Recently, I needed to undergo major surgery. Most staff will ask what you do professionally (probably to calm your nerves). In a haze of sedation and pain, I mostly answered “…something with Lean and Six Sigma”. It was good to hear many seemed to know what I was stammering about. A response I am sure I heard a few times was along the lines of….”Lean is not for us, we are about quality for clients”.
Now let me be clear, the care I received was exemplary, I can only bow my head in deep respect for all the staff in the hospital. The way they care about people, strengthens my faith in mankind.
Evidence of Lean was everywhere
Even on my way to surgery, lying in my bed wearing one of these gowns, which somehow always show more that you want and are really cold, I could see visual management, 5 S and standard work used in their protocols (just in case the confused me for my twin brother). Even the surgeon, just before cutting me open, mentioned stand ups.
So how is Lean not about Quality
After waking up, and the fog lifted, I could not get rid of this paradox, so many lean measures working, but Lean seen as something separate from quality (thus customers). I decided to see whether the people caring for me could tell me more….?
Most staff I asked, confirmed that their problem with lean is that it interfered with the quality they wished to offer their clients (read patients).
Listening to most of the staff, I noticed shared opinions. Lean is about tools that cost time (e.g. boards, protocols). It is driven by third parties, who know nothing about what really happens. It really is about cost cutting.
Summarizing, Lean was something you do because others tell you to do so and it is really not part of your daily work.
A quiet evening shift
After a few nights, you develop a rapport with some staff. During a quiet evening shift, I offered some of them my view. I asked some staff members whether their work had changed. Everyone said that medical science is developing, (my laparoscopic operation would not have not been possible a few years ago). Also, their patients were changing, growing older and multicultural. As a matter of fact their world was changing at a lightning pace.
A change of mindset
I then asked for their view on these changes. As expected most embraced it and wanted things to change. They agreed that if their work could be made easier they would have more time to adapt to change and have more time left for quality care for patients. I told them, that is what all Lean tools try to achieve.
The penny dropped. Tools were just tools. We should use them to make life easier and spend more time to really provide quality to patients.
A simple example was walking back to a dispensing unit if my medication i.e. oxycodone was not in the cart. Retrieving it, costs time which could be spent differently. Somehow, we needed to think of a way to enable this instead on relying on memory or patient initiative. It is a shift to a lean mindset, looking for ways to make what do you easier and giving you more time to spend quality time to your patients.
The next day
One staff member came up to me and said, aren’t you the lean guy (as I had lost 7 pounds, my answer was a double yes). She said, I have an idea about changing the activities on the handover between night and morning shift, it saves at least 30 minutes, but I just do it and nobody else. I said mention it during the next meeting. But what do I call it, she said? Well, just show them that it enables you to spend more time with patients.
Leaving and going home
Do you know the sense of relief, of knowing you can sleep in your own bed and not hear 3 other people snoring? In that mood, I was in my wheelchair, when the staff member I mentioned said, thank you for your clarification on lean (my response was, I should be the one grateful for their excellent care). She ended with, I have few more ideas!
Lean; a Mindset
At home I, could not suppress I smile, I really hope at least this one person sees lean as a state of mind, always looking for ways to improve and thus care for your patients. We cannot change the world but let’s start with one person at a time.
Michel C. Doppert
Master Black Belt Lean Six Sigma
The Lean Six Sigma Company UK