A late September edition of Mark Zeidel's weekly tutorial on Lean process improvement. See this pig exercise for a great example of this week's principle.
We have been describing the strategies for improving patient care, called, in Toyota parlance, “countermeasures.” Last week we described visual systems as tools towards standardizing processes and improving reliability. This week and next, we discuss standardized work. If we do not have a stable, standardized way of doing our work, we cannot develop ways to improve it.
Standardized work is a form of “playbook” for workers, defining the methods to be used, and the outcomes that we expect each person to reach, each day. Standardized work spells out the number of workers needed and what each needs to do, and in what order, to make sure that defined customer expectations are met.
The workers must understand the need for standardization. They must be trained and practiced in the expected methods to do the work and they must have the ability to improve and adjust the processes as they gain experience with them. Unfortunately, in much of what we do, any two people trained to do the same task likely perform it in completely idiosyncratic manners. Interestingly, we have policies and procedures manuals that fill shelves of storage, but these do not specify how the work is done.
Standardized work is the best way we know today to do the job to ensure that desired outcomes are met. In part because we have standardized the work, we are able to experiment with changes in the process, and then to modify the process of work to make it more effective. Without standardization it is impossible to improve.
There are many benefits to standardized work:
1. Improved process stability: Stability means repeatability and the ability to meet quality, cost, lead time, safety and environmental targets every time.
2. Clear start and stop points for each process: These plus an understanding of the customer’s rate of demand allow us to see if things are on track, ahead or behind, and to divide work among people in a sensible manner.
3. Organizational Learning: Standardized work permits us to preserve know-how and helps avoid problems that occur if work methods are not documented and key employees leave.
4. Audit and problem solving: Standardized work makes it easier to define the current condition and identify problems.
5. Employee involvement and error-proofing: If we have a stable process, then those doing it can improve it and can build in visual systems and other devices to avoid errors.
6. Kaizen: Standardized work provides the baseline against which to measure improvement.
7. Training: Standardized work makes it possible to train new people effectively.
Next week we will discuss the elements of standardized work, and approaches towards standardizing where possible the clinical care of patients.