Monday, March 24, 2014

The spread of Lean in Den Bosch

We're back in Den Bosch at Jeroen Bosch Ziekenhuis for the next phase of Lean training workshops for senior adminstrative and clinical leaders.  Our first session always includes the Toast Kaizen video, featuring GBMP's Bruce Hamilton.  It never fails to generate laughs from the crowd as Bruce fumbles his way through a series of process errors making toast for his wife. By presenting a simple, common task to the class, Bruce illustrates the types of wastes that occur in many product production and service delivery organizations.  It is easier for the students to then be aware of similar problems in their own work environment.

Then it was off for a period of shadowing front-line staff to see what life is really like for the people doing the work in the hospital.  Harriëtte, from the pharmacy, found herself observing the situation in the catheritization laboratory. But first she had to don appropriate headgear for the occasion.

Top level commitment to the training program was demonstrated by the participation of Peter Langenbach, a member of the executive board of the hospital, who serves as chief financial officer.  He, too, traded his suit coat for a white coat for the occasion as he shadowed a nurse and watched the process used to prepare medications for her patients.

Two separate groups of students met today and returned from the shadowing experience to describe and categorize the different kinds of waste they had viewed on the front line.  Their observations were typical of those that could occur at virtually any hospital.  They came to understand, too, that such waste does not exist because the staff is not well intentioned, thoughtful, and hard working.  Rather it comes to exist because the staff is well intentioned, thoughtful, and hard working. When front-line staff encounter obstacles to their tasks, they invent work-arounds so they can get the job done.  The problem, of course, is that work-arounds do not solve underlying systemic problems and, indeed, add to the complexity of the organization.  In the following workshop sessions this week, we'll explore how Lean principles can help in the design of counter-measures to offset these areas of waste.

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