Lean Healthcare Executive Materclass

As we’ve mentioned in previous posts, one of the biggest wastes we see in the NHS is executive teams implementing countermeasures to problems before accurately defining what exactly the problem is.

This behaviour is both dangerous and fraught with risk. As opposed to improving services, this behaviour actually makes thing worse. For example, we have learnt that chasing financial targets will actually make financial performance worse.

A bi-product of this behaviour is the distraction it causes, consuming the organisation’s precious resources and preventing them from doing the right things.

Unless a problem (or set of problems) is accurately defined, the effectiveness of any solution is at the very least debatable.

It is easy to declare victory in this world of not really understanding problems, with an illusion of progress. However the problem will re-emerge having not really been solved.

Any premature leap to solutions (often mistaken for ‘increased pace’) is, in reality, nothing more than tampering.

The management mantra “don't bring me problems bring me solutions” is perilous. This approach directs organisations rapidly to the above issues. Additionally staff in the organisation will begin to act in the same way, further reducing the organisations' ability to solve its own problems.

Imagine that instead of pursuing several hundred projects your organisation was able to focus everyone’s’ efforts on the vital few objectives that would make the biggest difference to your performance. Imagine that the top team had identified the size of the performance gaps that need to be closed to meet these objectives.

As a result we have designed, tested and are now offering a Lean Healthcare Executive Materclass.

Problems always come in bundles, some big, some small but all impact upon each other. This masterclass is designed to show executive teams how to un-pick these problems and funnel down to their vital few, biggest problems. The vital few that if resolved will (more or less) resolve the many. The concept of ‘leverage’.

It is not hard to imagine the acceleration in performance that would result from this much more effective use of executive time. We call it ‘Results Driven Lean’, where action is only taken to resolve clearly defined problems with an evidence based plan to achieve measurable results in performance.

It is also significant that the top team sets the example for the rest of the organisation by doing it themselves on their own work, which gives enormous credibility when they ask everyone else to follow their example. It also means they are in a position to mentor the next level down in the disciplines of evidence based planning and problem solving by asking questions to teach them how to think rather than telling them exactly what to do.

Lean Thinking for the NHS – The Sequel. We’re about to light the blue touch paper……

LEA’s report ‘Lean Thinking for the NHS’ published in 2006 identified the then existing lean pioneers and exemplars in healthcare and how lean could improve quality of care whilst containing costs.

When this first report was published it was almost midway through a ten year period that had seen the annual budget for the NHS in England more than double to over £102 billion up to a point where £1 of every £13 (7.7% GDP) produced by the UK economy was spent on healthcare.

Obviously that’s all changed dramatically now so we thought it was time to write an up-date. This reflection has lead us to a massive discovery, albeit something that we had suspected all along.

Another realisation was that this paper’s target audience must be the mandarins, the people at the top, the only one’s that can really make a difference. Remaining true to the scientific approach this paper describes the problem, the deep rooted causes to the problem and proposes countermeasures (quite dramatic ones)

As soon as this paper is completed fully, copies will be sent directly to the mandarins whereby we will be asking them to take stock and hopefully agree with, and endorse what we are saying.

Watch this space

Lean Health: Our Approach - Unplugged

We are often asked “So what exactly is your phased approach?” so we thought that it was high time to spell it out. As a result we will do so in a series of posts. On this occasion we are the ‘pacemaker’ here (the pacemaker concept will be revealed in post number 5 or 6) so for now all that we can say is that we will release this information one piece at a time (as opposed to batching) outlining our phased approach.

We are all gainfully employed because there exists a customer problem that needs to be resolved – right?

In this post we’ll outline the importance of really understanding the customers’ problem before our phased approach actually commences.

I’m a solutions person – Really?

We shudder when we hear those words……

Based on experience and observation, implementing countermeasures to problems before accurately defining the problem is one of the biggest wastes we see in healthcare.

This behaviour is dangerous and fraught with risk. Instead of improving services this behaviour actually makes thing worse.

A bi-product of this behaviour is the distraction it causes, consuming precious resources and preventing them from doing the right things.

Unless a problem or set of problems are accurately defined, the effectiveness of any solution is at the very least debatable.

It is easy to declare victory in this world of ‘not really understanding problems’ with an illusion of progress. However the problem WILL re-emerge having not really been solved.

Any premature leap to solutions (often mistaken for ‘increased pace’) is, in reality, nothing more than tampering.

In all industries the management mantra 'don't bring me problems bring me solutions' is perilous. This approach directs organisations rapidly to the above issues. Additionally staff in the organisation will begin to act in the same way, further reducing the organisations' ability to solve its own problems.

Voice of the Customer (VoC)

Prior to commencing our phased approach we always obtain the Voice of the Customer (VoC):

This exercise is critical. If we don’t obtain the Voice of the Customer then we will never ‘hit the spot’

This VoC although hugely important tends to be, even if expressed in plain English, fairly vague in that it is not measurable. As a result we then employ a process to translate this VoC into CTQs (Critical to Quality).

CTQs are the key measurable characteristics of a process, the performance standards or specification limits that must be met in order to satisfy the customer. They align improvement or re-design efforts with customer requirements.

A CTQ must be interpreted from a qualitative customer statement to an actionable, quantitative business specification usually a set of numbers, KPIs or metrics by which we can all measure how successfully the improvements are being implemented through regular review.

Right now we already know that any folks reading this that are exponents of either six sigma or lean will be crying out “but so far, that’s not lean, that’s six sigma”. However the folks reading this that truly understand, the folks that really understand the scientific approach will be thinking “So, what’s wrong with that?”

This is just the start. Phase one coming soon.....