5S: More to ‘shine’ than the surface

Regardless of where you are in your lean journey, it’s likely you’ve heard of 5S, the set of five words that serves as a methodology for organizing the workplace. In English, they’re Sort, Set in order, Shine, Standardize and Sustain. That’s derived from the Japanese origin of Seiri, Seiton, Seiso, Seiketsu and Shitsuke.

Detractors might say 5S is simply a “spring cleaning” activity where trash is discarded to make room for more, but it’s a great deal more than that. When you sort, you separate and eventually throw away items that are unneeded. You set in order items according to the frequency and sequence of use. You get rid of dirt, dust and any leakages and shine the workplace. Once you organize the items, you standardize their location and level of use. To sustain that organization, you create paperwork that operators or managers can use to reach that goal. 

If it all works so well, then, why do some still consider shine a dusting and cleaning activity? Some say it’s played a part in saving lives. Ever heard of the controversial “Broken Windows Theory? It posits that simple disorder can increase the tendency for crime in urban areas – if more trash isn’t removed, more will pile up. The New York City Transit Authority in the 1990s applied this to stop an increasing graffiti problem on subways, scrubbing down trains each night before resuming service the next morning. Over time, they got rid of the problem as other initiatives were put in place around the city, contributing to a remarkable decrease in vandalism and the crime rate.

When you ‘shine’ the workplace it has a positive impact on the operators working there. A dirty workplace tends to cause distraction and reduce employee morale and doesn’t convey a positive message about the company. With items in ready-to-use condition, working is safer with dust and dirt gone along with slipping and tripping hazards.

In short, a clean and safe workplace begets a safe and clean workplace.

What’s your problem?

I recently had to take a friend to an urgent care facility in town after she broke out in hives and itchy skin, likely an allergic reaction to a food item. After making it into the exam room, the medical technician very efficiently completed the vitals and reconciled medication and past illness history. Next in was a physician’s assistant, who performed a quick assessment and confirmed our suspicions about the food allergy.

But what food? We still weren’t sure, even as the hives were quickly spreading and my friend agreed to a Benadryl shot. Within 20 minutes, the itching was gone with the hives almost disappeared. One crisis averted, one very drowsy friend.

I have prescribed and given Benadryl shots to my patients in the past but this was the first time as a non-physician that I noticed how quickly the drug acts and makes the reaction disappear. It got me thinking about how a lot of the countermeasures many organizations implement to solve a problem act like Benadryl. Symptoms disappear but the root cause remains.

Cause Map
Cause map slide courtesy Peg Pennington

Most people, in fact, aren’t sure what problem they’re trying to solve. For example, if sales go down, marketing goes up. But what if your products are defective? What if customers are getting the wrong product or are waiting too long to receive it? What if a competitor is turning out a better, faster alternative?

You will only be treating the symptoms if you don’t know the:

–          actual problem you are trying to solve

–          root cause of the problem

There are many tools available to get to the root cause of the problem such as the 5Whys and Fishbone diagram.  I recently learned from a colleague a new method, causal mapping, which I prefer because it is visual and loose in structures, allowing for a free flow of ideas until you find the root cause.

My friend, by the way, is on her way to an allergist to nail down the real culprit.

Tell me where it hurts

Fair warning: This is one of those articles you read that makes you think twice about checking into an emergency room.

I’m still reeling from a recent New York Times article on a Department of Health and Human Services study that found hospital employees note and report only one in seven errors and other incidents of harm to hospitalized Medicare patients. One in seven: That’s an F in a classroom and includes instances that range from bedsores, acquired infections and other mishaps that could even result in death.

Medical error
This x-ray, courtesy BigHealthReport.com, illustrates a much-feared medical error.

The point here isn’t to encourage you to hit the Advil next time you fall off a roof. Read deeper and the lean alarm bells start sounding. According to the article, federal researchers say it isn’t shame or embarrassment that’s keeping these instances from being reported. Rather, it’s hospital employees not recognizing what constitutes patient harm or realizing a procedure has harmed a patient. In lean-speak, researchers hint the root cause lies deep within the procedures and training that line the backbone of hospitals’ operations.

