January 6, 2012

What’s Missing With Your Lean Initiative

We are currently looking at new innovative ways to deliver services to folks that have superior value.  We want to hear from you on what you would like to see from a consulting company that you don’t see.  It can be cost, product, services, or any other items but we want to hear from you.

Here are some of the ideas that are in the works:

-Distance facilitation
-Online coaching for managers
-Full package implementation (strategy, org structure, training, and some projects) at a single price point
-Strengths based problem solving

We’d love to hear your thoughts in the comments section or contact us directly.

Related Blog Posts:

Change Effort Not Working? Try Appreciative Inquiry And Changing The Culture

December 14, 2011

Lean in the Office

You might think of a scene like the one in the picture when you think of a “non-Lean office.”  The fact is that Lean in the office is much more than just a 5s program.  For those unfamiliar, 5s is a 5 step process to help organize the work space and more importantly you use 5s to help see where there might be opportunities for improvements.  The 5s process is 1) Sort 2) Set 3) Shine 4) Standardize 5) Sustain.  For more information please contact us.  
A Lean office is an office that is designed to deliver the most value with minimal waste to a customer.  5s is a great place to start because it will usually lead to other findings which you can improve.  We have found a slightly different way to approach a lean office.  First step is to give everyone Lean training and teaching people to see what is value and what is waste.  The next step is to look at what you are currently doing well and try to see how you can do more of it.  An example of this is at an office I helped they were a a couple of people great at communicating with customers/clients.  We decided to standardize as much as possible their process and train others on how to have good interactions with customers/clients.  The training was done by the people who  were thought to be the leaders in the area (a receptionist, a manger, and a technician).  You can find what’s working well by doing an appreciative inquiry.
After leveraging what you have working well then there is an opportunity to work on the problem areas.  We usually like to do some mapping events to get a good feel for where the main opportunities lay.  A value stream map or multiple value stream maps is ideal for this step.  In an office setting value stream maps can get a bit hairy and may not be as clear as in a manufacturing setting.  Don’t worry that is ok just do the best you can in mapping.  Once you’ve mapped out the current state for a particular area then design an ideal future state map. The difference from the current state and the ideal state will be the projects you will need to work on in your office.  Don’t worry if you can’t get everything done this year, just prioritize and pick which ones you want to do.  Just remember that this is iterative so if it’s not perfect then don’t worry you’ll have another change to improve it.  We recommend doing a value stream map at least once a year and doing both a current state and future state map.
From this point you can go in several directions but you will have multiple projects to work on through out the year.  For sustaining and continuous improvement we find that daily management helps.  This is a simple board with metrics and if the metrics aren’t meet then we try to root cause the problem and solve it so it doesn’t happen again in the future.  It’s a great way to engage all people and give them ownership in their work space.  For more information on daily management, value stream mapping, or any other questions you may have please contact us. 
December 8, 2011

Change Effort Not Working? Try Appreciative Inquiry And Changing The Culture

This is the abbreviated post for the more detailed post on how to make change management work.

Many of my clients approach me because they want one of three things.
1) Process improvement
2) Strategy facilitation
3) Cultural changes

Mostly they ask for the first two choices because they are more concrete.  When clients choose to do only process improvement or only strategy the gains from their efforts and the lean way consulting are short lived.  Ultimately true sustainable change only comes from cultural change and that is not easy.  Organizations fall into typically two categories.

1) An organization wants to do a process improvement effort like Lean and are excited to use the tools because of all the great things they heard Lean can do for their organization.  While that is true they miss the critical element of the management and sustaining side.
2) An organization wants to do a process improvement effort like lean and understands it’s more than a tool set but will focus on a problem orientation when implementing Lean.

The lean way consulting’s system for process improvement is to integrate cultural changes at the beginning with an approach called appreciative inquiry.  Appreciative inquiry is an approach designed to build on the strengths of an organization and address the weaknesses in the context of building on strengths.  Normal Lean implementations are based solely on what’s not working.

