When opportunity knocks

Any time I see a great lean process at a company or in real life, it looks so natural I’m shocked it wasn’t always that way. That’s probably why I had to read a recent Akron Beacon Journal article featuring Center for Operational Excellence member Akron Children’s Hospital twice before I saw the lean thinking behind the innovation.

Akron Children's Hospital

The Oct. 30 piece by medical writer Cheryl Powell focuses on the growing importance of so-called advanced-practice providers – you know them as nurse practitioners and physician assistants – at Akron Children’s and other hospitals. This is taking place because of restrictions on resident work hours and growing demand for service. Akron Children’s, however, is using that situation to create a lean environment where ownership is shared and the blame game isn’t played. Think about that when you read the anecdotes that open the piece:

“When the medical staff executive committee helps chart the future of Akron Children’s Hospital, nurse practitioners sit side by side with doctors as peers. As the hospital’s pediatric neurosurgeon finishes a complex brain operation, he usually steps back and lets a physician assistant close the child’s head. And if a cancer patient has a problem in the middle of the night, an advanced-practice nurse or physician assistant often provides the care.”

Much of the article focuses on the promising salaries of those advanced-practitioner careers, but what struck me were anecdotes about the Cleveland Clinic, which is using those workers to help patients with less-serious problems, “which frees up doctors’ time to spend with people who have complex problems.” Sounds like standard work to me.

The results, by the way, are the true goal of any standard work implementation: Smooth flow and more time for innovation. The clinic also boasts of higher patient satisfaction and quality scores coupled with lower average stay length and readmissions.

As in any industry, sometimes a problem becomes an opportunity.

‘People are the glue’

Hanging around operations professors for a few months has made me realize I think entirely too little about the small wonders in my everyday life. In short, I’m starting to feel like I should take a moment of awed silence with my iPod Nano before I shuffle to my running mix and hustle down the street. The supply chain for even the simplest product out there (a bottle of water, for one) is really anything but. On a global scale, it’s a tightrope walk of symphonic precision with a healthy dose of interpersonal diplomacy for good measure.

Professor Edward Anderson

It’s that diplomacy that slowly took center stage at the latest supply chain forum hosted by Fisher’s Center for Operational Excellence and featuring Prof. Edward Anderson of the University of Texas. On the surface, Anderson’s presentation to dozens of COE members on campus and streaming live was about the potential potholes that form in distributed product development (COE members can view the webcast here). As he illuminated ways for determining the best strategy to avoid potentially costly problems, a prominent theme emerged: This globe-spanning process doesn’t come down to widgets and machines. It comes down to living, breathing human beings.

And we’re a complicated and costly bunch, Anderson told the crowd.

“People are the glue,” he said. “The problem is, we’re expensive glue.”

This is Spinal Tap stonehenge
this-blog-goes-to-eleven.blogspot.com

Central to Anderson’s presentation was the idea that with the right people in place to manage risks from one boundary to another in product development, the lower the risk of lost money, drained value and public embarrassment.  And these crucial patches aren’t grand gestures – sometimes they’re as simple as hiring someone who knows how to tactfully ensure a supplier’s “i”s are dotted and “t”s are crossed.

A favorite example of mine: If only the titular rockers in the cult mockumentary This is Spinal Tap (pictured above) hired a designer who knew their Stonehenge replica should be 18 feet…not 18 inches.

How has your company used its work force to break down barriers in a supply chain? Have a “Stonehenge moment” you’d like to share?

Kind of a big deal

We’re pretty proud of the successes we’ve seen in just three years running Fisher’s Master of Business Operational Excellence program. And the same can be said of the industry heavy-hitters we line up to give students top-notch wisdom in lean leadership. Among those big deals is John Shook, the CEO of the Lean Enterprise Institute in the Boston area. Modest and easy-going as Shook is, he wouldn’t tell you that, but having him spend a day with our students is like taking a film-school course on westerns with Clint Eastwood as the prof.

Shook was kind enough to sit down with me after a full day of breaking down A3s with the MBOE cohort for a wide-ranging chat on the future of lean and some of his personal experiences (read the full interview). If you don’t know much about him, he spent time in Japan at Toyota Motor Corp. about 30 years ago and, quite simply, is one of the reasons lean is alive and well in the U.S. today.

John Shook Lean Enterprise Institute Fisher MBOE
Photo by Peg Pennington

While our chat was full of insight, one thing Shook said near the end has stuck with me since, and it’s about why companies make mistakes in a lean transformation, and more specifically in using A3s to solve problems. “All lean tools and processes,” he told me, “are like an iceberg. There’s more underneath them that embody different ways of thinking and going about work, and if we just copy the tools it’s possible for us to miss that and be implementing the tool for the tool’s sake.” Shook then referenced an old saying about hammers in search of nails.

He’s not talking about carpentry here. This is the heart of the matter when it comes to lean, the idea that we shouldn’t just be putting out fires (hammering nails) but digging deep behind them to discover what caused that spark. Switching metaphors here: A layer beneath the tip of that iceberg is the crucial root cause.

So what does digging for that root cause, maybe with the help of an A3, do for your company? Shook says it best:

“It helps us solve problems and create a problem-solving culture all at the same time so it can help us choose the right hammer.”

Now I’m a Believer

Unlike my blog-posting colleague, I’m a relative newbie at lean, having spent my years out of college in the newspaper business and only recently making the jump to Fisher’s Center for Operational Excellence. I’ve pored over the Lean Enterprise Institute’s Lean Lexicon, scratched my head at A3s and learned very well how to nod politely at jargon as I scribble down mental notes for later. No amount of memorization, however, has taught me more about the transformative power of a lean approach than my first simulation.

Only weeks into my employment at COE, I joined a small group of my colleagues and employees from member companies for the three-part, day-long effort, hosted by Institute for Lean Systems Executive Director David Veech. My table’s task: To cobble together the hull and carry out final assembly of a Star Wars-inspired Lego aircraft with enough small pieces to strike fear into a playground full of toddlers’ parents.

lego naboo starfighter
An example of the final product in the lean simulation.

With a stack of directions, the first round seemed simple enough, mimicking a batch production system still used by many companies. But when game time came, the results were an unmitigated disaster, wasted pieces and frustrated “factory workers” everywhere. The second round, a simulation of a company partway through a lean transformation, wasn’t much better as purchase orders piled up and attempts at “milk runs” for Lego pieces floundered.

Round three, a simulation of a fully lean enterprise, was catharsis defined. Tasked with picking up a carefully chosen selection of Lego parts for the final product, I flew around the room and handed off deliveries with a smile. Completed Star Wars fighters began piling up and the collective morale – as grim as a Netflix boardroom at times – skyrocketed. Literally and figuratively, the pieces were locking into place. And the jargon made sense.

Only after the dust cleared did I realize it was necessary to feel the intense frustration of a wasteful production system before I could appreciate the logic of lean. The problem in many industries today, however, is that operations don’t realize they’re in round one because the status quo is so ingrained. Even once the “Aha!” moment comes, much work remains to be done, and change – even for the better – isn’t easy.

It’s the job of those of who have experienced round three to communicate its value. I’ll certainly never look at Legos the same way again.