I'm always on the lookout for firms and institutions that embody a strong culture of quality and safety--in the work environment and in the products and services they produce or deliver. While health care has its special characteristics, there is always something new to learn from places that have done this well. Common features emerge, though:
Top-level leadership for whom excellence is an expectation and whose own behavior exemplifies what they expect for others in their organization;
Disdain for benchmarking against industry averages: People who understand that there is no virtue in benchmarking to a substandard norm;
A work environment in which front-line staff are empowered and encouraged and expecteded to call out quality and safety problems, with a special focus on near-misses, those conditions that represent systemic flaws in the organization, the time bombs that will one day lead to harm.
I've found the latest example of this combination of attributes in Gillette, Wyoming, at a family-owned firm called L&H Industrial. The business of the firm is to provide repair services to the mining industry and to fabricate those huge and complicated parts and machines that are used to retrieve coal, gold, and other products in the ground.
The two brothers who own the firm, Jeff and Mike Wandler, say the following:
L&H Industrial considers safety to be the most important component of our success. Keeping our employees safe is our first priority. Our mission is zero Lost Time Accidents (LTA’s).
They have recently passed the four-year mark on this objective, an outstanding result considering the work their folks do: Welding, heavy lifts, grinding, and so on. One brother explains, "We have engineered unsafe practices out of this company."
Citing the field work their folks do, fixing and installing heavy equipment at coal mines and elsewhere, the brothers say:
We are responsible for the safety of our employees no matter where they’re working. L&H Industrial makes field service safety a priority with frequent trainings and peer monitoring. Our on-site service business relies on our safety record - we don’t take that lightly.
Quality is the company's other pillar:
The goal is that zero quality problems reach our customers. Product quality is monitored through inspections at each step and non-conformances are documented and root-caused so corrective actions can be implemented to prevent recurrence.
Validation of this approach recently occurred when the firm was ask to fabricate and assemble a replacement lower roller assembly for NASA's Crawler Transporter, the world's largest self-powered land vehicle. Wikipedia notes:
The crawler-transporter has a mass of 2,721 tonnes (2,721,000 kg; 6,000,000 lb) and has eight tracks, two on each corner. Each track has 57 shoes, and each shoe weighs 1,984 pounds (900 kg). The vehicle measures 131 by 114 feet (40 by 35 m).
The specifications for this job are extremely demanding. The metal tolerances are exacting. There is essentially zero margin for error when a huge space rocket is being rolled from the fabrication building to the launch pad. L&H received this job after an extremely competitive solicitation, with dozens of NASA engineers reviewing the company's opoertaional plans and facilities.
All in all, an impressive record and one with lots of lessons for those of us in the health care world.
Top-level leadership for whom excellence is an expectation and whose own behavior exemplifies what they expect for others in their organization;
Disdain for benchmarking against industry averages: People who understand that there is no virtue in benchmarking to a substandard norm;
A work environment in which front-line staff are empowered and encouraged and expecteded to call out quality and safety problems, with a special focus on near-misses, those conditions that represent systemic flaws in the organization, the time bombs that will one day lead to harm.
The two brothers who own the firm, Jeff and Mike Wandler, say the following:
L&H Industrial considers safety to be the most important component of our success. Keeping our employees safe is our first priority. Our mission is zero Lost Time Accidents (LTA’s).
They have recently passed the four-year mark on this objective, an outstanding result considering the work their folks do: Welding, heavy lifts, grinding, and so on. One brother explains, "We have engineered unsafe practices out of this company."
Citing the field work their folks do, fixing and installing heavy equipment at coal mines and elsewhere, the brothers say:
We are responsible for the safety of our employees no matter where they’re working. L&H Industrial makes field service safety a priority with frequent trainings and peer monitoring. Our on-site service business relies on our safety record - we don’t take that lightly.
Quality is the company's other pillar:
The goal is that zero quality problems reach our customers. Product quality is monitored through inspections at each step and non-conformances are documented and root-caused so corrective actions can be implemented to prevent recurrence.
Validation of this approach recently occurred when the firm was ask to fabricate and assemble a replacement lower roller assembly for NASA's Crawler Transporter, the world's largest self-powered land vehicle. Wikipedia notes:
The crawler-transporter has a mass of 2,721 tonnes (2,721,000 kg; 6,000,000 lb) and has eight tracks, two on each corner. Each track has 57 shoes, and each shoe weighs 1,984 pounds (900 kg). The vehicle measures 131 by 114 feet (40 by 35 m).
All in all, an impressive record and one with lots of lessons for those of us in the health care world.
One of the great lessons taken from my years of reading your blog has been the applicability of the experience of many other industries (way beyond aviation) to the delivery of health care. This is perhaps rooted in your career history outside our highly insular field.
ReplyDeleteThe challenge is in getting leaders in health care to overcome the innate arrogance that our field is devoted to saving lives and therefore qualitatively 'different'. The only 'difference' is our abysmal ignorance of these basic processes that are central to others' daily operations. Thanks for helping to educate us.
nonlocal MD