The most staggering sentence in the article comes later: “In some cases … employees assumed someone else would report the episode, or they thought it was so common that it not need to be reported, or ‘suspected that the events were isolated incidents unlikely to recur.’”

This is a shining example of how a finger-pointing, siloed approach to daily work and problem-solving can infect an organization. On a shop floor, this could mean a malfunctioning widget. In a hospital, this could mean one less vacancy in the basement morgue.

The report is mostly, but not all, bad news. Medicare officials told the Times they’ll develop a list of “reportable events” to clear up confusion, a sure sign of progress. But much work remains to be done – a major problem in the system these days, the report states, is that once problems are recognized they very rarely lead to changes in policy or procedure. It’s a good start, though, to define what a problem is, design processes so they expose problems and then have a process in place to address them.

Reading the article, I’m reminded of a chat I had with lean guru Steven Spear when he visited Fisher to coach our Master of Business Operational Excellence cohort in November. Spear has loudly advocated that health-care providers should focus less on problems in the market and more on reforms in specific processes to effect meaningful change.

“I’m not sure that’s caught on in health care in a broad-based way,” he told me.

Unfortunately, he’s right.

Don’t let the Zen garden fool you

I wish you a very happy 2012 as you make progress in your journey of operational excellence.

I am sure many of you must have traveled during the holiday week. On a recent trip I took to Orlando to attend the Annual Institute for Healthcare Improvement (IHI) conference, a very common occurrence got me thinking. We all know how first-class and business-class members get the preferential treatment of boarding the flight before economy class passengers. In terms of customer service, that makes sense. They pay more and get to board earlier. 

What I find extremely ridiculous is that they get to walk on a small piece of carpet when they board the plane, while economy class passengers are diverted to a separate passage that bypasses the carpet. But only one entrance leads to the plane. As you can see in the picture, the airline managed to create a fake sense of “specialness” for first- and business-class passengers.

We see the same thing in hospital waiting rooms and other service operations. Excellent customer service would be no wait at all but service industries use the band-aid approach for the problem. They build Zen gardens and embellish the walls with beautiful artwork in waiting rooms to distract customers. Instead of improving the processes to reduce redundancies and waste, they focus on the perception of customers regarding wait times. If wait times increase beyond a certain time because of “unavoidable” circumstances, customers are given freebies in the form of free parking passes or gift certificates.

The key is to attack inefficiencies in the processes and give customers what they came for. If you went to a grocery store looking for your favorite box of cereal and had to spend a half-hour hunting, guess where you’d go next time? A competitor.

Customers can’t be fooled by superficial embellishments. Give them what they want. Improve the process, not the ambience. That’s true customer service.

Practicing what we preach

Even if many of the speakers who come before COE members have lean-transformation success stories to share, all of those tales have to start with some gory details about problems at their organizations. In the spirit of quid pro quo, I’d like to share one of ours and fill you in on what we’re doing to make it better. Think of it as the Fisher College version of US Weekly’s “Stars: They’re Just Like Us!”

Our Dec. 2 seminar featured fantastic and well-received presentations from Cardinal Health Inc. and Starbucks Corp. (don’t believe me? Check out these pics). If you logged in to watch either of these events via a live webcast, however, you got a front-row seat to some technical problems we had in the morning and afternoon. Live audience members in the afternoon were privy to an audio glitch at the start of the Starbucks presentation as well.

Fisher College COE cause mapping
COE joined with the audio and visual teams that helped with the Dec. 2 seminar to dissect some of its glitches.

In a world without lean thinking, we’d hoist the blame on the shoulders of the good folks at Fisher and the Blackwell Hotel who handle audio and video for us and be done with it. Easy? Sure. Fair? Not at all. So in the spirit of lean thinking, we spent a half-day this week creating cause maps with the audio and visual teams that revealed a number of issues that fueled the fire. And like the dutiful lean thinkers we are, we emerged with some proposed changes to our event planning and execution next year that should boost the quality of COE members’ experience and lower our blood pressure readings.