By looking at the positive side of things we activate the parasympathetic system which allows us to be more creative and able to solve problems easier (this is an oversimplification of the biological system of the PNS but the end result is still the same).  It doesn’t take much effort for people to be more positive and open to other solutions.  Cornell university did an experiment where they asked physicians think out loud while they solve a case of a patient with liver disease.  They found that when they gave physicians just a small bag of candy or some kind of small gift those physicians were better at integrating case information and less likely to become fixated on the initial ideas and coming to premature closure in their diagnosis.  This is the type of thinking you want from every person in your company.  You get less resistance, more buy-in, and a sustainable solution.  Here is the basic approach the lean way consulting uses for a new change management effort:

0) Training (ongoing)
1) Start in a place where there is a need
2) Build out an area to experiment and grow momentum
3) Expand by creating tension to constantly move people out of their comfort zones
4) Integrate what you are doing in strategy

For more information please contact us oh where you can get started.  You can also take our free assessment and we will analyze your current culture for free.

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How To Make a Change Management Effort Like Lean Stick

December 2, 2011

How To Make a Change Management Effort Like Lean Stick

Change is inevitable – except from a vending machine.

-Robert C. Gallagher

If you are involved in any kind of change management effort that is large typically it takes about 2-5 years to make the change sustainable(The Banks Report December 2005). A Lean implementation is no different and in this blog post I want to talk about the initial conditions you need to make a Lean (or any other change effort) sustainable in the long run. Before we get into how to change a culture let’s look at all the factors that influence culture:

Mission/Vision of the company – ex. Nike’s mission; “To bring inspiration and innovation to every athlete in the world.”
Process controls – ex. role cultures have many rulebooks and power cultures relay on individuals to get things done.
Org. Structure – ex. decision flow, hierarchies, etc.
Power Structures – ex. where are decisions being made, are they made by groups or individuals, how concentrated is the decision making?
Symbols – ex. employee of the month pictures/parking, logos, designs, offices vs. cubicles, etc.
Rituals and Routines – ex. meeting schedule and how each meeting is run, reports that are more habitual instead of useful, etc.
Stories and Myths – ex. building up people and events to get a message across, GE’s story of how Thomas Edison invented the light bulb.
(source: Johnson, Gerry (1988) “Rethinking Incrementalism”, Strategic Management Journal Vol 9 pp75-91)

A good change management program will tackle most if not all of the elements. In a Lean transformation you will typically change process controls, org. structure, power structures, symbols, rituals and routines, indirectly change the stories and myths and possibly the mission/vision statement. So why isn’t every change management program successful? There has to be a driving force moving people out of their comfort zones. These forces can be either internal or external but it needs to be significant enough to drive people to change.

In designing systems Lean designs include pull systems. A pull system is designed so a product/customer doesn’t move to the next step until the next step is ready and “pulls” the product/customer into the step. Please seen this wikipedia article for more information. The main question becomes how do you generate pull for a change effort. When ever we do change efforts we look at these factors:

1) Sponsorship support – What level is the sponsor that supports the change, are they the CEO or owner?
2) Support structure – Are there others who want the change?
3) Current situation – What are the current conditions like morale, productivity, turn over, etc? Is there opportunity to get a quick win in any area that is measurable
4) Resources – Does the company have the right people or do they have plans to either train, hire, or bring in consultants to help? Do they have time and money dedicated to the change?

If these 4 factors are in place then we move forward with the change effort. If they are not then we address them first before moving forward if we even move forward. Usually training is a good alternative to a change management program if you don’t have the above 4 factors.

