CoverMyMeds to share ‘stealth lean’ journey at June COE event

Columbus-based healthcare software maker CoverMyMeds made headlines earlier this year when McKesson Corp. announced a $1.1 billion deal to acquire the company, but it’s been a dynamic player in central Ohio’s tech startup scene for nearly a decade.

Fast-growing and routinely honored as one of the region’s best places to work, CoverMyMeds also has been working to ingrain a culture of continuous improvement into everything from its day-to-day software development to its big-picture strategy. But how does a structured approach to lean and agile thrive in a casual, jeans-day-every-day culture?

The Center for Operational Excellence is thrilled to host for its next IT Leadership Network forum on Tuesday, June 6, two leaders at CoverMyMeds at the forefront of its efforts to drive lean practices: Director of Quality and Risk Management Rick Neighbarger (pictured, right) and Agile Coach Nate Lusher. Neighbarger and Lusher in this wide-ranging discussion will offer insights on:

  • Operational excellence in a startup culture: Driving change in a consensus-building, not top-down, environment;
  • “Stealth lean:” Teaching the tools and behaviors without getting lost in the lingo;
  • Garnering buy-in: Selling change up and down the ladder; and
  • Moving forward in the face of change: Continuing a lean journey after the McKesson deal.

This session not only offers an inside look at the nationally recognized culture at CoverMyMeds but offers insights on leading and sustaining change that leaders can apply no matter the industry or company.

Click here to register for the morning event.

COE Summit 2017: In Pictures

The Center for Operational Excellence launched its first-ever Leading Through Excellence summit in 2013 with a crowd of 200 process excellence leaders – and a vision for bringing together teams from a variety of companies to dive into the latest insights on leadership development and problem solving.

Just this month, COE concluded its fifth-annual summit, smashing records with a sold-out event that brought more than 400 change agents from more than 50 companies to Columbus. Here’s a look back at the event in pictures from photographer Jodi Miller:

Nearly three-dozen breakout sessions, workshops and keynotes take place at the Fawcett Center over Leading Through Excellence‘s three-day span, but hundreds of attendees also head off-site as well. COE member Engineered Profiles, led by President Mike Davis, hosted one of several tours during the summit, offering attendees an inside look at how the manufacturer sustains leader standard work in the plant and office sides of the business.

COE featured a leadership icon in sports – Buckeyes Football Coach Urban Meyer – as one of its keynote speakers. Meyer encouraged the crowd to “empower your people, give them ownership,” outlining how his trademark 10-80-10 philosophy allows him to leverage the talents of his elite players to build excellence throughout the team.

How can the A3 problem-solving structure be leveraged to involve all members of your team and generate discussion? Cal Poly Prof. Eric Olsen took 50 Leading Through Excellence attendees through an interactive workshop exploring lean facilitation methods that can be adopted at any organization.

Keynote speaker Donald Sull, a senior lecturer at the Massachusetts Institute of Technology, brought key insights from his book Simple Rules: How to Thrive in a Complex World. Sull and co-author Kathleen Eisenhardt set out to see how the best companies balance the need for standardization and efficiency with creativity and innovation. Sull offered that “simple solutions aren’t always better than complex ones, but just because it’s complex doesn’t mean it’s better.”

Fisher College of Business students are a vital element of Leading Through Excellence, where they volunteer on tours and introduce speakers and showcase some of their own work. Here, students share takeaways from Six Sigma projects they completed at non-profit and for-profit organizations in the Columbus area.

Dozens of teams from companies across the country – including this group from COE member and summit sponsor Huntington Bank, pictured here with Executive Director Peg Pennington (far left) – use the summit to hit “pause” on their schedules at the office and search for new insights they can use upon their return.

Summit breakout sessions are a mix of insights from Ohio State researchers and presentations from leaders at a wide variety of companies. Here, American Woodmark Corp. CEO Cary Dunston opens up on his journey as a leader and the crucial role of emotional intelligence.

 How can the art of storytelling be used in business to make a case for change? Aditi Patil (pictured, top right image) and Tony West of ThedaCare in their full-day workshop guided attendees on how to blend “hand,” “head” and “heart” to tell impactful stories as leaders.

Fisher Prof. and Associate Dean Elliot Bendoly, one of several faculty researchers featured at the summit, shared results from recent research he’s conducted on how cutting cycle time in different stages of research and development can help – or harm – market performance.

