Doctors Bash “Taylorism” and “Toyota Lean” in the New England Journal of Medicine | Lean Blog

This is another great piece from Mark Graban on lean healthcare. In this post, Mark addresses critical comments made in the New England Journal of Medicine. These negative quotes reminded me of similar attitudes reflected in Atul Guwande’s book, The Checklist Manifesto. Dr. Guwande shows how using simple checklists greatly improve surgical outcomes. For me, the most interesting part of the book, related to how resistant doctors were to the concept that they did not know everything. We see this regularly in business. Senior leaders shun standard work (like checklists) because they are deemed too rudimentary.

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Mark writes:

It’s not credible to say Lean is inappropriate or that Lean doesn’t work. That said, there are many wrongheaded things done in the name of “Lean,” when people don’t understand the mindset and philosophy behind Lean.

Read the entire post here: Doctors Bash “Taylorism” and “Toyota Lean” in the New England Journal of Medicine | Lean Blog

Standard Work Is a Verb

from Mark Hamel’s Gemba Tales blog: http://kaizenfieldbook.com/marksblog/archives/799

Standard work is not a once and done proposition. That would be lean anathema. In fact, the Shingo Prize Model reflects a lean principle (one of ten) called “integration of improvement with work.” We don’t stop working, why would we stop improving?

This dynamic is consistent with the evolution from system-driven kaizen to principle-driven kaizen. System-driven kaizen is represented mostly by kaizen events as pulled by value stream improvement plans. Really good stuff, but it can and should get better.

Principle-driven kaizen is system-driven PLUS the integration of daily kaizen. Daily kaizen, as defined in my Kaizen Event Fieldbook is, “small, process- or point-focused, continuous improvement that is conducted by engaged and enabled employees in their everyday work… Daily kaizen opportunities (problems) are readily identified by workers using simple robust lean management systems and by a pragmatic comparison of the current state with the envisioned ideal state. By applying common sense and learning developed in kaizen events, training classes and direct application, employees, as individuals and within teams, engage in PDCA through the use/execution of actionable, low bureaucracy suggestion systems, mini-kaizen events, kaizen circle activities, ‘just-do-its’ and the like.” OK, it’s a really long-winded definition!

While standard work is often initially developed within the context of a kaizen event, it can’t stop there. As employees adopt PDCA thinking and learn to become experimentalists, they will/should continuously improve the standard work. Truly, when the culture becomes principle-driven, people feel happily compelled to improve their processes and thus the standard work.

So, think of standard work more as a verb and less as a noun. Next time when you’re at the gemba, take note of the revision date of the standard work sheets and standard work combination sheets. If they haven’t been updated and improved over the last quarter or two, then you might have an issue. There’s a good chance that you’ve never left the land of system-driven kaizen. Related post: There Is No Kaizen Bus Stop! Tags: daily kaizen, Kaizen, Lean Principles, PDCA, Shingo Prize This entry was posted on Saturday, April 24th, 2010 and is filed under Kaizen, Lean Principles. You can follow any responses to this entry through RSS 2.0. You can leave a response, or trackback from your own site. No comments yet.

Andon

Andon (アンドン, あんどん, 行灯) is a manufacturing term referring to a system to notify management, maintenance, and other workers of a quality or process problem. The centrepiece is a signboard incorporating signal lights to indicate which workstation has the problem. The alert can be activated manually by a worker using a pullcord or button, or may be activated automatically by the production equipment itself. The system may include a means to stop production so the issue can be corrected. Some modern alert systems incorporate audio alarms, text, or other displays.

At Toyota, each team member is a quality inspector. At any time during the production process, any team member who spots a problem can stop production by pulling the “andon cord” located next to the assembly line. An andon board (left) lets supervisors know the location of the problem with a blinking light and a distinct musical tone.

An Andon system is one of the principal elements of the Jidoka quality control  method pioneered by Toyota as part of the Toyota Production System and therefore now part of the Lean approach. It gives the worker the ability to stop production when a defect is found, and immediately call for assistance. Common reasons for manual activation of the Andon are part shortage, defect created or found, tool malfunction, or the existence of a safety problem. Work is stopped until a solution has been found. The alerts may be logged to a database so that they can be studied as part of a continuous-improvement program.

The system typically indicates where the alert was generated, and may also provide a description of the trouble. Modern Andon systems can include text, graphics, or audio elements. Audio alerts may be done with coded tones, music with different tunes corresponding to the various alerts, or pre-recorded verbal messages.

Usage of the word originated within Japanese manufacturing companies, and in English is a loanword from a Japanese word for a paper lantern.

References

Liker, Jeffrey (2004) “The Toyota Way” New York:McGraw Hill ISBN 0-07-139231-9

Learning to See the Whole

One of the most important things that continuous improvement practitioners must to is to help people learn to see the enterprise as a whole.

This is the best example I have ever seen of optimizing one part of the process, but sub-optimizing the whole process.

While this is an old clip, the “workers are the problem” attitude of many managers is alive and well many years later


Making Toast the Lean Way

from GBMP (http://www.gbmp.org/)

Learning About Process Improvement

The #1 selling Lean training tool in the world is the Perfect introduction to Continuous Improvement.

Narrated by and featuring Bruce Hamilton, Shingo Prize Recipient and GBMP President, this 27-minute video highlights the seven deadly wastes found in both administrative offices and in manufacturing processes. In this training tool, the process of making toast is used to represent the before condition and the target condition of a manufacturing or transaction-based process and helps your people to identify with the process of Kaizen(small and continuous improvements). Whether you are already on the Continuous Improvement journey or you are just beginning to realize the power of continuous improvement implementation, this video is an essential learning tool for your entire workforce.


Click here to open the video file.