Ok now we’re ready to start a change management effort like Lean, how do we start. Here is the traditional approach:
0) Training (ongoing)
1) Start in a place where there is a need
2) Build out an area to experiment and grow momentum
3) Expand by creating tension to constantly move people out of their comfort zones
4) Integrate what you are doing in strategy

There are many steps in between and it’s not always this linear but it’s like a pyramid where you start at the tip (small) and expand out. This process can be a lot of pushing to get changes made. If you want to generate pull start with upending the pyramid and start will the whole system. I want to introduce to you a new tool that is being taught at Toyota university and that’s Appreciative Inquiry. Appreciative Inquiry (AI) is different from a traditional approach:

Traditional approach:
1) Felt need/identification of problem
2) Analysis of Causes
3) analysis of Possible Solutions
4) Action Planning

Appreciative Inquiry Approach:
1) Appreciating & Valuing the Best of What Is
2) Envisioning What Might Be
3) Dialoging What Should Be

(source: David L Cooperrider;Diana Whitney. Appreciative Inquiry: A Positive Revolution in Change (p. 13). Kindle Edition.)

How does an appreciative inquiry approach get people excited about change? That is where the AI process is different from the traditional approach. AI focuses on strengths and and the foundation is in positive psychology. Positive psychology is not about being a cheerleader 100% of the time but it’s about finding what’s good, how to be resistant, and being aware of what could go wrong the negatives of a situation. What happens with appreciative inquiry is that we ask people what is right with the system and how do we do more of what is right. By appealing to people’s positive emotions we have seen high levels of engagement with staff members and better sustainability with efforts. Below is an example of how appreciative inquiry can lead to results:

Roadway began holding Al Summits throughout its North American operations, realizing that to thrive in an industry in which net profit margins are less than 5 percent in a profitable year, each of its twenty-eight thousand employees must assume leadership responsibility. The results have been impressive. When the work began, Roadway stock was around $ I4 per share. In two years the stock rose to more than $40 per share, before any merger discussions with Yellow, whose stock was a much lower $24 per share. Following the merger in 2003, the combined company was valued at around $42 per share because of the strength of Roadway’s improvements. But beyond stock prices, many other measures have steadily improved at statistically significant levels, including operating ratios (the lowest in years) and well-documented overtime changes in survey data looking at measures of morale, levels of trust, clarity in focus and priority vision, commitment levels, and confidence in a new and better future. Many of the changes occurred during an economic downturn in the industry and have been traced to the power and effect of the new culture of engagement fostered by more than twenty large-scale Appreciative Inquiry Al Summits. Jim Staley, Roadway’s CEO, says he’s seen tremendous employee involvement in task teams at terminals that have held Al Summits, and each team has produced results. “The Appreciative Inquiry approach unleashes tremendous power, tremendous enthusiasm, and gets people fully engaged in the right way in what we’re trying to accomplish,” Mr. Staley says. “It’s not that we don’t deal with the negative anymore,” he explains. “But the value of Al is that, in anything we do, there’s a positive foundation of strength to build on in addressing those problems.

(source:David L Cooperrider;Diana Whitney. Appreciative Inquiry: A Positive Revolution in Change (pp. 40-41). Kindle Edition.)

You might be asking yourself how do you integrate this approach with Lean? One way The Lean Way has found works well is to start your lean efforts with training everyone so they have a general knowledge of lean and how to think lean then start the whole system design approach of appreciative inquiry. This is an oversimplification of the process and each organization is unique so for specific questions please send questions to us from the contact page.

We have started the effort in a hospital system in Cleveland and we decided to tackle group performance. We wanted to make a better working environment for the PMO group so we decided to take the appreciative inquiry approach. During the process the team had comments like “This process gave me hope that things can be better” and “Wow this is great and I never thought of it this way.” With the results that came from the effort the team decided to redesign the team building events for the upcoming year to foster a better working environment.

Call 615.852.LEAN[5326] and Follow on Twitter and Facebook.

March 31, 2011

Rethinking Value Streams In Healthcare

Value stream maps are a great way to see your processes in a way that a customer or patient will see your processes. A typical value stream for a hospital might be a diabetic patient who is over the age of 70 and is coming in for chest pains. Another example might be a heart surgery patient. The granularity of what constitutes a value stream is variable and by improving one value stream you will improve others that touch those same departments. For example if you improve the flow for a breast cancer patient you will help improve the process for other cancer patients because you will help improve areas like chemotherapy, x-rays, and lab testing.

