenging projects.

Are Water Cooler Chats A Boon for Productivity?

I attended a Kaizen today and during visioning several memebers of the team questioned the need for standard work.  It was in their opinion that standard work leads to less creativity and they “did not come to work to be robots.”  It was amazing to me how passionate they were about keeping standards out of their work.  A year ago I would have tried to sell the value of standard work to them, but today I simply asked them whether our patients would agree with their logic.  Nobody had a good response.

My parents are in town so I am taking a couple days off to explore the cascades with them.  It will be a much needed break and an opportunity to reflect on how far we have come and how far we still need to go.  Here is a quote for the road:

“We choose to go…not because it is easy, but because it is hard, because that goal will serve to measure and organize the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win.”

—JFK

Today I dropped in and spent some time with the team that works in the process we focused on during last week’s Kaizen. About half of the changes have been implemented and many more changes will go live over the next couple of days once people have been trained to the new standard work. Often the week after the Kaizen is a taxing one for a team due to being tired from the Kaizen and fatigue from all of the changes. Walking into the work environment today it was immediately evident that this was not the case with this team. There was a ton of energy in the room and many staff mentioned how amazing it was that “changes they had been trying to make for years had finally come to fruition.” It was energizing to steal their energy. The next couple of weeks will be hard, because the changes are so transformations, but I am confident they will be successful. If the team keeps their energy up there is no telling how successful they will be.

Technology is magical. I am writing this as I hike through Seattle’s Interlaken Park to get to our Capitol Hill specialty center. (I haven’t figured out another way to get up the massive hill)
Because I am going to a rapid process improvement (RPI). My thoughts are much different than if I was going to “the office.” Instead of going over all the things I need to do, I am thinking of all of the things I hope to learn and all of the ways I hope to help our patients, nurses, and doctors. I have no idea what I’ll be doing an hour from now. Just that I’ll be meeting new people, people I’ve known, and we’re going to make our care system better.
What a different job description than the one I started this job with. I can’t believe I get paid for this on top.

In reading about various management approaches, I was referred to an article in the November 6, 2005 edition of USA Today “Generation Y They’ve arrived at work with a new attitude.”

One quote I particularly liked it the following:

“Generation Y is much less likely to respond to the traditional command-and-control type of management still popular in much of today’s workforce,” says Jordan Kaplan, an associate managerial science professor at Long Island University-Brooklyn in New York. “They’ve grown up questioning their parents, and now they’re questioning their employers. They don’t know how to shut up, which is great, but that’s aggravating to the 50-year-old manager who says, ‘Do it and do it now.’”

When we think about the staff that we work with today, we need to think about the staff we are working with tomorrow. It’s estimated that Gen Y individuals were born between 1978 and 2000. This means that some of these individuals are now entering the medical profession as physicians and nurses and other staff.

Source:”Generation Y They’ve arrived at work with a new attitude.” (MONEY) USA Today, Nov 7, 2005 p01B.

So I got this quote by Jack Welch in an email from the blog’s co-author and I love it so much I am going to steal it for the Quote of the week.

“Your goal, in other words, should be to make your bosses smarter, your team more effective, and the whole company more competitive because of your energy, creativity, and insights. And you thought school was hard!”
PS–We finished the Kaizen today in ISD with the following highlights:

• 75% less process steps
• 13 down to 4 handoffs
• 14 down to 3 checking steps
• Requests completed in 5 not 11 days

Way to go Team!