Event preview: Keys to collaboration in any industry

As a researcher, Prof. Aravind Chandrasekaran doesn’t hang his hat in one particular industry.

In the 12 years he’s been contributing to our knowledge on issues such as innovation, knowledge creation and health-care delivery, he’s walked the floor in manufacturing plants, chased high-tech electronics as they move through the R&D pipeline, and scrutinized discharge instructions for kidney transplant recipients.

At the heart of his research is the question of handoffs: How can we move information more efficiently? How can we bring products to market more rapidly? How can we discharge patients and ensure they won’t be readmitted days later?

Prof. Chandrasekaran is bringing key insights from his research across this variety of industries to the Center for Operational Excellence’s Dec. 2 seminar, where managers can learn how they can collaborate across departments – even across their supply chains – and avoid common roadblocks such as employee burnout, intellectual property leaks, and scope creep. His 10:30 a.m. presentation is followed by a 1 p.m. keynote from Pete Buca, a top executive at manufacturer Parker Hannifin who’s giving an inside look at the company’s remarkable collaboration with Cleveland Clinic.

COE spoke to Prof. Chandrasekaran about his research and what attendees can expect at his Dec. 2 keynote.

COE: This summer, you led a three-part “Innovation Summer” series for COE. How does your upcoming keynote build on that?

AC: We focused this summer specifically on product and process innovation by looking at companies such as 3M and Johnson & Johnson. This keynote is meant for the R&D folks that attended this summer but a much broader audience, as well. I’ll be sharing keys to the “perfect handoff” by looking at examples in manufacturing, health care and IT services, not just R&D. There’s not a single COE member that wouldn’t benefit from it.

COE: Let’s talk about health care, specifically what non-health care companies can learn from your extensive research in that field.

AC: A lot of discussion in recent years has centered on what health care can learn from other industries, particularly manufacturing. I think the reverse is true, too: In health care, you have specialists – physicians, nurses – who are extremely skilled at what they do. At the same time, you have a complex ecosystem with tons of variation across patients, even caregivers. Those two components are present in just about any industry. As a result, many of the tools and processes I’ve worked with caregivers to apply in health care can be easily transferred to other settings.

COE: Speaking of handoffs, what are some of the biggest mistakes companies make when collaborating across departments or the supply chain?

AC: I think a really common one is that departments or companies take for granted that the other party has a clear understanding of the process. This is at the root of so many problems I’ve seen in R&D and health care. There’s also a misconception that the rules and requirements established at the beginning of a process don’t change. They can, sometimes in a way that can take us by surprise. I’ll be sharing insights in my keynote that can help managers address both of these common missteps.

COE: What’s causing more of these surprises?

AC: The increasingly global nature of business plays a not insignificant role here.  More than ever, companies are dealing with language and cultural barriers, regulations and political risks – and the stakes for success have never been higher.

To register for Prof. Chandrasekaran’s keynote and the entire Dec. 2 seminar, click here.

Parker Hannifin, Cleveland Clinic partnership focus of Dec. 2 keynote

Being a top hospital in the country, Cleveland Clinic is home to countless great ideas poised to transform into life-altering, even life-saving, medical advancements.

Getting those ideas out of the heads of its top-ranked physicians and onto the market has been the focus of a remarkable collaboration between the hospital and one of its neighbors in the Cleveland economic scene: Manufacturer Parker Hannifin Corp.

pete buca
Pete Buca

This partnership, which began quietly nearly a decade ago and was formally announced in 2014, is the focus of the afternoon keynote at the Center for Operational Excellence’s Dec. 2 seminar. At the event, Parker Hannifin VP Pete Buca will share details on the Cleveland Clinic collaboration, which has become a bustling pipeline of medical device ideas the company is working to bring to life using its own product development process, dubbed “Winovation.”

Recently ranked the No. 2 hospital in the country, Cleveland Clinic sees more than 5 million patient visits a year and employs more than 3,000 caregivers. That same U.S. News & World Report ranking called it the No. 1 hospital in the country for cardiology and heart surgery and one of the top five for diabetes and endocrinology, gastroenterology, orthopedics and pulmonology, among others.

