Mistake Proofing – The Foul Pole in Baseball

What is mistake proofing?  Well, mistake-proofing to me (poka-yoke is the japanese term generally associated with this) is to make it impossible for someone to make a mistake.  Let’s talk about what mistake-proofing is NOT.  It is NOT dumb-proof, since if we use this term (“dumb-proof”), we are implying people are dumb.  One of the tenets of lean is Respect for People, or, as the Shingo Model calls it “Respect Every Individual” and, as such, we do not point fingers at people, but instead look at Continue reading →

Relevant Tweets from #SHS2015

Last week, I attended the #SHS2015 conference (Healthcare Systems Process Improvement Conference).  It was great, just as I expected.  This event continues to improve year after year.  This was my first year twitting at the event.  I managed to amass a decent collection of tweets and retweets and I want to share those with my readers, as well as have a good reference for me for the future. Don’t forget to follow me on Twitter to get updates on all news and content about healthcare Continue reading →

Theory of Constraints

These days of Healthcare reform are requiring organizations to look at their existing processes and improve them.  We sometimes hear words like “efficiency” or “productivity” following the “improve” piece.  In my interactions with many healthcare organizations, it sometimes amazes me that people, very smart people, very often think that the only way to improve throughput of a process is to throw more resources at it.  “We need more staff“, is a familiar cry for help we have heard often.  Every time I hear this, however, Continue reading →

Box 3 Thinking

Today’s post is not my average post talking about lean concepts and examples of how I see these concepts used in industries ranging from manufacturing to healthcare, nonprofits and government. Today I want to share with my readers the good fortune I had last week.  I had the opportunity to observe a talk by a gentleman who has been ranked #3 in the list of Greatest Business Thinkers of our time.  He has written books that have been #1 in the Wall Street Journal Best Sellers list.  I am Continue reading →

We can never have too much communication

What are the three foundational elements of successful change?  Communication, communication, communication. In any continuous improvement culture, there is change, and hopefully a lot of it.  In fact, kaizen, in Japanese means “good change” (change for the better).  On an earlier post, I talked about a few Change Management Secrets and my main focus was the same as today’s post: communication. When we are trying to drive improvement, we need to communicate three things: Communicate that the change is coming Communicate while you are performing the Continue reading →

Taking the name of Standardization in vain

I am a big proponent of standardization.  In fact, I often call it “my one-string banjo”.  When I made the move from the aerospace industry to healthcare, I was appalled at the lack of standardization and resistance to it.  I have been quoted as saying, “there are 7 CRNA’s performing the process 9 different ways”, because not even one person does it the same from one time to the next! There are many opportunities for standardization in healthcare.  But that does not mean “cookbook medicine”.  Continue reading →

Adding Value: The Three C’s

This is the second part of the post I started last week about Adding Value. Last week we talked about how to recognize waste and the seven (or nine) waste categories.  If you need a refresher, take a few minutes to review it. Now that we have a way to identify waste, let’s talk about how we define value.  If you look up the definition of value, you will find that value is “the importance, worth or usefulness of something”.  That is exactly how we, Continue reading →

Adding Value: Recognizing Waste

This is Part 1 of a two-part post about how to identify value, and  its nemesis: waste.  If you want to jump ahead and find out how you can determine value, read Part 2. If #Lean can be defined as “the relentless elimination of waste in pursuit of perfection”, we must be able to distinguish between waste and what is not waste, i.e., value.  Waste (“muda“, in Japanese) is everything that does not add value.  These are activities, processes that just consume resources (people, time, Continue reading →

No substitute for the gemba

“gemba”, like many terms used in the Lean philosophy, is a Japanese word. gemba     noun : the real place; the place where the action is; used in business to refer to the place where value is created or where the work is actually taking place During a recent improvement project at a hospital, I was part of a team tasked with mapping a process for cleaning out intubation scopes.  Our client had gone very briefly over the process during our introductory meeting and we had Continue reading →

Not even Major League Baseball is above “Resistance to Change”

Here I am watching the Major League Baseball All-Star Game in Minneapolis and as they interviewed Commissioner Bud Selig about his legacy (he is set to retire in January 2015), he said: ““The changes were painful and it took a while…”  “Baseball was always resistant to change, but… we are a long way from where we were in 1992”.  And that made me think back about my earlier post about change and it is just more confirmation of what I said that “everybody resists change”. Continue reading →