Businesses can’t ignore the digital revolution and have to decide “if you’re going to be the taxi cab or Uber,” keynote and Mindset Digital CEO Debra Jasper says in her presentation. 

Summit closing keynote Chris Yeh, (Buckeye fan and) co-author of The Alliance: Managing Talent in the Networked Age, argued that companies today need to view their employees less as a family and more as a team, empowered to reach outside to their extended networks to help solve tough challenges. “People are your differentiator,” Yeh said.

For a look at all summit photos, head to our Flickr page.

Want to join us in 2018? We’re back April 10-12 with featured keynote and The Power of Habit author Charles Duhigg.

COE Summit 2017: 10 weeks out, 10 things to know

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In just 10 weeks, 400 process excellence leaders from around the country are gathering at the Fawcett Center in Columbus, Ohio, for the Center for Operational Excellence’s fifth-annual Leading Through Excellence summit, a wide-ranging deep dive into problem-solving and leadership insights featuring two-dozen speakers.

Here are 10 things you should know as the April 11-13 event approaches:

We’re 70% booked. Registrations are coming in at a record pace that could lead to a full sell-out before April 1. If you’re considering returning to the summit or joining us for the first time, now’s your opportunity to guarantee your spot and have the best access to available Tuesday workshops and tours.

Early bird pricing ends Feb. 13. Right now, all member and non-member registrations to the summit are automatically discounted by 5%, while groups of five or more that register trigger an additional 5% discount. On Feb. 14, one of those price breaks will vanish, leaving only the group discount on the table. Gather your team now and sign up before then to ensure the best pricing.

fedex_servicesMost breakout sessions are up for view. Leading Through Excellence offers five breakout session windows across April 12-13, with four options during each session. Of the 20 total options, 15 full abstracts are now posted on our website, with the remaining five set to debut by Friday, Feb. 10. Take a look now at what’s being offered and some of the organizations featured, including Cleveland Clinic, Bose, LeanOhio, IBM, LeanCor and FedEx.

debra jasper
Debra Jasper

Another keynote will be announced next Friday. Right now, we’re thrilled to feature Mindset Digital CEO and organizational communication expert Debra Jasper and The Alliance co-author Chris Yeh as keynotes for Leading Through Excellence. If you’re joining us for the Feb. 10 seminar via live-streaming or in person, you’ll be the first to hear our latest keynote announcement, which we’ll be posting on our website and via social media later that day.

Workshops and tours are filling up… Even with a record 15 workshop and tour offerings on Tuesday, April 11, some sessions are beginning to fill up. The all-day “Business Storytelling for Leaders” workshop hosted by ThedaCare has reached capacity along with the morning “Aligning Improvement with What’s Important” strategy workshop hosted by lean expert Beau Keyte. In the afternoon, tours to Anheuser-Busch InBev and Fuse by Cardinal Health – 2016 offerings back by popular demand – have booked up, as has a tour of BMW Financial Services.

cleveland clinic logobut many are still available. The upside? Another 10 tour and workshop offerings – including a newly added afternoon session of Keyte’s “Aligning Improvements” session – are still up for grabs. That includes an all-day lean office-focused tour of the Cleveland Clinic’s massive Revenue Cycle Management area, a morning crash course in data analysis, a zombie-themed afternoon Six Sigma workshop, a trip to Honeywell Aerospace, and more.

We’re going digital. Leading Through Excellence is debuting an official app for this year’s summit that includes all information on sessions and keynotes, speakers, sponsors, exhibitors and more. Attendees also will have the opportunity to connect with others via messaging, rate sessions, and submit Q&A electronically. The summit app will roll out a month before the summit, giving you a chance to explore what it  has to offer and make the most of it across the event’s three days.

Hotel deadlines are approaching. Coming in from out of town? Bringing a group? There’s still time to take advantage of specially reserved hotel blocks at two venues near the Fawcett Center: The Hilton Garden Inn and Staybridge Suites OSU. Hilton Garden Inn’s block pricing is available through March 10, while a newly added block at Staybridge must be booked by March 25. Rooms in the summit block have sold out each year in advance of the deadline, so head to our lodging/travel page to make your reservations.

Our summit schedule has changed – for your convenience. To better accommodate travel schedules on the summit’s final day, Thursday, April 13, Leading Through Excellence will kick off at 8 a.m. and conclude with a 12:30 p.m. lunch following closing keynote Chris Yeh.