Parker Hannifin, meanwhile, is an $11 billion-a-year maker of motion and control technologies that spent about $360 million on research and development in its latest fiscal year. It’s a supplier to more than 400,000 customers that span just about every significant manufacturing, transportation and processing industry in the economy: Food and beverage, life sciences, renewable energy, agriculture and aerospace, just to name a few.

Parker and Cleveland Clinic began collaborating several years ago in an effort to connect the engineering and product development prowess of the former with the critical insights into health-care challenges at the latter. To translate these two capabilities into action, Parker employees sat in on surgeries and communicated with surgeons, leaders told Crain’s Cleveland Business. Interactions like these spawned the 100-plus ideas that initially populated the partnership’s pipeline.

One product seeking to eventually make its way to the market is what’s called the Cleveland Multiport Catheter (CMC), a bold attempt to advance the treatment of brain cancers. Gliomas – a type of tumor in the glue-like supportive tissue of the brain – are resistant to radiation and other common therapies, largely because of the natural barrier in the body that keeps circulating blood out of the brain.

Surgical catheters that pump cancer drugs directly into the brain have been used on a trial basis for the past few decades, according to an October 2015 article by a CMC inventor, but have key limitations. Two in particular, according to the article, must be used in a special operating room, and left in only for several hours. The CMC, which began development in 2009, can be implanted in any neurological OR then be left in place for several days, ultimately delivering more cancer drugs, wrote inventor Dr. Michael Vogelbaum.

Cleveland Clinic partnered with Parker Hannifin to manufacture the CMC and treated its first patient with the device about two years ago. A March update revealed seven patients have undergone treatment with the CMC, which now has an Investigational New Drug application formally on file with the U.S. Food and Drug Administration. Dr. Vogelbaum said in a CMC update video that the device ultimately could help treat other neurological conditions such as Alzheimer’s Disease, Parkinson’s Disease and epilepsy.

At COE’s Dec. 2 seminar, Buca will share other exciting developments with Cleveland Clinic and detail how other organizations can learn from their collaborative innovation efforts. The featured keynote at the seminar’s morning session is Fisher College of Business Prof. Aravind Chandrasekaran, an award-winning researcher who will be sharing keys to collaboration.

Head to COE’s website to read more about this members-only session, or register now.

Below the equator, a classic process problem

The next time you think your organization’s process problems are so singular they couldn’t be happening anywhere else, ask Joe Langlitz and his colleagues how they spent the first month of their summer this year.

botswana students
From left: Bi, Langlitz, Goetter

Langlitz and fellow Fisher College of Business MBA students James Goetter and Wenzhao Bi closed out their first year in the program with an 8,000-mile trip below the equator to Gaborone, Botswana. They were one of eight groups of students sent overseas through Fisher’s Global Applied Projects (GAP) program to work up-close with a corporation to solve a business challenge. Sponsoring the students’ gap team was the Botswana arm of British banking giant Barclays, where Fisher alumnus Jeff Davis serves as Chief Risk Officer.

Looking back at the work Langlitz and his team completed, Davis says they’ve helped lay the groundwork for some major improvements in Barclays’ business loan approval process. Getting there, however, entailed a frenzied three-week mission to hunt down process waste that put to work what each team member brought from the classroom and enlisted the help of a few Center for Operational Excellence members, too.

‘I wanted a revolution’

Davis cut his teeth in the birthplace of lean manufacturing, working with automakers and suppliers as they applied lean/Six Sigma principles. Today he’s a top officer at Barclays Botswana, which employs 1,200 at its corporate office and 42 branches and ranks as the second-largest bank in the market.

“When I got into financial services later in life, I would see our processes through the lens of the learnings I had in the automotive industry and would get frustrated at our inability to do true lessons and root-cause analysis in our pursuit of simple, repeatable processes.”

A particular target of Davis’ frustration was the corporate loan approval process at Barclays Botswana, which could – and often did – take as few as two days but also could stretch past six months in some instances, putting average turnaround just shy of four months.

“I wanted a revolution,” Davis said. “I wanted 500 percent better.”

Project Firefly

Davis took his first steps toward a solution by connecting with the GAP program at his alma mater, eventually bringing the trio from Fisher to Gaborone and pairing them with two MBA students from the University of Botswana. The project team had zero formal corporate banking experience – and that’s exactly what Davis wanted.

