Monthly Archive : June 2006
by Ted Eytan, on 06 Jun 2006 04:45 am
The Journey
Day 2 in Washington DC
I am here at the second day of the Agency for Healthcare Research and Quality (AHRQ)¹s annual Patient Safety in Health IT conference. My ears are of course tuned to anything involving LEAN. LEAN has been mentioned once, as a quip of a joke. Something along the line of ³we need to be LEAN, and I¹m not talking in the Toyota Motor way.²
That¹s just great. On the other hand, what does that say about health care¹s interest in transformation? I wish and hope that my professional colleagues will read beyond the headlines and think about how everyone can improve. On the other hand, there will always be room for a change agent or two.
by Lee Fried, on 05 Jun 2006 08:58 am
The Journey
Things are Changing
Last Friday I had the privilege of being invited to a leadership retreat where I got to witness first had how much of an impact LEAN is having on our organization. All six of the initiatives that were presented are grounded in LEAN principles and many are using tools like Value Stream Mapping to uncover waste and increase value. As each executive sponsor took their turn to present it was readily apparent from their language and their strategies that they now used LEAN principles to view and execute their work. The group discussion and questions the followed each presentation were also a demonstration in how far the organization had come in a short period of time. Statements like “optimize the whole”, take a “long-term approach” and from the “patients perspective” were sprinkled throughout the discussion.
A year ago I doubt there would have been nearly as much excitement in the room. The discussion would have most likely been based in the budget and short-term focused. I love to see transformation in action!
by Ted Eytan, on 05 Jun 2006 06:16 am
The Journey
Is the public ready to hear the “L” word?
I am visiting Washington, DC, this week, to learn more about advances in health care information technology and its application to patient safety.
On the ride over, I was reading the CEO’s monthly column in Alaska Airlines magazine. The subject of the article was the fact that Alaska is committing itself to a 100% Boeing built fleet.
Toward the end of the article, though, he mentioned that Boeing was also providing other services to Alaska - assistance with “lean” management processes. Right there in the article.
Up to this point, I have not seen “lean” referred to as lean in communications geared toward the public. Could it be that “lean” is understandable enough in Alaska’s culture that they feel comfortable sharing it with their customers?
I think this is a big advance.
by Lee Fried, on 02 Jun 2006 01:59 pm
The Journey
Quote of the day
A good end to a good week requires a good quote. So here it is:
“People are always blaming their circumstances for what they are. I don’t believe in circumstances. The people who get on in this world are the people who get up and look for the circumstances they want, and, if they can’t find them, make them.
–George Shaw
by Ted Eytan, on 02 Jun 2006 05:41 am
The Journey
LEAN, the Tipping Point, and the Magic Group Size of 150
I just finished reading The Tipping Point by Malcolm Gladwell and was struck by the portion of the book dealing with manageable group size. The theory goes that our brain has a specific “channel capacity” and therefore an ability to comprehend and work with a certain size group. In studies, this is shown to correlate to neocortex size, with the idea being that a bigger neocortex came from a need to work and live with larger groups. The magic number is 150. Beyond that number of people, it is theorized that clans emerge and division occurs. People lose track of members of the group and relationships become fragmented. There is an article on this on the Web.
The company, Gore Associates, makers of Gore-Tex brand, are discussed as an example. It has deliberately capped the size of its plants at 150. Each parking lot has 150 spaces; when people start parking on the grass, a new plant is commissioned. As the story goes, employees within a plant have strong relationships with everyone else in the plant, across disciplines. Engineers know what marketing is doing, for example. An example was given of Lucent, which had a plant of 650 people. In that plant, there was less awareness across disciplines of people’s talents and skills.
This sounded like “cross functional” to me, and it made me think of our medical group, which is about 900 in number. Our competitive advantage is supported by the idea of a group practice. We have natural groupings by medical center of groups typically less than a hundred. What would it be like if there were groups of 150 tied together? Would these groups behave in a cross functional way that would support LEAN methodology in healthcare?
by Ted Eytan, on 01 Jun 2006 01:21 pm
The Journey
LEAN is everywhere I look now
I was delighted to come to work at one of our medical centers this morning and plug my laptop in to this branded power strip. I feel like I am using a piece of the rock.
by Lee Fried, on 01 Jun 2006 08:54 am
The Journey
Growing Up in the Process
I spent some time yesterday with a group of managers that just finished up a LEAN facilitators course. They are really excited to get started in applying the principles to their work area, but are having a difficult time seeing the opportunities. What was interesting is how easy it was for them to identify opportunities in upstream and downstream processes. I told them not to get frustrated. It is always hard to view work differently and it will take time, especially when it is your own work. Employees that grow up in a process, know the history, thus they have a lot of justification for why things are done a certain way, even if its waste. The more they ask why, the more they will be able to see.