Traditionally that is how Value streams are done in Healthcare. We take existing processes and find how they align to patients. I would propose a new way of looking at patients. I recently had the a chance to hear Dr. Atul Gawande, author of The Checklist Manifesto: How To Get Things Right, and he mentioned a staggering fact. About 5% of the medical patients make up 60% of medical costs and the facilities that provide the best care are not the highest cost structure. If you can deliver better care to the 5% of the most expensive care patients it should improve the care to the other 95%. The 5% that make up most of the costs are also the more complex cases who typically visit hospitals for their care.

Instead of look at a value stream by hospital and patient type I propose looking at a value stream by prevention and management of diseases instead of treatments. With that you have to look at several more factors like how do you prevent more diseases as well as effectively manage current ailments so there doesn’t need to be emergency treatment. The value streams becomes more of a value chain linking public health, in home care, primary physicians, and hospitals all playing a crucial role. Currently if you have a diabetic patient with heart disease most of the care they receive is through the hospital that would be able to handle their complex case. In this new model the patient is intercepted before coming to the hospital and focuses more on preventative care through in home care via an in home care person or program as well as a primary physician. If the patient has an emergency or needs some more specialization then they can come to the hospitals. Distribute the care away from hospitals and more at the source of the problems is the idea behind the healthcare value chain. Catch problems early and often.

A downside to this is that hospitals would see less revenue if they continue with the current model but patients would receive much better care. Not to mention it would bring down healthcare costs to treat patients since the rate of major (and more expensive) incidences would go down with proper management.

Call 615.852.LEAN[5326] and Follow on Twitter and Facebook.

February 22, 2011

Motivating Employees Without Money: The Carrot and the Stick


I came across an interesting problem. How do you motivate employees to change their behavior after an event or project that changes their work. In my experience I’ve seen some interesting approaches. In a wire harness manufacturing company I saw the stick (punishment) being used to discipline people who were not following process. If you diverted from the new written processes during an audit then you could be written up. In a major hospital system I’ve seen financial rewards for performing the new behaviors. Patients in MICU needed to be turned to prevent pressure ulcers. The nurses who would turn the patients the most got a monetary reward.

So what works, the carrot, the stick, or both. The approach at the Lean Way Consulting is that it depends on the organization.
Here are the questions that are asked to know how to approach the changes:
1) Is there a process defined for the change well enough for anyone from outside your department to come in and audit the person doing the work on accuracy?
3) How much does the staff want to make the change (level of desire)?
4) What is the level of competency of the team to execute to the idea (able or unable to do the task)?
If you answered No to the first question then don’t bother going further until you can answer yes. Without clear expectations it’s very hard to change behaviors. If you need to know how to do that for a process please leave a comment or send me an email ankit@theleanwayconsulting.com for more information.
Once you have the first element now gauge your team’s desire to change and their ability. For simplicity we’ll use the following values:
High desire
Low desire
High ability
Low ability
If your team has low ability and low desire to change then the carrot methods for motivation will not work. You will have to dictate how the work needs to be done and use more of the stick approach. For example you may want to discipline people not following new processes. Once your organization starts adopting the new changes then you can consider rewarding good behavior.
If your team has low ability but high desire then you need a mix of motivational tools. You need to praise the good behavior but at the same time you need to correct the bad behavior but maybe not in a harsh way.
If your team has high ability and low desire I’ve seen all methods work depending on the environment. If you use a carrot method then having a friendly competition to see who can do the new process best can work. A mix of process discipline maybe needed as well. One of the main differences in this scenario is that you can have your team help come up with their own ways of solving the problem of sticking to the new process. What I’ve found that works well is to get the team into a meeting and ask how can we accomplish “xyz” goal in the new process.
If your team has high ability and high desire then you will need minimal effort to have the change take root. In this scenario be careful not to do anything that will hinder the change.
If you are thinking about giving a monetary reward as your carrot I would caution you. Sometimes giving monetary rewards will lead to behavior changes as long as you keep paying. Once you stop paying then the behavior goes away. That is exactly what happened to the MICU once they stopped giving a financial reward. If you punish too much with out some reward or recognition then in the long run you can get demoralized employees; this is what happened at the wire harness company. The key is to find the right balance.
January 13, 2011

Lean For Haiti


All,
I want to share with you a message I recived from a friend and a collegue Mark Graban.


