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?

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.

Understanding the Problem

Picture this:  You’re a leader in an organization, perusing financial and safety reports compiled by managers tasked to boost sales, cut costs, and grow safety and quality. In one report, you see exactly the opposite happening. So what do you do?

You call that manager, have him or her explain why this is happening and he or she insists: “There’s nothing to worry about. That has happened before, it was taken care of and this time it won’t be any different.” You hand out targets and a deadline and ask to stay updated. Case closed.

A great lean leader takes a different path early on in this process. The manager is called in, but the first priority is understanding every messy detail of the problem and making sure he or she does as well. Per the Merriam-Webster dictionary, a problem is “a question raised for inquiry, consideration, or solution.” The word “solution” isn’t last by accident.

While many of us are equipped to be “firefighters” and immediately jump to solutions, that’s tantamount to giving fever-suppressing paracetamol to a hospital patient. The symptom is resolved but the underlying cause is just waiting to come back.

First, we must recognize the type of problem at hand.

Author John Shook in his book Managing to Learn defines two types of problems:

Shook Problem Types
John Shook's Problem Types

It is important to understand that the presenting problem e.g. increase costs, a safety hazard, decreasing sales in some way relates to the way work is designed or being done.

What is the Right Thing to Do?

When I moved to the United States from India nine years ago, an important early addition to my vocabulary was the word “silo.” In agriculture, it’s a structure used for the bulk storage of grains. Outside that trade, though, it’s used widely to describe the compartmentalization that forms inside organizations.

Ohio Silo
Ohio Silo by Mrinalina Gadkari

When I saw a silo for the first time upon moving to Ohio six months ago, I snapped a photo, a reminder to myself and my students of how difficult it would be for departments and units with that mentality to communicate with each other.

This happens in many organizations. Everyone follows protocol in their own department, happy they’re meeting targets set by management. The notion of how one’s job is affecting workers in another department rarely surfaces, nor does a worker’s idea of how his or her job is affecting the overall service, product or customer base. “Us” and “them” sentiments are predominant, as is the phrase, “I followed protocol. It’s not my problem.” But it is. The silo problem is a reality in most organizations in all industries.

So how do you deal with it?

Start by asking a simple question: “What is the right thing to do?” With those seven words, barriers break, people step up and take responsibility and what is “not my problem” becomes everyone’s problem.

As author John Shook writes in his book Managing to Learn, switching from a so-called authority based debate (Who is at fault?) to a responsibility focused conversation (What is the right thing to do?) has a radical impact on decision-making. Consensus forms and decisions are made by focusing on indisputable facts, not projecting blame.

How have you worked to break silos in your organization?