MBOE recap: Gemba walking the Cleveland Clinic

Fisher’s Master of Business Operational Excellence degree program runs a health care-focused cohort on a parallel track. Following her recent recap of a week in the life of the industry cohort, Fisher Senior Lecturer takes a look at the other track through the remainder of the week.

Cleveland Clinic MBOE
MBOE-HC students on a recent gemba walk at the Cleveland Clinic.

The health-care cohort of the MBOE program started its latest week in action with a trip to the Cleveland Clinic, where students visited four different gemba areas: The infusion room at the Mellen Center for Multiple Sclerosis Treatment and Research; the cath lab; Taussig’s Chemotherapy infusion room; and the clinic’s lab building. Students were able to see how using value stream maps and other lean tools these areas achieved higher level efficiency such as creating more appointments, reducing the lead time and creating more capacity. The process improvement leads, what the clinic call embeds, are dedicated to different areas and help doctors, nurses and staff apply process improvement strategies to improve how they do their work. Joe Seestadt and Timothy Pettry, key leaders in the continuous improvement effort, helped organize the gemba visit.

Later in the week, Executive in Residence Gary Butler in the MBOE session on tools, system and principles asked a provocative question: You can delegate responsibility, but can you delegate accountability? The consensus was that accountability comes from internal motivation. This notion that lean is more to the underpinnings of the people and the process is something Butler discussed in a recent MBOE session.

Students also got a look at how lean plays out in the health-care space from speaker Sharon Schweikhart. She pointed out the difference between service and manufacturing and mentioned how the unique characteristics of services are both challenges and opportunities for managing service operations. Those core differences:

  • Intangibility: Usually the outcomes of a service are activities, benefits or satisfactions which are intangible.
  • Perishability: Services are time dependent. E.g. an appointment missed without being filled by another client or an empty seat on the airplane once it takes off.
  • Heterogeneity: Service is delivered by different people whose performance may vary from day to day.
  • Simultaneity: Simultaneous delivery and consumption of services

Schweikhart also mentioned how, unlike manufacturing, a customer participates in the service process as an input. A customer is a co-producer in the operation and as a result customer variation has an impact on the operations. The key to deal with this is to understand the variability, and design systems to accommodate it and leverage it.

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