MBOE Recap Week 4: The flow-stoppers

Imagine how a river becomes turbulent as it flows across rocks. A process in the same way can become inefficient or unpredictable due to the multiple roundabouts and rework we force our people to do while providing care to a patient or manufacturing a defect-free product for the customer.  What flows – the water – in a process are people, materials and information. Those rocks are waste, and our MBOE students in their latest on-campus session got a taste – no pun intended – of how it works.

The rocks of waste
The rocks of waste in the river of a process can turn a smooth trip downstream into a wild ride (Photo courtesy WhitewaterRafting.com)

How does the simple act of buying beer affect production? Through his beer game simulation, Prof. James Hill made it possible for the students to experience the monsters that suppliers, manufacturers, wholesalers and retailers have to deal with on a daily basis due to lack of communication. These monsters are many and include the frustration and cost of variable production and the inability to keep up, ultimately leading to customer dissatisfaction and defects.

A sample of the other experts and activities covered in the busy week:

  • Gary Butler walked students through the eight components of inventory and how to balance the production using Heijunka leveling, a lean tool to level production.
  • Jean Cunningham, author of two Shingo Prize winning books – Real Numbers and Easier, Simpler and Faster – exposed the MBOE Healthcare students to the world of lean accounting.
  • Kathryn Correia, CEO of HealthEast in Minnesota and Bill Boyd, value stream manager at Thedacare in Wisconsin, provided an insight on the flow-stoppers in healthcare, helping students identify process gaps in their organizations.
  • Yours truly led a simulation to show the complexities of multiple interactions and handoffs in the processes in an emergency department. Students from both cohorts went through the first round of the simulation to experience the flow-stoppers and applied improvements in the second round to reduce the chaos and unnecessary movements involved in providing care.
  • Barb Bouche, director and adviser,  process improvement at Seattle Children’s and Tom Mooney, manager,  lean transformation at Goodyear tire and rubber company, stressed the importance of efficient flow of materials and supplies to enhance how care or product is delivered to the customer.
  • On Friday morning, a gemba to the Giant Eagle grocery store and pharmacy provided a real-life example of producing to customer demand and shrinking the inventory in the backroom warehouses by increasing the number of delivery runs. Darren Evans and Brian Dorazio from Giant Eagle gave an overview of their lean journey and provided a tour of the store and pharmacy. It was a great example of application of a heijunka board to track the number of prescriptions filled through the day.
  • Finally, COE Executive Director Peg Pennington facilitated inbox simulation to help identify the ‘invisible’ wastes in electronic communication in an office setting.


  •  Stay tuned for the overview of the next MBOE session in June.

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