It’s disheartening and even scary to dig beneath the surface and expose the frayed wires in our process but they remain a problem waiting to happen until you do.

Discuss: How has operational excellence influenced the way you or your organization dissects problems after they occur?

MBOE recap: The fine art of stocking shelves

When I walk into a Giant Eagle, I know exactly where I can find my favorite multigrain Cheerios. I also know a box will be waiting for me when I want it. The logistical engineering behind making that happen never occurred to me until a recent presentation by Prof. Thomas Goldsby for our MBOE industry cohort on lean logistics.

Tom Goldsby
Tom Goldsby speaks to Fisher’s MBOE industry cohort

Lean logistics and a supply chain make many processes seem like magic. Think, for example, about a company like DeBeers, exploring unknown lands, discovering diamonds, cutting and polishing them and then supplying them all over the world. Or a hospital, well-stocked with syringes, needles and oxygen cylinders. Logistics account for $1.2 trillion of the U.S. economy, or about 8 percent, meaning that for every $1 spent, nearly a dime of it goes to logistics. Of that cost, 63 percent is transportation.

So what is a supply chain? It’s the network of companies that work together to provide a product or service for the end-use market. Simply put, an apple grown in an orchard doesn’t come to grocery stores in baskets. Logistics facilitates the flow of materials and products into and beyond a facility. Lean logistics facilitates the flow by minimizing wastes.

Back to those apples: If a store stocks up on a ton because a farmer had a good season, those take up not only too much space but likely will result in waste. On the other hand, if demand spikes that doesn’t mean retailers, distribution centers and farmers should go into overdrive. Supply chain and logistics is about balancing demand, inventory and the number of trips needed. The question: Are you going to manage your supply chain, or is it going to manage you?

Next time I visit my grocery store for those Cheerios, I’ll have a completely different perspective.

How do logistics and supply chain management affect what happens in your organization?

MBOE recap: Wrapping up

After three long days over last week, the final day of the MBOE session’s first week came with wrap-ups from COE Executive Director Peg Pennington, Gary Butler and yours truly. Peg went over the basics of A3 problem solving and provided an overview on DMAIC to get the students ready for the six sigma in August. I spent time teaching students the basics of future-state value-stream mapping, a topic that sparked discussion on process time, lead time and cycle time. Gary and Peg discussed the do’s and don’ts of the the student capstone projects.

COE Executive Director Peg Pennington
COE Executive Director Peg Pennington, pictured in an archived photo, spoke on the last day of the first MBOE session

I’ll close with some reflections from students ending their first week in the MBOE cohort:

“The purpose of lean is not just elimination of wastes. It also means producing twice at half the input.”

“It is making sense how a value stream map makes waste visible.”

“We hope that the value streams we created at the gembas would be helpful to the managers there.”

“Value stream mapping is not rocket science.”

MBOE recap: Airplanes are not cars

Barb Bouche, an MBOE coach and director of process improvement at Seattle Children’s Hospital, told students at this week’s session that she began exploring the option of applying Toyota Production principles to the hospital a few years ago. She met with resistance from the organization, the argument being, “Patients are not cars.” Shortly afterwards she happened to cross paths with some people from Boeing. They told her during their lean journey the argument they commonly heard was, “Airplanes are not cars!”

MBOE students strategizing production game plan
MBOE students strategizing production game plan

It didn’t take Barb long to realize that argument arose from a resistance to change. In last decade Seattle Children’s has completely changed how it do esbusiness by applying lean principles. Officials have significantly reduced the inventory of supplies by working closely with their suppliers and developed a world class process for materials management.

Speaking of airplanes, the MBOE students spent their second day on campus manufacturing StrikeFighters using Legos.  After struggling through the first and second round of the chaotic batching process they finally were able to create flow using the lean principles of takt time, work cell, one piece flow, level loading, kanban and simplification. My co-author, Matt Burns, wrote about this same simulation in an earlier post.

