DailyKaizen

This might sound simple and obvious to many of you that are more experienced so please accept my apology in advance.  Yesterday, as I sat in the back of the room during our annual leadership conference I reflected on how we were going to begin to change the culture of an organization of 10,000.  During the event our senior leadership engaged in a large scale process of catchball (feedback and enrollment) with 900 managers.  It was the first time anything like this has ever happened.  Basically, senior leaders were opening up the doors to all of the leaders in the organization and sharing real time data about where they are in their learning process, the real challenges we face, and where we need to go next.  It was open, honest, raw and completely transparent. 

It occurred to me that creating transparency was really at the heart of everything we are doing and will do over the next few years.  At all level and for all purposes we need to create an organization of complete transparency.  A transparency in making visible everything from the problems that we face, to the resources that we have within each function, to the competencies or lack there of that we have as leaders.   This openness will allow us to know realistically where we are, where we need to best focus our improvements and what will come next. 

It has already begun in pockets and we have real experience about how hard it will be to accomplish this goal.  At the organizational level we have begun the process of implementing a strategy deployment system.  We are a typical organization that is used to planning within silos and by the budget.  This means that very few people have a broad view of the organization nor do many have a deep view of any function but their own.  Thus as a first step toward focusing and aligning the organization we are asking each leader to make visible their work in progress, their capacity for supporting improvement and their biggest problems.  Only then can we have a realistic foundation by which we can begin to build a plan.

At the work team level we spent the entire year last year working in our Model Line area creating transparency.  We made demand and work-flows visible through the application of Lean tools and visual management.  We mapped value streams and began to measure key metrics for the first time.  And most challenging we implemented standard work and made use of skills matrix that allowed everyone to see how capable they are in supporting their processes.  Our purpose in doing this was not to embarrass anyone or any team.  Our purpose was not to punish those that were not as skilled as others or teams that were not performing as well as others.  Our purpose was to make visible a realistic assessment of how we were performing so that we could focus on the right improvements.  Teams for the first time knew where their problems were.  Team members knew what skills they needed to develop and we could build a plan for them to get them.   But it took a lot of energy to break away from cultural norms that ran counter to our goals.

Through this view I guess you might say that one key principle of Lean is to create complete transparency.   What do you think?

Our Sensei once told me that he knows when right from the start when he begins working with a company whether or not they are really applying Lean.  If he walks in the door and all they can talk about is how great things are and how great they are he knows that if is a charade.  On the other hand, he knows when he has entered a great Lean company right from the start, because they are always the organizations that are the most humble and most open about discussing their problems.  These companies not only have cultures that reward making problems visible, but they also have employees that have been trained to develop a problem consciousness. 

Over the last couple of years it has been very interesting to watch my own organization begin to shift is culture and begin to develop an awareness of its problems.  We are young on this journey, but have made a lot of progress.  At first, it was hard to get leadership to talk about problems in concrete terms.  It was rare that a manager would step forward to ask for help, because this would imply that they were not doing their job.  The culture was not supportive to making problems visible.  I remember when I first started working with the VP of the Model Line area and he began to shift his thinking on management as he spent more time in gemba and more time reflecting on his own behaviors.  He stopped blaming other departments and began to become more open about the problems that were coming from his own operations.  It was like a collective sigh of relief came from all 650 employees under him.  Slowly others began to open up about their own challenges.  He had made it right through example for other to open up. 

I think the organization has made great strides over the last year in following the VP leads.  Every day the conversations seem to become more open and honest.  We still tend to soften problems and often we find ourselves falling back on old behaviors, but overall the organization has learned to become hard on the process and not so hard on the people. 