Thursday’s early start is worth it. A very special guest will take the stage at 8 a.m. on the summit’s final day – and you won’t want to miss it. Intrigued? We’ll be making the announcement in the March summit preview edition of our Current State e-newsletter and on this blog.

Ready to register? Click here or check out event details on our official site.

First breakout sessions revealed as summit discount deadline approaches

Planning to attend the Center for Operational Excellence’s Leading Through Excellence summit in April? Less than two weeks remain to get the best available pricing on the three-day event.

summit-banner-resized-smallAny registrations before Jan. 1, 2017, automatically will receive 10% off the total price. Group registrations of five or more receive an additional 5% off, a discount in effect the duration of the summit sign-up period. The automatic early bird discount for individuals and groups of up to four drops to 5% at the beginning of the new year.

Leading Through Excellence, COE’s signature event, will take place April 11-13 and feature a wide variety of workshops, tours, breakout sessions and keynotes designed to help attendees sharpen their problem-solving and leadership skills. This year, we’re taking attendees to the Cleveland Clinic, exploring the power of business storytelling, and hosting sessions from leaders at companies including IBM, Bose, FedEx and more. Keynote speakers include communication expert Debra Jasper, CEO of Columbus-based Mindset Digital, and Chris Yeh, co-author of the bestseller The Alliance: Managing Talent in the Networked Age.

Details on all 20 breakout sessions will be posted by the end of January, but the first several are already up for review. They include:

cary dunston
C. Dunston

Emotional Intelligence: Becoming a Leader Who Cares, hosted by American Woodmark CEO Cary Dunston. In this session, Dunston will explores why leaders with the best intentions often make choices that limit their ability to be effective. The root cause, he proposes, is a lack of “emotional intelligence,” which can steer leaders to become emboldened by purpose and aligned with their core values.

The Power of Lean Habits, hosted by Eric Olsen, a professor at California Polytechnic State University. Drawing from Charles Duhigg’s bestseller The Power of Habit, Olsen in this session explores how companies can leverage the key components of the habit loop – cue, routine, reward, craving – to identify the lean and non-lean habits at work in their organizations.

Building the Fit Organization, hosted by Dan Markovitz, Shingo Prize-winning author. Markovitz wrote his book of the same name after realizing too many companies in their pursuit of operational excellence were trying to mimic “the Toyota way” without translating the core concepts of lean into a language that resonates with their employees and in their unique corporate culture. This session offers the keys of the Toyota Production System in jargon-free terms.

The clock’s ticking. Read up on other breakout sessions or head to the summit website to explore the rest of the event and register! Fees start at $695 for employees of COE member companies, $975 for non-members.

Fisher collaboration brings op-ex tools to realm of education

An unconventional effort to reform Ohio’s K-12 education system is sending a new pack of leaders out with more than an MBA from Fisher College of Business and a certification to serve as a principal.

They can wield some foundational operational excellence tools, as well.

bright student fisher mba
BRIGHT fellow Shaun Mitchell, right, shares the results of his A3 problem-solving project.

Fisher this summer graduated 30 students as part of the BRIGHT New Leaders for Ohio Schools program after they spent nearly a year working as administrators in high-poverty schools around the state and completed an accelerated MBA program at Fisher. The program, launched in 2015 with $3.5 million in state funding and help from Fisher and the Ohio Business Roundtable, takes business professionals from a variety of backgrounds – largely non-education – and deploys them throughout the state as principals. BRIGHT fellows, as they’re called, must serve as a school administrator for at least three years after graduation.

At a presentation prior to graduation, a number of BRIGHT fellows showed the results of their work tackling the A3 problem-solving methodology, one of a few tools Center for Operational Excellence Executive Director and BRIGHT educator Peg Pennington introduced to the curriculum.

“The BRIGHT program itself is an experiment, so I thought to myself, ‘Why not do an experiment of our own here?’” Pennington said. “These problem-solving skills – A3s, root-cause analysis – are powerful tools anywhere, and I think they can really help cut to the heart of some of issues that plague our education system.”

For the BRIGHT fellows, those issues included lagging math and reading scores, a lack of collaboration between upper- and lower-grade students and educators, truancy, and discipline referrals, among others. Pennington in her classes with the BRIGHT fellows showed how the A3 and root-cause analysis can properly define the problem and, medically speaking, move past managing symptoms to truly treat the underlying ailment.