“We wanted an injection of new ideas,” he said.

(From left) Langlitz, Bi and Goetter taking a break from the office at Botswana's Mokolidi Nature Reserve
(From left) Langlitz, Bi and Goetter taking a break from the office at Botswana’s Mokolidi Nature Reserve

Langlitz admits to a dose of culture shock upon arrival. Gaborone is the governmental and economic capital of a country with a fast-growing economy, but one that also still relies heavily upon mining and the cattle trade. It’s the latter – particularly their penchant for wandering onto busy roads in Gaborone – that struck the team in their early days.

“The first week we were there, it really sunk in: ‘We’re on the opposite side of the equator,’” he said.

The more time the team spent in country, however, the more familiar it became – and the more Langlitz and others saw how universal challenges such as those at Barclays are.

“They’re just like any institution,” he said. “They’re trying to figure out better ways to serve the customer.”

The GAP team and their University of Botswana colleagues took on what Barclays dubbed “Project Firefly,” an extensive effort to visualize the loan approval process flow in the form of a value stream map and, importantly, flag non-value-added elements therein. The long-term goal is to slash average loan-processing time a staggering 90 percent to only 10 days.

Mapping the process required interviewing numerous stakeholders across different offices and navigating at-times fraught situations.

“With the overall process so fragmented, teams tend to be myopic when dissecting which processes are adding to uncompetitive turnaround times,” Davis said. “We asked the team to hold a mirror up and tell our people what’s going on without placing blame, and they did a nice job of lowering defenses.”

Enlisting help

In addition to receiving regular coaching from COE Executive Director Peg Pennington, the Project Firefly team also sought insights on the challenge at hand from two member companies: Huntington National Bank and KeyCorp.

“A lot of the pain points they had,” Langlitz said, “were pain points Barclays has been dealing with.”

Jeremy Winstel, a senior manager of enterprise lean/Six Sigma for Key, said reducing customer hassle has been a regular focus for the bank in its process improvement efforts. His insights served as a key early benchmarking opportunity for the project team before and during their stint in Gaborone.

“Providing this knowledge transfer assistance has been a great way to get plugged in to Fisher and try to help out,” Winstel said. “That’s what the COE’s about, holistically.”

Kevin Plaugher, senior vice president and business banking credit manager at Huntington, also spent time walking the team through the credit approval process and imparting a key bit of wisdom:

“It’s like physics,” Plaugher said. “If you want to extend credit to the customer, there are certain things you have to do, and you can’t pretend steps in the process can be skipped or eliminated. Still, even with the most manual processes, there are tools to make it faster, simpler, and clearer.”

Langlitz said benchmarking with Huntington and Key “sent us down the right path” to ultimately making this key discovery: More than half of the time Barclays Botswana spent processing loans was non-value-added. This opened the door to substantial improvements.

Just the beginning

The Project Firefly team capped their nearly three-week stint with Barclays Botswana by reporting out their findings and recommendations to the bank’s executive leadership team and its Managing Director, the region’s top-ranking official. Langlitz said the team took particular pride in the fact that none of its recommendations came strictly from qualitative information.

“All our recommendations were data-driven,” Langlitz said. “These weren’t just because we heard someone say it was a good idea.”

The results and recommendations provided major clarity for Barclays going forward, even if Davis and his colleagues already knew process waste was a problem.

“We knew there was a lot of waste in the system, but we’d never been able to measure it,” he said. “They did a great job of taking a complicated set of data from a lot of locations and distilling it down to a very clear story to tell.”

Through the summer, Barclays Botswana began hiring additional associates and making its first strides in implementing some of the Project Firefly recommendations. Improvement efforts are set to ramp up through the fall, Davis said, for what is expected to be an ongoing process.

As for the students, Langlitz said he and his colleagues gained invaluable process improvement skills, through an unforgettable experience, no less.

“Being able to say I’ve been there, done business in a different culture, I’m a lot more comfortable now.”

For more behind-the-scenes details on Project Firefly, check out the blog the students maintained for the trip. For more details on the GAP Program, click here or play the video below:

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

manufacturing tomorrow
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.