What has been even more interesting has been watching leaders develop and gain greater consciousness of the problems that they have.  We are now three months into applying the methods of a Hoshin System, which require leaders to bring data and go through root cause analysis.  At the same time many leaders are spending more time in Gemba then they have in the past.  This collectively has allowed the organization to begin to understand not only where the problems are, but the breadth and depth of these problems.  It is not like these problems did not exist before Lean.  We just could not see them, did not understand them or did not think they were problems at all.  For many leaders this transformation is humbling, overwhelming and relieving at the same time.   The more you know, the bigger the challenges you become aware of the better the opportunity to focus on what is most important.  Powerful.

Time, one of the most valuable resources many of us have.  Yet, how many of us treat it like it is?  For the last couple of month I have been working with our Senior Leadership team to standardize their work with a goal of freeing up time to support improvement work.  One our our strategies is to create a standardized calendar for the entire organization which facilitates a cadence and sequencing to checking meeting’s, consolidates oversight meetings, reserves time for being in the Gemba as well as sets up two hours a day (first thing in the morning and lunch time) for “non-meeting zones”. 

The non-meetings zones were created with the intent of reserving time each day for leadership to simply think and reflect.  Variation in management practices and the pace of change had created a situation where most leaders spend 8-10 hours a day moving from one meeting to the next.  Not untypical of most organizations.  The only time leaders seem to have to stop, think, reflect and learn is late at night or on the weekends.  This overburden has all kinds of challenges that don’t need to be explained.

As a consultant in support of this leadership team I have had similar challenges lately.  With enterprise wide support for transformation we suddenly find ourselves moving at a pace far faster then we are used to.  It is rare that I have a minute to spare.  This weekend I had an email exchange with my Sensei about making sure we are building in time to reflect on our own processes to ensure we are learning and making improvements.   In other words, I need to practice what I preach.  Here I am working with leadership to standardize their work and finding time for reflection, and at the same time not taking the time to standardize my own processes and calendar.  Just like them I need time to think and time to reflect.  Time for adjustment….

I wanted to take the time to respond to a recent post that Jon Miller at Gemba Research (http://www.gembapantarei.com/2008/01/the_pros_and_cons_of_model_lines_for_lean_implemen.html) made discussing the pros and cons of starting a Model Line.  This is an excellent and accurate description of Model Lines.  I think I might be able to add some insights in this area having spent the last year and a half working in our organizations Model Line, which by the way was very successful.  Hopefully these insights will help others that are considering using this tool within their organizations.

For those of you unfamiliar a Model Line is a tool organization uses to take a part of an organization and apply Lean thinking, tools and principles deeply in order to increase the rate of transformation.  If done correctly the Model Line then becomes the learning laboratory for the rest of the organization.  Tools can be tested, refined and taken to the larger organization.  Employees can be reassigned to deepen their knowledge and expertise.  And most importantly in our case the organization can learn how to develop a disciplined management system that can then be replicated across the rest of the organization. 

Here are a couple of my insights that we learned along the way that may be helpful to other based on the categories that Jon called out in his posting:

• Building a Model Line:At our organization this was a challenge, because we have a lot of value streams, but they are very different.  Thus we knew that we had to take on a large enough part of the organization that we were able to impact operational, service and professional teams.  Our Model Line included over 85 teams and 650 employees, which is the size of many large companies.  In our case this was necessary, but I would not recommend it for others.
• Resources:When we first kicked off our Model Line we had to make a significant investment in Lean and supporting resources to get it going.  But we approached the Division we were working with a teach to fish philosophy.  We asked that they put skin in the game and give us a couple of their top manager to be trained as Lean consultants and over time integrated this model into their leadership development track.  Thus, they are now almost completely self-sufficient.
• Problem Identification: As we began the planning process for our Model Line we quickly realized that most of the problems that we were going to run into were systems problems and the cause would not be within the control of the Division we were working with.  Thus we knew we needed to have active sponsorship as well as active participation from supporting services like HR. 
• Commitment: When we began the Model Line work we did not have senior leadership commitment for organization wide Lean transformation.  This is exactly why we formed the Model Line.  For a couple of years our leadership struggled with whether or not Lean could be successfully adopted in Healthcare and if it would be a good fit for our culture.  Thus we knew that we needed to transform a large enough part of the organization to show that Lean would work.  At the same time we needed to have a way to educate leadership in an environment that they recognized.  Nothing is more powerful then going on a site visit to your own organization and seeing the difference in employee engagement, member satisfaction and hard business results.  Over time our executive leaders became drawn to our Model Line and spent more and more time learning from the Gemba. 

