Hi, this is Mark Raven. Welcome to episode 249 of lean blog audio. This is a post from February 2nd, 2018 titled, employee complaints about lean and Healthcare, even at some of the best organizations. Now, recently, I blogged about some employee complaints related to rotating day and night shifts at the Toyota, San Antonio plant in that post, I mentioned that employees who post on glassdoor.com and other sites might not be a representative sample of the full employee population.
So with that in mind though, what happens when we search the glass door, surveys of some well-known lean hospitals, quote unquote, I posted a few of those employee comments on LinkedIn. The other day is a short post, that's received over 50,000 views and prompted, a lot of discussion. One of the employee comments about a health system that many would consider to be a long time in leader, in lean Healthcare said, the employee complaint read.
Management needs to have a better understanding of the work because this Health Systems lean culture changes are made on a continual basis by people, not in the work and who don't understand who is all impacted by the change and of quote, as I said on LinkedIn in a lean culture. Improvement is supposed to be done with people or by people, it's not supposed to be done to them. Here's another sad comment from a different well known lean
hospital. It says the hospital has gone too far and it's attempt to cut costs, many behind the scenes. Employees work in squalor and are treated like slaves, they are encouraged to skip lunch and breaks and are in constant fear of being fired. As a new employee. It only takes a few days to realize that you will be asked to commit hari-kari if you make an honest mistake, that is the Japanese parentheses. Lean way and of quote.
Well no no I mean the lean way doesn't blame or punish individuals for an honest mistake. I don't understand how the leaders in these organizations maybe misunderstand lean or or maybe didn't bother to learn. If even one employee has this perception I guess perception is the reality is they say we need to do better. Another employee comment says there's so much focus on lean and know. So focus on building better managers. Well, that's sad to hear.
I mean lean is supposed to focus on developing people. Including managers lean is a different way of leading and managing not to set a set of tools or projects. Now are those comments representative of what most employees? Think? Well, probably not, but even if even a handful of employees have major and understandable issues with what they're experiencing with lean, then that represents an opportunity for improvement.
Do these organizations need to be more consistent with what lean really is. Do they need to invest in additional or more capable coaches for those leaders who are perhaps misunderstanding or Miss applying lean mean we're 20 years into the lean movement in healthcare but there are still way too many organizations where lean is limited to relatively trivial things, including straightening up, the workplace, or having daily Huddle's at the Frontline.
I'd say a majority of those organizations that are quote unquote. Eating lean don't have Executives who are actively learning about lean yet alone, teaching it or modeling. The behaviors would want to see in an effectively in culture. So what health systems are these employee comments about? Well, it kind of makes me harken back to a scene from the movie Fight Club. A major one is Ed Norton character set in the movie.
Actually, it's major ones here are some of the comments from LinkedIn about my post and those employee. Kevin pots. Wrote leader, should be the teachers and developers of their direct reports in lean. This can't happen if the leader is vacant or misinformed on lean who was or where is the teacher of the leader, what is their understanding of lien could questions. Terrence T Burton wrote many of these and similar comments are testimony to a failed lean approach in healthcare.
Many consultants simply ported over the tools and methodologies for manufacturing and implemented lean as quote. Unquote imposed Improvement program. They did not take the time to understand the unique Health Care industry and adapt continuous Improvement to a very different organization and cultural environment.
I too have, heard many comments like we finished lean five years ago, and I've heard about the silly lean demonstrations, like setting up a pole system to replenish yogurt and putting on the floors having nurses wear a rainbow of color, coded bracelets, and many other things that have not impressed the Listen, clinician, staff lean is viewed by many as getting, in the way of patient care. I went for blood work a few weeks ago, and talked to the nurse about the hospital's
previous lean initiative. She said, I'm glad it's over and don't want anything to do with lean. So the big question, how do you resurrect lean and CI and Healthcare is the accepted daily cultural standard of thinking and working the need for improvement. Did not go away. It's greater than ever before James C, Larson reporting, Wrote a big part of the problem is Six Sigma and lean or often used as tools to the self aggrandizement
of an elite few. These people espoused values like quality and patient centeredness but what they really value is power and money the True Value creators and Healthcare are the people who get the job done. The doctors nurses Tech's housekeepers Cooks, AIDS billers Etc, when Executives and managers value these people. That's when the magic happens. Kenneth stem wrote the failures of land are caused by the same reasons.
For the failure of tqm back in the 80s, a vast majority of upper management views lean as a set of tools to be implemented, Deming used to rail against the whole concept of implementing quality management. The same thing is happening now, sadly, most upper managers believe they already know all there is to know and therefore fail to realize that their job is to deliver value to the customer, develop people and drive out waste throughout the Many would agree.
But what most managers do not understand is that there is no known answer, how to specifically do each of those. In other words, we must learn. I would add we must practice lien, which is why number of us, wrote a book called practicing lean, which you can find at www.pricescion.com by the way. And his comment reminded me about. I think a still relevant book from 1994 about tqm failures. Something that I blogged about you can find a link to that blog post. The parallels between tqm
failures and lean failures. You can go to lean blog dot org, slash audio. 249 a few other comments here. Todd McCann, wrote people who do the work should be the idea generators to improve the work if they need help leaders, clear the way not stand in the way or create barriers for patient care, man. Even if change outside, the span of control should be managed and leaders should be stepping up to
ensure, positive outcomes. Focus on the patient while set final comment, Holly Barrett. She wrote as the leader of a large Global organization. I became a lean student and Zealot. The day, I participated in a structured direct observation of work performed by some of my more Junior Finance employees. I'll add a comment. This was at Intel where Holly worked for a long time. Tapping into those experts using Kaizen events to improve the quality and efficiency of the work was invaluable their
results. Far exceeded those, a top-down approach, would have delivered and with minimal resistance to the changes because the buy-in was quote-unquote designed in. So I'm curious to hear what your thoughts and reactions are and you can go to lean blog dot org. Slash audio 249 to join the conversation.