When an organization decides to pursue an improvement initiative (Lean, Six Sigma, etc.), and let’s be honest, they almost always start out as an ‘initiative’ or ‘program’, the organization needs to determine which areas it will apply this new technique in first. Some will argue that the starting point should be an area that will provide the most benefit to the organization, regardless of the time to complete the initial project. However, most times, we are told to “go for the low-hanging fruit” in order to show the benefit of the methodology to management. How often does this backfire?
I was speaking to an executive at a healthcare organization the other day about how they were using their Lean Sigma Black belts, and if they were still seeing the benefit from the approach. He told me they were using them, but were not holding Kaizen or Rapid Improvement Events anymore, just focusing on the projects. I asked him why and he said simply, “we don’t have time for that.” Deciding not to push the issue, I wished him the best of luck.
The organization had gone from attempting to embrace Lean as an improvement methodology through the use of engaging the people through Value Stream Analysis and Rapid Improvement Events, investing thousands of dollars over the past several years, to that of having a couple of “internal consultants” act as project managers, and reduced the size of the Lean Sigma group by 50% in the past 2 years.
There are several reasons for the demotion of the LSS group in the organization, and it appears to be following the “Continuous Non-Continuous Improvement Cycle” I presented in an earlier post. These reasons range from senior management not really buying-in from the beginning (paying it lip service), to financial issues in a post merger environment. However, one issue that has clearly hurt was the approach to get quick wins and try to make an impact.
While an organization can’t try to “solve global hunger” at the start, there must be an attempt to balance those activities that will generate immediate impact and those that are longer term in their improvement to the organization. This becomes very difficult, since in many organizations these executives have the strategic attention span equivalent to the life-cycle of a mayfly. When the ‘quick win’ approach is taken, the savings / impact becomes like a drug to the executives. They see the benefit and they want more – NOW. Usually they are able to get this for a while, since they are very interested in the program at the beginning and show their support thought attending events and removing obstacles, and in general there are a lot of opportunities in healthcare for immediate improvement. However, as these opportunities dry up, and the work gets harder, while the executives focus shifts elsewhere, the expectation is to continue to deliver exponential results (a clear sign the truly do not understand the fundamental concepts at play here), and those who are leading the Lean charge, try to appease. This leads to two possible outcomes:
1) The Lean leader starts to “stretch” the numbers and begins to take credit for things that can’t be attributed to the improvement efforts (see “Consultants who give Consultants a Bad Name”)or,
2) The Lean leader attempts to deflect the impatient executives and focus his team on issues that will improve the long-term situation.
In the first outcome, the Lean leader’s peers begin to resent the portrayal / perception that the Lean group are the only ones who can generate any savings and quickly begin to disavow themselves and stop supporting the initiative. Additionally, depending on the organizational culture, they either directly or indirectly, start disparaging the initiative to senior executives and each other. The senior executives, seeing that line-management does not see the benefit, become disenchanted with the Lean effort.
In the second outcome, the patience of the senior executive group usually wears thin, and although there are still benefits coming in, they are not quick enough. They also begin to feel like “they can do this themselves” and do not need the expert facilitation and coaching a Lean expert can provide. The Lean effort is doomed.
To help mitigate the risk of an organization falling prey to this, it is important to thoroughly educate the senior leaders on what starting an initiative such as this will entail. Yes, there will be some quick wins that have huge financial impact, but more often than not, there will be smaller wins, with minimal financial impact. What needs to be stressed is that these wins add up, and over time, the benefit is huge. The other important impact to stress is that an initiative such as this, in order to be successful, is teaching the organization to think differently. The approach to problems becomes more systemic and lateral instead of the traditional siloed approach. The challenge is this takes time, especially in the beginning. But, it is time well spent.
Healthcare executives who want to embrace Lean initiatives need to slow down, relax, really take the time to understand, and maximize the impact on the organization. Healthcare executives who are focused only on cutting costs should not call their actions a Lean initiative, but should call it what it is – Cost Cutting, nothing more, nothing less.
Let me know your thoughts.