David Maile, a longtime plant farm owner who transitioned out of the business two years ago, signed onto the BRIGHT program and found himself as an administrator at Highview 6th Grade Center in the Cincinnati suburb of Middletown, where the poverty rate has jumped from 9 percent to nearly 14 percent in about 15 years. Maile leveraged root-cause analysis and A3 problem-solving to improve math scores in the school, where he said much of the challenge was in bringing a level of consistency and precision to data collection.

Other process-improvement projects were of a more qualitative nature. Jeff Greenley, a lawyer by training, worked in the Switzerland of Ohio School District in Appalachian Ohio, the highest-poverty region in the Buckeye State. Greenley’s school housed a wide age range of students that rarely interacted, in large part because they didn’t see the value in it. Greenley did.

After defining the problem via an A3 and enacting countermeasures, Greenley finished the school year with more than four in five upper-grade students helping out and interacting with elementary-age students. The A3 process, he said, was eye-opening.

“There are not a lot of tools at our disposal in education to think about operational problems,” he said. “This is a hammer we can use to hit the nail.”

Regardless of the challenge, the BRIGHT fellows discovered very quickly that data was a crucial asset in their problem-solving journey – even if it wasn’t used as such in their schools. Astrid Arca, an economist for the state of Ohio, served in the same Appalachian school district as Greenley and took on the challenge of improving reading and math schools in a student population with a high percentage on so-called individual education plans. The data needed to cut to the heart of the problem, Arca found, existed – but weren’t being analyzed to inform instructional practices.

“There was almost a fear of the data,” she said, “and most of my job was removing those barriers.”

BRIGHT leaders are hoping that spirit has a transformative effect in the schools where its graduates are heading this fall and beyond, even if the difference in background for many fellows hasn’t gone unnoticed. Deborah Copeland, a BRIGHT principal coach with a nearly 30-year background as an elementary school principal, acknowledged a level of skepticism around “outside” people taking a leadership role in education. Often, she said, it just takes spending time alongside the fellows to see that they have the skills and capability to drive change.

“It’s been a joy watching these fellows coming in with a different perspective, full of hope and promise and not weighted down by the barriers that those of us who’ve been in the trenches often get blinded by,” Copeland said.

The BRIGHT fellows themselves are the source of a telling data point: About 90 percent had K-12 principal or assistant principal jobs locked in at the start of the school year.

COE summit highlighted on ‘Manufacturing Tomorrow’ podcast

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Have five minutes to spare?

The Ohio Manufacturing Institute just released the latest edition of its semi-monthly Manufacturing Tomorrow podcast, which they recorded at the Center for Operational Excellence’s Leading Through Excellence summit just last month.

Podcast Executive Producer Kathryn Kelley in this edition interviews a trio of COE members – Agrana Fruit’s John Labrador, Crown Equipment’s Craig Wreede and WillowWood’s John Matera – on what operational excellence means for them. Listen here, and check out the podcast’s website here.

COE regularly partners with OMI to bring speakers to Manufacturing Tomorrow. Past COE collaborations have resulted in podcasts interviewing Goodyear’s Norbert Majerus, COE Executive Director Peg Pennington, Snap-On Inc. CEO Nick Pinchuk and more. They’re all on the podcast archive.

Special thanks to Kathryn Kelley and the OMI team for visiting the summit and featuring our members.

 

Management Sciences Prof. Benton receives ‘Best Paper’ award

Furthering Fisher College of Business’ reputation as a top operations research powerhouse, a Management Sciences professor recently received honors from a major engineering journal.

W.C. Benton Jr.
W.C. Benton Jr.

IIE Transactions, the flagship journal of the Institute of Industrial Engineers, honored Fisher Prof. W.C. Benton Jr. with the ‘Best Paper’ award. He’ll be formally acknowledged at the publication’s research conference in May.

Benton’s award came for his “Determining Core Acquisition Quantities When Products Have Long Return Lags.” This research tackles a common problem for closed-loop supply chains: Having a sufficient supply of reusable products, a tricky balancing act between accidental shortages or inventory overloads. Benton in his research culled live data from original equipment manufacturers and remanufacturers to develop a new forecasting approach that better balances product returns with demand volume.