 

‘Joy Inc.’ author, former summit keynote Sheridan returning in May

Miss last year’s Leading Through Excellence summit? Looking to revisit one of our most popular keynotes?

Rich Sheridan during his keynote at Leading Through Excellence 2015
Rich Sheridan during his keynote at Leading Through Excellence 2015

The Center for Operational Excellence is partnering with Fisher College of Business’ Master of Business Operational Excellence program to bring to campus Rich Sheridan, CEO of award-winning software developer Menlo Innovations LLC and author of Joy Inc. Employees of COE member companies are invited to join MBOE program alumni the morning of Friday, May 13, for a keynote by Sheridan, who kicked off the 2015 Leading Through Excellence summit and led a half-day workshop.

A programmer by trade, Sheridan entered the corporate world and found at the midpoint of his career that he no longer experienced the joy that had drawn him to the industry. After losing his job as a software development executive when the dot-com bubble burst, he founded Menlo Innovations in 2001, saying the company’s purpose was to “bring joy to the world through software.” Menlo has gone on to win the Alfred P. Sloan award for Business Excellence in Workplace Flexibility for eight straight years and has earned five revenue awards from Inc. magazine.

In his keynote, based on Joy Inc., Sheridan will offer an inside look at the culture that’s flourished at Menlo over the last 15 years that leverages visual management, an open and collaborative workspace, and a “fail fast” ethos that has garnered attention nationwide. All attendees will receive a complimentary copy of Sheridan’s book, Joy Inc.

Click here to register for this limited-capacity event.

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.

COE leader’s podcast appearance offers crash course on center

Looking for a crash course in the Center for Operational Excellence and how we’re partnering with our member companies?

peg penningtonExecutive Director Peg Pennington recently visited the Ohio Manufacturing Institute to talk COE on its Manufacturing Tomorrow podcast, a twice-monthly sit-down with leaders in the trade.

Pennington’s wide-ranging chat with host Kathryn Kelley touches on COE’s philosophy and its mission in the context of the needs of today’s business world.

“If you ask most leaders today what they want in their people, they want problem solvers and they want people that are going to learn and adapt quickly and build problem-solving processes,” Pennington said.

Pennington also explores where some companies go wrong in their efforts to drive continuous improvement: A lack of shared purpose.

“Companies sometimes come at this by picking a tool, saying, ‘Oh, we have to standardize work.’ All of those (tools) are great but they have to be nested together in this complex organization, and associates in that system have to understand the ‘why.’”

Pennington’s visit to Manufacturing Tomorrow, which you can stream in full here, was followed by another COE-affiliated leader, Norbert Majerus of Goodyear Tire & Rubber Co. Majerus and Pennington are among seven COE-affiliated podcast guests who have appeared since the show launched last year. To visit the full back catalog, including Majerus’ appearance, click here.

Management Sciences staffer Spadaro given top OSU service award

A longtime staffer in Fisher College of Business’ Management Sciences department was honored this week with a top service award from The Ohio State University.

Spadaro, front row, middle, with Management Sciences faculty and Fisher Dean Anil Makhija (front row, far right).
Spadaro, front row, middle, with Management Sciences faculty and Fisher Dean Anil Makhija (front row, far right).

Laurie Spadaro, assistant to the department chair in Management Sciences, received the Distinguished Staff Award, given to only a dozen staff members each year who have served the university for at least five years. Spadaro joined Ohio State nearly 18 years ago and has been with Fisher for 11 years.

Staff are nominated for their work in making a significant difference for colleagues or customers, providing outstanding and ongoing excellence in service, and developing creative solutions to problems that ultimately make their department more efficient and effective.

Department Chair Kenneth Boyer in his nomination called her the “heart of the Management Sciences department” who’s never afraid to problem solve and innovate. Associate Professor James Hill, meanwhile, said Spadaro’s “willingness to contribute to the team, her positive attitude and her selfless approach to her job have assisted in building a department faculty, staff and students can be proud to be a part of.”

Spadaro also has maintained a commitment to continuing education, attaining her bachelor’s in business administration in 2013 from Mount Vernon Nazarene University and earning a Lean Six Sigma Yellow Belt through MoreSteam.com this year.