Lean-ing nicely in Den Bosch

I had a chance today to visit one of my favorite hospitals, Jeroen Bosch Ziekenhuis in the Netherlands, and spend time with a number of managers who have been exploring a wider application of the Lean process improvement philosophy.  Frans van de Laar, who runs the blood and urine laboratory, recently introduced one of the simplest and most effective examples of standard work, a morning huddle with the staff who collect the daily flow of samples from inside an doutside of the hospital.

You see Frans here with the white board, around which the staff huddles each day.  After talking about projected workload and staffing responsibilities, one component of the huddle (seen below) is to identify a problem of the week that the group will attempt to solve or a situation which they will attempt to improve.

Below that item, the group decides on an inspirational slogan for the week.  This week is was: Treat a patient like you would want yourself to be treated.

Frans was pleased to note that the huddle has changed a bit since he introduced it, with comments and suggestions from the staff being the impetus for modifications.  Beyond the more serious changes, there was the addition of this humorous priority item in the huddle summary:  Friday + [pictured] coffee and apple pie with ice cream!

Another item adopted by Frans and his team is this voluntary assignment board for minor tasks that need to be done around the lab.  Items are coded by whether they need to be done monthly, quarterly, half-yearly, or on an ad hoc basis and put in the left-hand slots. When a person has a lapse in regular lab work, s/he can volunteer to do the job.  Once finished, the tag is moved to the right-hand side, with notes documenting when it was completed.

One can imagine the alternative, spending time assigning people and monitoring their compliance with these items, possibly creating resentment at being assigned humdrum tasks.  Instead, people volunteer during their slow work periods and feel a sense of contribution to the team effort.

These two examples demonstrate that Lean is a state of mind and a philosophy:  Small improvements, engaged front-line staff, and a manager who views his/her job as one of empowerment and service to the team.