Sustain Your Gains
Sustain Your Gains, Accelerate Improvement, Sustain Gains, The People Side of Lean-Six Sigma, by Michael McCarthy, Performance Management Publications, 2011 We’ve been thinking a lot lately about white collar applications of lean tools, especially for offices and healthcare. Although most of the tools derived from the Toyota Production System and industrial engineering are applicable to these areas, some are more effective than others in uncovering problems with high pay-offs. That’s why this little book is so clear and useful – the examples demonstrating how to work with office flow problems are perfect.
Part Two: Tools to Accelerate and Sustain Gains covers the basics. Don’t worry about the tired questions of which comes first – culture or tools; just focus on the examples and follow the value stream steps to see how these tools might work in other situations like yours. Page 74 for instance, includes a sharp guide on how to discourage talk you want less of (Skill 5), such as “They need to….” Or “They need to get us newer equipment” and “They need to straighten out these terrible suppliers.” Here the author advices do not reinforce these comments because they are inactionable – move on to others that can be used as suggestions to solve problems.
Chapter 6 contains a brief section on how to handle information flow. This will be especially important to healthcare and other office teams. In fact, it make take several iterations to observe, analyze, track and present current state information flows. A billing process, for example, may involve multiple pay loops; billing is not in healthcare a simple single transaction flow process and it may require several kaizen projects to bring it into something clearer than a spaghetti chart. On page 85 the author illustrates using patient lab work. Triangles on the information flow identify wait times – are wait times reasonable for patients as part of the value they receive? Anyone who has survived the suspense of waiting for a postcard on results of a serious test or exam has no problem answering this question! But how many other processes in the healthcare system, which accounts for 17% of the US total GDP, provide no value to physicians or patients?