Dear Friends-

Today marks the one year anniversary of the earthquake that devastated Haiti on January 12, 2010.

Last year, I was fortunate to meet a special person – Russell Maroni, an x-ray tech at Akron Children’s Hospital. He volunteered in Haiti for 15 days in February 2010 as part of the earthquake relief efforts. He was unexpectedly, and necessarily, pressed into service in a medical role, not only caring for patients, but also using his formal lean training from ACH to help improve processes and radiology patient throughput at a field hospital.

Russell wrote a very compelling, and very personal, journal during his time in Haiti. He and his colleagues took many pictures. We are sharing this all in a PDF eBook that we are freely distributing – to share the story and to create awareness for Haiti relief needs. We are asking people who read the book to consider donating to the Friends of the Orphans, which runs an orphanage in Haiti.

The journal isn’t mainly a “lean story,” although it does include his hand-drawn A3 plan. It’s a very personal story, of his own prayer and contemplation of the trip, and his experiences in the midst of that tragedy.

I hope you will consider spreading the word about this project to your readers and/or listeners – on blogs, LinkedIn, Twitter, Facebook, radio, etc.

To read more, go to http://www.LeanForHaiti.org, which has links to the PDF and our social media sites. If you have ideas for helping promote this, to hopefully make it “viral” in the Lean community, please let me know. We can kaizen the site and the book itself.

If you can help support this online, please share a link to any blog posts, etc. and I’ll list you and your site on the “Supporters of This Project” page on our site. If you have any questions, please let me know.

Thanks for your time and consideration.

Mark


I first want to thank Mark for the email and taking initiative on spreading the word. This is my small way of trying to help any way I can.

I would also like to note that Lean is a great system to help non-profits and to help with deliver of services to people who need it most. Let’s do what we can to help people who need it most.

Here are some other places to donate besides http://www.LeanForHaiti.org :

If you have any questions please let me know and I’ll make sure we find an answer.
Thank You,
Ankit
January 3, 2011

How To Get To The Root Cause Of A Problem

First off Happy New Year to Everyone and I hope 2011 is a fantastic year for you all. Now for how to get to the root cause of a problem. I was working with a client who plays in the IT recruiting space and they have started some great activity around strategic alignment and policy deployment. One of their big hangups is when is a slip on the schedule when is the slip up caused by an accountability issue and when is there something else that might be the root cause to the slip. Now initially everything was an accountability issue and there were many fingers being pointed in all directions. After talking with the team and we decided to change some items around in the meeting.

1) Always dig deeper into issues. No longer will “I didn’t have time” or “I was waiting on XYZ” be an acceptable answer to why we are missing on our dates.

2) Ask the 5 whys to get to the root cause of the problem. The source of most of the problems can be easily traced using this methodology correctly.

Problem: I missed my due date on an action item
Why: I had an emergency come up with a client

Why did we miss even though we had the emergency: We didn’t have enough people properly trained to do what needed to be done so my efforts were diverted to the emergency

Why was there no one trained to do the other items: We didn’t have a standard around how we deal with the emergency or standards on how we do daily work so any emergency that comes up will cause this same issue in the future

Containment plan: Realize that this is an issue moving forward and work on the solution plan

Solution: Standardize daily process and emergency processes as much as possible so there is agreement on what and how we do business.

The solution is much deeper than just an accountability issues; it is a systemic issue at the company that if not addressed will cause problems again in the future.