At Fisher, Benton is the Edwin D. Dodd Professor of Management and a professor of operations and supply chain management. He’s a prolific researcher whose more than 120 articles have appeared have appeared in publications including the New England Journal of Medicine, Journal of Operations Management, and many others. He has consulted for a wide variety of public- and private-sector entities throughout North America.

Team building, problem solving take center stage at 2016 COE summit

The Center for Operational Excellence’s flagship annual event has more than a few things in common with the fast-paced racing world featured in the kickoff to the fourth-annual Leading Through Excellence summit.

In the span of three years, COE’s April Leading Through Excellence summit has grown to a gathering of nearly 400 process excellence leaders from around the world: 50 companies, a dozen workshops and tours, 20 breakout sessions, four dynamic keynote addresses, and countless insights across three days aimed at helping organizations harness the power of process improvement.

Here’s a look back at the event:

PIT action

Leading Through Excellence began with a bang as nearly 100 attendees plunged into the high-paced world of pit crew racing, guided by Mooresville, N.C.-based training ground Performance Instruction & Training (PIT). The session’s focus on handoffs, coordination and standard work drove home the importance of having a high-functioning team for Cheryl Cole of KeyBank, which sent 17 employees to the conference. “We can all benefit from what we experienced from PIT,” she said. “Teams tend not to be aware of the significance of being in sync.”

PIT team
Team-building emerged as the heart of Leading Through Excellence, where a number of companies brought upwards of 15 employees. “Getting a team together, you start bouncing ideas off each other,” said attendee Linda Schaefer of COE member Clopay. “You get more people involved, the excitement builds, and great things always come of that.”

Markovitz

Operational excellence isn’t bound by the Japanese words that make the foundations of lean. Author Dan Markovitz (A Factory of One, Building the Fit Organization) in his workshop offered a jargon-free look at continuous improvement that’s at the heart of his own passion to break down barriers to understanding. “If we could speak to them using analogies and metaphors that make sense to them, all the sudden we don’t have to go uphill,” Markovitz told COE in a pre-summit interview.

Cardinal

Longtime COE member Cardinal Health Inc. hosted a “train the trainer” workshop hosted by Luis Loya (pictured, middle) that modeled the health-care company’s own best practices in teaching lean practices.

SRI
Off-site tours during Leading Through Excellence ranged from a trip to Anheuser-Busch InBev’s massive Columbus brewing facility to a trip through the production line at COE member Abbott Nutrition. Here, Ohio State’s own Spine Research Institute demonstrates its trailblazing work in studying back problems, a hugely costly yet widely misunderstood workplace ailment.

Ben Cook
After hosting two high-paced rounds of pit crew training simulations on the first day of Leading Through Excellence, Performance Instruction & Training’s Ben Cook took to the stage to kick off a full day of breakout sessions. Before a crowd of nearly 400 people from 50 companies, Cook illustrated PIT’s “think inside the box” philosophy, that’s hinged on driving precision from a highly functioning team and reducing human error as much as possible. “The problem is the human element – that’s what happened with us as pit crew members. If we break down, then we lose the race; the car’s not gonna lose the race for us anymore.”

Hagene
True leaders don’t bark answers – they ask questions that help dig to the root of the problem. Attendees practiced asking effective questions in a packed session hosted by lean expert Margie Hagene.

Guru
More than half of all breakout sessions at Leading Through Excellence are hosted by industry leaders, sharing stories of what worked, what didn’t – and how we can all learn from it. Pictured is Guru Vasudeva, SVP and Enterprise CTO at COE member and summit sponsor Nationwide, who shared his own “day in the life of a lean leader.”

Aravind
The balance of the breakout sessions at Leading Through Excellence are hosted by Fisher College of Business faculty members sharing their own research. Pictured is Prof. Aravind Chandrasekaran, who offered insights he gleaned from working with high-tech manufacturers facing sudden – and potentially cataclysmic – shifts in project scope.

Dumas
Matt Dumas (pictured, above) of COE member Honda R&D said the summit is “a great event for a team. To have more of the organization thinking about lean and understanding these principles makes it that much easier to take it back and work together to apply it.”

Catapult
Lead summit sponsor MoreSteam.com gave attendees a hands-on taste of process design principles with a catapult workshop that had participants taking a “MacGuyver” approach and facing off in friendly competition.

Murli
Longtime lean leader Joe Murli in his keynote address offered his decades-in-the-making perspective on the lean management system. Of the summit, he said “this isn’t just leading-edge thought, but edge of the envelope thinking here. It’s little things that we can pluck off the tree and bring back to put into what we’re already doing. That makes it much more powerful.”