A student commented, “I think I am just beginning to see what lean is all about!” Another said, “I did not know what I was doing in the first round. The last round made it very clear after all the chaos was gone and there was finally some coordination and flow among my team members.”

In the evening, Capt. Michael H. Glazer, commanding officer and professor of naval science at OSU’s Naval ROTC  gave a captivating overview of flight deck operations and aircraft carrier facts. With multiple safety programs, Glazer said, the naval aviation mishaps decreased from 776 aircrafts in 1954 to 39 in 1996. Keep in mind naval aviator trainees are landing the aircraft on a short run of only 330 feet.

Another long day for the students!

New operational excellence program at Fisher makes big debut

Excitement is high this week at the Fisher College of Business as we launch the first cohort of our MBOE Healthcare Program. MBOE, by the way, stands for Master of Business Operational Excellence, a program we introduced three years ago with a group of students mostly from the manufacturing and service industries. In the last cohort, however, we noticed nearly half of the students were from the health-care sector – and what we did about it is this very program.

Dean Poon
Dean Poon speaking to the MBOE class

MBOE Healthcare is a one-year program focused on achieving operational excellence using lean and Six Sigma, combined with effective leadership skills and team engagement techniques. The program aims to develop each student – a manager, leader or other professional with a passion for operational excellence and change –  while improving the systems and processes in his or her organization. 

This MBOE program isn’t just in a classroom. Students will head to hospitals to visit the gembaand observe successful changes. They’ll also take part in online learning and a combination of on-site and distance coaching by industry experts. The students apply this knowledge to a strategic capstone project carefully selected with the active involvement of the student’s supervisor or sponsor. They also work closely with the original industry cohort in the four weeks they’re together on campus to learn from each other.

MBOE Students

Each of the eight weeks on campus involves four full days of intense learning from Wednesday to Saturday. Past students have called these weeks “exhausting and exhilarating” as experienced faculty members and guests teach using their own experiences working in organizations all over the country.

A student of class 2011, Susan Moffatt-Bruce, Assistant Professor of Surgery and Chief Quality and Patient Safety Officer at the Ohio State University Medical Center, told me the program “has provided me the tools to implement change through shared understanding and team engagement.”

Stay tuned for a daily update on the first week of the MBOE program.

Want some value-stream mapping tips from the pros?

Our good friends at the Cambridge, Mass.-based Lean Enterprise Institute are giving operational excellence junkies a chance this week to learn from a few masters this week – without leaving the office.

Tuesday Nov. 29 at 2 p.m. EST, the institute is hosting a free webinar titled “Learning to See the Whole Value Stream: The Power of Extended Value-Stream Mapping.” It’s set to last one hour and will be led by Jim Womack and Dan Jones. Those of you brushed up on your lean reading might notice they’re the gents who quite literally wrote the book on some hallmarks of lean thinking including, well, Lean Thinking, Lean Solutions and Seeing the Whole Value Stream.

recent value-stream mapping session
COE Executive Director Peg Pennington hosted employees from Grange and Huntington for a recent value-stream mapping session

The cost? Your time, an hour of it to be exact. Click here to register for the webinar.

The concept of value-stream mapping will be fresh in the minds of a few of our member companies: Grange Insurance and Huntington National Bank. A group of employees from each company came to Fisher earlier this month for a day-long session on VSM led by COE Executive Director Peg Pennington. They’re part of a growing contingent of transactional companies in COE – and they’re making great strides in apply operational excellence strategies to new realms of the corporate world.

Amy Tomaszewski, Grange’s assistant vice president of operational excellence, told me the event was a great success for her company and “provided quite a few ‘Ah-ha!’ moments.”

“The instruction was excellent and tailored to the service transaction environment, which is often overlooked in lean training,” Tomaszewski said. “Through the real-life computer simulation of the movement of electronic work and the team exercises around value-stream mapping and a simulated Kaizen event, we were able to see the result of both positive and negative changes that can occur when a company looks for and acts upon improvement opportunities in a value stream.”