In conclusion, without having had the Model Line we would never have been able to get to where we are today with a commitment for organization wide Lean transformation!  It has also given us a huge jump start in learning about what works and does not work in our organization’s culture and management system.

A couple key recommendations for those of you considering a Model Line:

• In selecting the area make sure it is contained business unit with a P&L or a value stream.  Do not select a department.
• If you don’t have top leader sponsorship make sure you select an area that has a leader that is willing to take risks, stay the course and open to learning.  Additionally, make sure you have at least a minimum commitment from a senior executive that they will come and check the work personally on a regular cadence.
• Thoroughly capture the current condition before you begin.  Take lots of picture and capture the baseline data.  You will want to promote the success and it will come. 
• Get your communications, HR and Finance groups involved from the beginning.  Without them on board you will have an uphill climb

Good Luck!

 Lee

As I discussed during my last post this week was a big week for the organization and I am glad to report that the event was a success.  Thursday night we concluded our three day session with first draft of the organizations Mother A3’s (strategies) in each of the focus areas.  Today we came into work and everyone was exhausted from the energy expended over the three days.  We spent a couple of hours debriefing and planning the next steps for the organization’s deployment process.  I thought I would take this chance to share some of my own reflections about the week and what is next for the organization.

Overall, it amazes me how fast we are moving.  Just two months ago the decision was made to move forward with Lean as an enterprise-wide management system.  This decision came after many years of experience applying Lean as a tool, testing the waters by sponsoring a model line and long debates.  It was clear this week that the debate over.  The “what” was no longer in question and the “how” was prominent on everyone’s mind.   What a huge relief, since as a consultant I am far more helpful in teaching and coaching around the “how.”  But to be honest, I had to check myself often during the session as I found myself looking for reasons to try and convince others that Lean was the right direction when they were already there.  How gratifying, yet, strange.

It was clear that most participants were excited and overwhelmed at the conclusion of the session.  We spent three solid days talking through our problems, gaps and getting clearer about priorities.  For those that expected to have a polished product (plan) at the end of the session I would bet they went home disappointed.  There was a common realization across the group just how much work we still have to do in order to finish the deployment process.  The deeper we got, the more problems we found, the more work we realized we needed to still do.

At the end of the session the CEO did a great job in summarizing his thoughts.  I thought his final remark was the most powerful and thought I would conclude with sharing it:

‘We all knew coming into this session that we have a lot of challenges that we need to overcome.  Over the last three days we have learned a lot more about what they are.  These challenges may seem overwhelming, but just because we now understand them better does not mean they did not exist before we came into the room three days ago.  We now have a much better idea of what we need to do.’

I will apologize in advance and let folks know that this is going to be a short post, because I still have a lot of prep work to do for a Lean session tomorrow. 

Today was a good day and a key milestone on our Lean journey.   Two months ago our Executive team committed to adopting Lean as an enterprise management system.  As a critical component of this commitment they have asked us to teach them the Strategy Deployment process as well as support the facilitation of the development of one year plans and their deployment.  Over the last two months we have worked hard to prepare for this process.  We have begun to implement leadership standard work at the executive level, we have translated targets and themes from our long term strategic plan into a deployable form and we have done a whole lot of teaching and coaching.   All of this in advance of today and the next two days where we are working with the Executive team and other key business leaders to draft Mother A3’s  (business strategies) for four focus areas of Affordability, Growth, People and Quality.   As an organization we have never been good at focusing our activities and limiting the amount of improvement work that we commit to.  Strategy Deployment provides a new way of working through this challenge, but it will still be a challenge.