Kalman
Connecting an organization’s purpose and mission down to day-to-day work can be a formidable challenge for any company. David Kalman of Root Inc. in his popular breakout session showed attendees how visuals can help close that gap.

Gino
Harvard Business School researcher and professor Francesca Gino, author of the book Sidetracked, guided attendees through the wild world of decision making, where our hard-wired instincts often stand in the way of the right calls. “We are human beings,” Gino said. “Often we start with a plan, a clear goal, and we take the time to come up with a clear action plan. When we look at the outcome, we’re often a little bit off target.” Knowing how to counteract the unconscious biases and instincts we possess, Gino said, can lead us to better decision making, she said.

Volunteers
The behind-the-scenes action at Leading Through Excellence was fueled by more than three-dozen Fisher College of Business undergraduate students, graduate students and staff members, who served as volunteers and introduced speakers throughout the event.

Henry
Accidental Creative founder and acclaimed author Todd Henry closed out Leading Through Excellence, urging the audience to ask: “How are you bringing yourself to the table every day as a leader? A brilliant idea is not enough – in order to succeed, you have to develop your voice as a leader and you have to help your team develop its voice.”

Want to see more? Check out the full album of summit photos on our Flickr site. And mark your calendar for Leading Through Excellence 2017, April 11-13.

Do we really understand lean deployment in health care?

by guest author Aravind Chandrasekaran, associate professor of management sciences, Fisher College of Business

Anyone who has taught lean principles grounded in the famous Toyota Production System (TPS) to organizations outside the manufacturing industry has – at least once – heard this common refrain: “(Insert industry here) isn’t cars on an assembly line. This doesn’t apply to my work.”

A. Chandrasekaran
A. Chandrasekaran

Leading lean thinkers, of course, have learned how to work with individuals and teams to move past this roadblock and garner buy-in – that’s why the practices and tools intrinsic to TPS have made their way into countless industries. Lean still can be a target for criticism, though, and one need look no further for proof than an article published earlier this year in the New England Journal of Medicine – and the debate it ignited.

The January issue of NEJM featured an article called “Medical Taylorism” where authors and physicians Pamela Hartzband and Jerome Groopman assert that lean principles “cannot be applied to many vital aspects of medicine. If patients were cars, we would all be used cars of different years and models …” This tipped off a flurry of rebuttals, including one from Lean Enterprise Institute CEO John Shook boldly titled “Malpractice in the New England Journal of Medicine.” In his piece, which itself attracted widespread attention, Shook writes that the foundational lean principles of continuous improvement and respect for people are critically important in the health-care system.

Shook is right, but I’d like to approach this discussion from a different angle, namely that this line of criticism has emerged elsewhere – and it’s rooted in a lack of understanding of lean deployment.

One of my initial research areas sought to understand how standardization and “smart application” of Six Sigma principles can aid R&D and innovation efforts. I pursued this as a number of business press publications and industry practitioner blogs lamented the damage Six Sigma does to creativity and praised the need for variation for innovation. Several years of research with my colleagues in Fortune 500 companies made us realize such sentiments don’t hold much water. We found, in fact, that principles of Six Sigma – when applied to the innovation process correctly (hence the “smart” in “smart application’) – can help reduce unnecessary variation and stop worthless innovation activities that consume R&D funding.

Credit: bostonmagazine.com
Credit: bostonmagazine.com

I’ve more recently collaborated with researchers and physicians to tackle similar questions in health care. Once again, the findings – published in several academic and practitioner outlets – are very similar: The smart application of lean and continuous improvement principles can help develop a safe and patient-centered health-care system.

In arguing that patients aren’t cars, the NEJM’s authors are absolutely right – but they’re dead-wrong in concluding there’s no place for lean in “many vital aspects of medicine.” As with our R&D research, we’ve found that lean deployment in hospital settings minimizes unnecessary variation that comes from care providers, not patients. In fact, it frees up time and effort to cater to the necessary variability in a population diverse in its illnesses, economic backgrounds, languages and more.

