tag:blogger.com,1999:blog-32053362.post4021103466734341031..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: Now, let's graduate to Lean 404Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-32053362.post-16202321418618750032011-06-08T22:45:28.462-04:002011-06-08T22:45:28.462-04:00This is where LEAN meets naive, where the most exq...This is where LEAN meets naive, where the most exquisite design meets a primate. As finely tuned as we hone the machine, every human interface remains a gaping fault line for failure. This is never more obvious than healthcare. Behavior - its variation and determinants - of in situ life is just too messy for most disciplines (we like a lab), and our efforts are blindly stuck in assumptions of rationality. As you say, culture eats strategy for lunch. But what about culture? What behavior? And why?<br /><br />Horizontal organization is really difficult not just because systems are not designed that way. It is really difficult because the benefits of hierarchy are so strong. And humans are designed to create them and take great advantage of them when they can. This demands a different ecological, rather than just operational, design. I'd like to see LEAN data on human failure as well studied as the easier links in the chain. But I don't think that we are even asking the right questions yet.Anonymousnoreply@blogger.com