I am going to keep this file updated with kaizen pictures.
Tell me what you think!!!
Please feel free to contact me with any questions at firstname.lastname@example.org
Friday, March 23, 2012
Wednesday, March 21, 2012
Lean in the healthcare world is certainly taking hold. And, why wouldn’t it be? Our country is facing a healthcare crisis of epidemic proportions. Certainly healthcare is a unique business. The supply and demand curve is totally inelastic. When a new technology is brought to the health care arena, the capacity in the equipment is used up almost immediately. I certainly have never been to a walk-in MRI suite.
In the midst of all of this focused improvement, I found a diamond in the rough. The place I am referring to is not in the middle of a grandiose transformation. No consultants have been brought in. No formal training had been done. Yet, the same minor procedure I had done in a different surgical center took three to five hours, whilst this one… well, was much shorter.
Let’s start with a timeline (All times are approximate, I had sedation that day):
Arrived onsite for a 10:00 appointment
First registered nurse escorted me to the back
Vitals signs were taken consent formed signed
Second nurse started IV for monitored sedation
Anesthesiologist performed quality check and briefed me about sedation procedure
Second nurse escorts me back to the procedure room
Monitored sedation begins
Discharge form signed
We exit the parking lot
How is that possible? How is it that two identical procedures have such substantially different cycle times? The second surgical center hadn’t spent any incredible amount of time working on optimizing their processes. What was the difference?
One word: Flow! For reasons unknown to me, the surgeon had placed a premium on flow. Let’s investigate the timeline a bit further.
Why did the second nurse start my IV? The first nurse called her for assistance when she saw the surgical room was about to be free. No, she didn’t pull a switch, sound an alarm or stop the line. She did, however, pull an andon. She identified that she was behind in tact and took action to correct it. The physician, whether by design or on accident, staffed the production cell with an appropriate number of people.
Lean Learnings: Cutting costs will only get you so far. What is the value of one employee if it permits you to keep you constraint from being starved? Priceless!
Additionally, I heard the first nurse talking to the second nurse, “Thanks for helping out. The doctor wants us to have the next patient ready to go as soon as the previous one walks out the door.”
Again, I don’t know if this was purposeful or not, but the doctor had figured out that he was the constraint. He knew that he could generate more revenue if he kept himself in the value added task longer and he prioritized communicating that mentality to his staff. He also knew that he was the value-added bang of the property. Not in an aloof way, it was obvious he respected his team and they respected him back.
Constraint management is an integral part of establishing flow in any organization. It doesn’t take six months of training and a purple belt to understand the concepts of flow and value. It takes a unified team focused on the right priorities!
Monday, March 19, 2012
1. The effects of a negative culture
"Come on, come on! Send... Finally." For some reason, unbeknown to me, my network always lagged after hitting the send button on the end-of-shift report to my peers and site leadership. I said cursory good-byes to my team and genuine ones to my production assistant, Ty; he was the only bright spot that existed within the night-shift management. I basically ran to my high mileage SUV and proceeded to exit the parking lot and drive- one state away- to my bed. I can't conceivably call it a house because I would only get about four-and-a-half hours of sleep before driving back for yet another exercise in futility.
It was about 7:00 am when I the button on the automatic garage door opener. As I unbuckled my seatbelt, I discovered the aromatherapy of bacon grease coupled with hot maple syrup and butter. I gave, what my wife, Nichole, coined, a "less than 50% smile." As a former cheerleader, she took personal responsibility for pumping me up when I had a bad day. Unfortunately, this was becoming the standard instead of the exception. I polished off my blueberry pancakes, kissed Nichole good night, and jumped into bed for my nap.
As I was driving down the turnpike to go back to work, something hit me. I had been in my role for over a year and I was totally frustrated. Uncontrollably, I started crying and I just couldn't bear going back in. I loathed my boss, Tony, and everything he stood for. He was condescending to me in every way possible. He was playing the other two managers on my shift and me against each other. This mentality between second line managers was ubiquitous. Everyone was at each other’s throat and in ninja-style competition. This type of behavior was encouraged and even praised. The more negative performance management documents that I wrote because my front-line team hadn’t hit their productivity numbers, the better my superiors received me. The more production that I was able to squeeze out of my team by riding their backs throughout the shift, the better congratulatory email I received from the site leader. What was really starting to eat me up inside was that I was good at it; I was ranked the top new manager on site. I had always been good at playing the proverbial game, but in about year I had terminated thirty people. I don’t know if the rabbit hole goes this deep, but it almost seemed to be a positive thing when you terminated an associate for not hitting quality or productivity metrics.
The company I worked for was in the middle of a lean transformation. This lean system is one that I have coined a "check-the-box-system." For example, you want to have front-line associates on the team of a weeklong kaizen event; this company would have 1 on a 10-person team. "Check!" It is 5S rollout time. "Check!" Look at our new kanban system that helps us pull material (at the expense of a ten percent throughput reduction). "Check!"
You get the idea.
