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Gerry Cronin

Health Care

It’s a Small World After All

Healthcare offers lean lessons for industries faced with life-or-death changes

Published: Thursday, December 12, 2013 - 17:15

At GBMP’s recent Northeast Shingo Prize Conference in Hyannis, Massachusetts, the Center for Comparative Medicine (CCM) displayed adaptations of lean to biomedical research in its Community of Lean Lounge. Conference attendees were drawn in by the wacky display of dangerous animals and props, but CCM staff realized that most of the representatives from different industries shared their frustrations about getting employees involved in active problem solving and engagement.

It appeared that everyone—regardless of their work—is faced with the same challenges when developing a culture of continuous improvement. The CCM is attempting to address this challenge in novel ways, and here’s an example that its staff shared in the lounge.

Pulling the cord

During a kaizen event focused on improving our gemba walks, the team leaders and frontline technicians recognized that many members of our staff weren’t making the connections with how 5S and problem solving are integrated into everyday work. Many still see lean as “another thing to do,” a “thing” that requires dedicated time for them to find, think, test, and implement solutions to problems. The kaizen team announced, “We’re pulling the cord, and we need more help to coach our staff to connect the dots.”

Making it real

To address this problem, leadership set out to create a realistic life-or-death simulation that would clearly illustrate how 5S, standard work, and problem solving are part of everyday work. From this setback was born the “5S Wetlabs,” a portable, 90-minute training session that was designed to reinforce the importance of standard work, workplace organization, and stakeholder involvement. During the intense and dramatic simulation, a critical step goes haywire, which activates an emergency response to save a life. The “first responders” encounter a dysfunctional and chaotic situation that makes the life-saving process totally ineffective, resulting in the tragic death of the victim. The responders fail miserably to perform their responsibilities effectively; they articulate feelings of disappointment and being demoralized, embarrassed, and frustrated by their inability to save the victim.

Shoveling against the tide—or making excuses

As part of the simulation, the first responders are asked to list what went wrong, which inevitably becomes a shopping list for 5S-related improvements. The responders are then asked, “Who killed the victim?” and told to write an “obituary” for the victim that will be presented to the family members at the wake. The obituary is often comically uncomfortable, forcing the responders to identify “who” and “what” failed, as well as their contribution to the victim’s death. The obituary exercise illustrates how we tend to make excuses, even when we have influence on a process.

A short problem-solving session follows, which then leads to responders identifying dozens of improvements that will make the emergency situation foolproof, especially since the participants now realize that they are personally relying on the quality and effectiveness of the system because they could be the next victims. The participants are then challenged to create an improved system that will save their own lives if an emergency response goes wrong. 5S principals are thus demonstrated by transforming a mundane exercise into a realistic, life-or-death situation that makes the mistakes painfully personal.

Lean learning works both ways

The theme of CCM’s 2013 Lean Lounge was “If we can do it, anybody can.” The 5S Wetlabs display was an instant hit. It attracted many trainers and managers who were interested in an unconventional approach to teaching the benefits of workplace organization and problem solving in a short period of time. One such company was a major aerospace manufacturer that had recently experienced system failures that involved multiple process owners. The continuous improvement director instantly saw the value in a life-or-death scenario training for engineers and maintenance technicians who develop and maintain machines and processes that can result in death from catastrophic failure.

Other companies that visited the CCM booth expressed interest in the novel approach to personalized training concepts, and many remarked that perhaps the time has come when industry can now learn from healthcare. Although healthcare has been catching up for years, problems encountered in a dynamic healthcare setting can provide useful lessons for all industries when faced with change that threatens the life or death of an organization. The learning pendulum has shifted, and healthcare may now be the very industry to illuminate the way to rapid improvements in a threatening market or environment. Can lessons learned from healthcare help your organization?

Julieanne Brandolini, the training program manager at Massachusetts General Hospital, contributed to this article.

This article was originally published on Bruce Hamilton's Old Lean Dude blog.

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About The Author

Gerry Cronin’s picture

Gerry Cronin

Gerry Cronin joined the Center for Comparative Medicine (CCM) at Massachusetts General Hospital (MGH) in September 2010 as the Kaizen Promotion Office Manager where he coordinates the utilization of lean principles and tools throughout the center. Prior to CCM, Cronin was MGH’s operations manager overseeing eight in-patient and clinical areas for six years. Cronin has a bachelor’s degree in industrial engineering management and an MBA. He is a lean Green Belt and has been awarded a full scholarship to attend the Deming Immersion Program with the Deming Institute. Cronin regularly gives presentations on process improvement to nursing schools in the Boston area.