Today we focused on getting the participants just in time education so they are prepared to begin developing strategies for the next two days.  In general, I think the team was both excited and overwhelmed by the challenge that will come in the near future.  Not only do they need to execute on the most ambitious strategy in our history, but they have to do it through the application of whole new way of thinking about their work and roles as leaders.   So many of the mental models they have counted on throughout their careers will need to be adjusted.  The good news is that we are all in this together.  We will take the next couple of months one step at a time and check often our progress to ensure we can adjust when needed.  I will fill you all in on the details this weekend.  Stay tuned…

This is a norm we often set during our Lean training and improvement events to get people to break away from the paradigm that improvement always has a price tag.   I have learned over the last couple years just how important it is to set and hold to this norm.  It is always surprising to me how strong the mindset is in American culture that there is a cost to every change or improvement.   How often have you heard ‘If we only had more money or resources we could improve?”  This is a dangerous thinking grown out of complacency and entitlement.  I am always impressed by the rare companies like Toyota that have integrated this norm into their cultures.  I grew up working in family run, small businesses that also practiced this way of working, simply because we have no other choice, there was no extra money.  Scarcity teaches enginuity.

I have been involved in countless planning conversations and brainstorms, at various organizations where every idea for improvement has an associated cost.  Just this last week I talked with a group of managers about a major problem in their area of responsibility.  They had themselves convinced that the purchase of one of several new technologies (for a lot of money each) was the only possible way to solve the problem.  I got a dazed look back from them when I asked if they had explored any options (like simplifying their process) that did not require a large, upfront, investment.  While I left the conversation frustrated, I can’t not afford to in the future.  I need to help these managers and many others learn how to see waste in their processes and the opportunities that are available to them for no cost, but their time and thinking. 

In Healthcare, as well as most industries in this country the luxury of throwing money at problems is not longer viable.  Resources are becoming less and less available.  Most companies are responding by adding cost controls.  Just pick up the newspaper and their are countless examples all over the business page.  These may be necessary, but not sufficient steps.  More importantly, organizations need to teach people how to do more with less and put incentives in place that lead people to take the right actions.  A challenge that we will all be working to solve moving forward…

Happy New Year to everyone!  I am back to work after some excellent time off with many great opportunities to reflect during my many hours snowboarding in the mountains.  I hope you all had some time off as well.

Since it is that time of the year I thought I would take the opportunity to share my new year’s resolutions.  To be honest I have never been very good at living up to my yearly resolutions, so maybe by becoming transparent I will do a little better this year.   Last year I had three work related resolutions and only one did I fulfill.  I hoped to find more time to spend in the field working one-on-one with the consultants that are working for me, but while I did better then the year before I still missed the mark.  I hoped to get more organized and standardize many of my own processes, but only made moderate improvements.  Finally, I pledged to improve my coaching skills, which I think I have done.

So this year I have two new resolutions in additions to the two that I did not accomplish this year.  First, I would like to greatly improve my Lean technical skills.  More specifically I would like to focus on implementing a quality assurance system as well as learning how to put in work leveling and capacity planning systems.  Over the last two years I have skipped many steps in my development as Lean has been embraced by our Senior Leadership team very quickly.  This has meant that I have not had sufficient opportunity to gain real life experience.  If I am every going to be an effective Lean leader I need to role up my sleeves and learn by doing.

Second, I would like to spend more time working with clinical teams that are working in direct patient care.  While I have some experience in this area I would like to supplement it.  For the last two years I have spent most of my time working with Information Services teams, administrative teams, and ancillaries like laboratory and pharmacy.  It is time for me to lead a large scale change in a clinical environment with all of the challenges and rewards that it will bring me. 

I hope next year I can write a post about how for the first time I hit my resolution objectives 100%

Does anyone else want to share their resolutions for the year?