In this example the people understood their process and systems pretty well but what about a much larger organization where an employee may not see all the moving parts. How would you find root cause there?

In the healthcare world Hospitals are the perfect example. I was working with a catheterization (cath) lab on their patient turn around times. We started digging into the reason why the turn around time was taking so long and there were multiple reasons and here is one of those lines of reason:

Problem: The turn around time in the cath lab is longer than expected.

Why: Some labs just have lazier workers
Why: They are just lazy
Why: Because they just are
Why: That’s the way they were raised
Why: What is the point of this? They need to be held accountable.

So the line of reasoning was that we just need to hold people accountable and that is fine but the what the folks didn’t understand is the root cause. The source of the problem wasn’t that people were lazy or inept; it was that there is nothing in place to hold people accountable. There was not standard where a manager could come in and say you are not doing your job to your work instructions because there were no work instructions.

The folks in the cath lab didn’t know enough about the processes and the system to understand that the root cause of the problem wasn’t accountability but was the lack of standards. Fixing that lack of standards fixes all the issues in this one problem set for turn around time and in fact we did see (if all other variables taken out) 40% improvement in the turn around time by just standardizing and we expect to see a reduction in infection rates due to the fact that we are now standardizing the preparation of the patient to sterilize completely and consistently.

The summarize:

To fix the root cause ask a lot of questions and make sure you understand the system. One way to know if you fixed a root cause is that the problem dosen’t and has no chance of coming back in the future. Ask the right questions to get to the right solutions. This is a bit art and science. Ask for help if you need it when it comes to finding the root cause.

August 20, 2010

Factoid Friday – The Market Has Changed… Where Were You?


Markets are always changing but companies don’t always recognize the changes. According to Harvard Business Review Daily Stat 1/4 of all households now only have a cell phone and no land line. How have you seen the land line market change because of this shift in the market? How do you see traditional land line companies changing their business models to accommodate a higher rate of cell phone only households?

What if your business had such a shift? How would you respond? How does your business system adapt to a changing market? Is your business system able to :
1) recognize a change in the market quickly
2) change your operations to meet the demand
3) deliver a high quality product/service
4) deliver the product/service at a competitive rate
5) fosters a flexible work group to deal with changing demands and day to day operations

If your business system cannot do all of those items listed above then what are you going to do when the next market shift happens in your segment?

August 17, 2010

How Do You Know What To Standardize In Your Business

If you have read the E-Myth and in the book it talks about having a system put in place to be able to duplicate and expand your business. To do this you have to standardize processes. The biggest question I get is what to standardize. The question usually comes from the belief that what is being done is unique. The perception is there is a scale ranging from 100% repeatable to 0% repeatable. The more repeatable then more standardization can be applied. The reality is that you can actually standardize just about anything.

To get started on how to standardize you can first breakdown a process into 3 categories:

100% repeatable – These are tasks that are the same every time and we can easily standardize the process. Example: Installing a screw into a panel.

0% repeatable – The task is diffrent every single time with no elements that repeat. Example: I have never experienced a 0% repeatable process

0% repeatable – Most tasks fall into this category. Example: Checkout process at the grocery store.

Once you take an inital look at your processes and determined which catagory they fall into then you look at to see if you can maximize the repeatable elements.

What every you can repeat make sure everyone is does it the same way and what ever cannot be repeated then standardize as much as possible. An example of a non standard process is diagnosis of a problem on a computer. Fixing a computer once you know what is wrong is a standard process but trying to find out what is wrong is not a standardized process. One way that your business can standardize something like a computer troubleshooting is to come up with a flow chart or a decision chart where it will help everyone start the diagnosis process.

The biggest obstacle to standard work is the thoguht that “I’m unique and my work cannot be standardized.” Try to fight the urge to think that way and instead think about how you can standardize your business.

For more information or any other questions please contact us.

Related posts:
“I Want To Do It My Way And Not The Standard Way”

Call 615.852.LEAN[5326] and Follow on Twitter and Facebook.

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