As an example, I spent years with other researchers – including some physicians – looking at Ohio State University’s Wexner Medical Center, specifically a lean deployment effort in its kidney transplant discharge process. Medical research has found that transplant recipients after discharge must drink at least three liters of fluid a day – failure to do so can spike creatine levels, elevating blood pressure and increasing the likelihood of readmission. In our study, we found variations in how nurses delivered these instructions to patients: One nurse, for example, recommended drinking “a lot of fluids” while another suggested 100 ounces. Interestingly, nurses varied their wording across patients, while one patient would receive different instructions from more than one nurse. This wasn’t a matter of intentional deception, but the inconsistencies confused patients as they took in a tremendous overload of instructions.

Overhauled through the lean deployment via standard work design, nurses in our medical center now clearly explain the specific volume of fluid, use a jug to visually illustrate, and discuss the consequences of not following the instructions. Preliminary findings show this approach soothes patients’ anxiety levels and has reduced the chances of readmissions in the first month after transplant.

This isn’t just a lean approach to a problem – it’s a smart lean approach. And in an environment that, yes, isn’t cars on an assembly line, that matters more than ever.

Lean, the Four-Letter Word: Dan Markovitz on his new book – and his newfound approach to teaching op-ex

The core principles at the heart of Dan Markovitz’ latest book, Building the Fit Organization, are the very essence of lean thinking. Just don’t expect to see the word “lean” past the introduction. Or, for that matter, any references to a certain automaker, its namesake production system, or a litany of Japanese words.

And that’s the point.

D. Markovitz
D. Markovitz

Building the Fit Organization, which the author breaks down in an exclusive half-day workshop as part of COE’s Leading Through Excellence summit on April 12, is Markovitz’ response to a disconnect he sees in how we communicate lean concepts and leadership principles to our people. We recently spoke to Markovitz about what that disconnect is – and how first book since his Shingo Prize-winning A Factory of One tackles it.

COE:  There are a ton of books on lean out there. What inspired you to write this one?

Dan Markovitz: Over the years I’ve seen a lot of really smart people work with companies trying to improve operational performance by driving a lean transformation – and yet the number of companies that actually succeeded is vanishingly small. This book is an exploration, my attempt to explain one of the root causes of this and rectify it.

COE: So what is that root cause?

DM: We’re asking people to think about their work differently, yet we make it unnecessarily difficult for them to accept it. I see a lot of people using the language of Toyota, literally using Japanese, telling people working in a bank or a hospital how Toyota builds cars. Their very first response is to lean back in their chairs, cross their arms, and say, “We don’t make cars.” The leader, consultant, or improvement professional then has a huge uphill battle to explain that they’re not trying to turn them into factory workers. Then, after a week, a month, or six months, people may start to get it. If we could speak to them using analogies and metaphors that make sense to them, all the sudden we don’t have to go uphill.

COE: You’re definitely not letting consultants such as yourself off the hook here.

DM: It’s been a failure of imagination on our part to not be able to say, “Let me put this in a language that makes sense to you.” There’s nothing requiring Japanese to describe these ideas – they happen to have just been described in Japanese first. If we can express these ideas in English that resonates with people now, it makes it easier to get to “That totally makes sense. I get it.”

COE: You went with a physical fitness metaphor for your book. Why?

building fit organization_coverDM: Fitness works for me – I used to be a competitive runner and a running coach. You could just as easily use a metaphor of music or writing, all kinds of things. I believe that if we’re a little more creative about the way we tell the story, the way we present the ideas, it’ll be a whole lot easier for us to sell the ideas and get people to embrace and implement them.

COE: You also made the very conscious decision to leave tools out of your book. What led to that?

DM: Oftentimes, we lead with tools and we end up losing people. The tools that people learn – 5S, for instance – often are designed to solve specific problems. Who knows what your specific problem is? With this book, rather than talking about tools, I wanted to talk about principles. It’s important that people grasp the fundamental concepts and understand how to become better, fitter organizations before messing around with tools.

COE: What do you see as the audience for your book and, by extension, your workshop on April 12?

DM: Certainly both are for people who are relatively new to the idea of continuous improvement but might be intimidated by the all the Toyota, 5S, kanban, water spider talk. The second audience, though, is companies who have started lean or some continuous improvement program and seen it stall out. This is a way for them to reintroduce it in a fashion that would be more accessible. I also think this would be really valuable for leaders in an organization. The principles I talk about really need to be lived and embodied by leadership. If a leader’s not committed to a fit organization, it’s not going to take hold.

Learn more about Dan’s session, and others being offered at Leading Through Excellence, on the official event website.