During the first kaizen event that I led, I poured my heart and soul into improving one of the most manual processes in the building. We spent the first day and a half mapping out the process while being coached by a Japanese sensei from a well renowned consulting company. We were trystorming like crazy on day three and four on day five we all stayed late to finalize the remaining changes. We were so proud of hitting our target metrics that were set as stretch goals. I think I got a grand total of twelve hours of sleep during that week, but after all of that effort... the change died. The culture of the site was so bad that no one would embrace the change. I had hand selected line associates from the correct departments to help drive the changes, but it was just not enough to overcome years of bad programming.
Back To My Road Trip
So, there I was about seven miles from work and I called off with a personal day. I had never in my life felt this way before. I had always prided my self on being an excited, motivated and energetic person; the culture that was omnipresent at this organization had left me a shell of a human being.
I made a U-turn and suddenly the tears were gone. I never let Nichole know that my tears were directly catalyzed by the impending doom that was the last five miles of the turnpike. I knew she would understand, but she isn’t the type of person who is going to sit down next to you and rationalize your problems. She is more of a fix-it girl.
I should have seen this coming: The next day my wife had made me an appointment with a psychiatrist. This only led me to further have self-doubt and fear about my career and home life. Was I a failure? Why is this happening to me? I was scared and, worst of all, had no plan to get out of this mess.
Leadership Learnings: People are not the soft side of business. They are the only side of business. When you boil everything down to where it needs to be, all you have are people.
2. The Therapist and The Recruiter
We weren’t speaking while we were driving over to the appointment that Nichole had scheduled for me. I wasn’t exactly mad at her for scheduling the impromptu visit, but I cannot safely say that I was thrilled. I had never seen a psychiatrist before and at this point it seemed about a million miles from ideal, but the constant crying and self-loathing behavior was far from what any reasonable person could consider normal.
Whenever there was silence between us, Nichole felt it necessary to fill that dead air.
“So, Dr. Kitari is just going to be asking you some questions… I think. I don’t think it will be that big of a deal, hopefully it will be quick and we can get some lunch before you have to go back to work. Are you going to speak to me today?”
“Yes.” I responded begrudgingly, “Just give me some space right now… I’m having a tough time at work.”
Dr. Kitari’s office was nestled into a small shopping center next to the local mall. I signed myself into the front-desk and had a seat amidst the sea of unfamiliar faces and waited for my name to get called. It hardly seemed like where I was supposed to be in my life; I mean, how did I end up here? What had changed in my life to turn me from the happy, life of the party to a bitter person who was angry almost all of the time?
“Good Afternoon!” Dr. Kitari said. She was a middle-aged Asian-Indian woman with a mild accent.
I smirked casually at her and said, “Hello.”
I was rather embarrassed at the fact that I had received a ‘referral’ from my wife. I had no idea she even knew to call the number on the back of the insurance card to get an authorization before she scheduled an appointment.
“What seems to be the problem?”
“Well, my wife made me this appointment… I am trying to manage through my problems as best as I can.”
“Ok” said Dr. Kitari, “What would your wife say is the reason you are here?”
The List as She Saw It
“Hmmm… that is an interesting question; she would probably rattle off the following”
He calls off of work because he doesn’t want to go.
He cries on the way to work.
He is angry most of the time.
He sleeps all day during his time off.
He has lost all of his interest in socializing with our friends.
Things that used to give him joy suddenly do not any longer.
He doesn’t spend time with our son.
“That is pretty much what she told me.”
Dr. Kitari scribbled some notes onto her pad and looked pensively at them for a brief moment.
“Have you ever thought about suicide or made a plan?”
I started to tear up and responded with a reluctant, “Yes, I have.”
Dr. Kitari scribbled some additional notes; I think it is required for a psychiatrist to scribble between questions. I can’t be sure, but it all seemed very staged.
“So, do you know why you are so unhappy?”
The Power of a Negative Culture
“That is simple; my job is sucking the life out of me.”
Again, the scribbling continued. “What part of your job is making you unhappy?”
I responded, with what I thought was a clever quip, “Its not my job that is making me unhappy; I am making me unhappy. My job is just putting me in an environment where attaining that happiness is very difficult.”
Dr. Kitari made some additional notes, but commented, “You are avoiding the question; what is difficult about the job. There is no right or wrong answer.”
I proceeded to give her the following list:
1. Management is encouraged to disregard the importance of the front-line employee
2. There is a cutthroat, zero-sum game competitive nature that exists among managers.
3. Management is encouraged not to trust front-line employees.
4. Performance is managed with mostly sticks and very few carrots.
5. A healthy amount of workplace fun is discouraged
6. General air of negativity throughout the site
7. Copious amounts of micromanagement present and expected
I realized at this point that I had lost her. I think she expected me to say I was being harassed or I was having performance problems. Quite the contrary existed. I was the number one rated manager on site and I was totally miserable. I received daily emails from upper management praising how successful my improvement projects and shift performance were. Again… totally miserable! She wrote me a script for two different antidepressants, an anti-anxiety drug and some sleeping pills. At the behest of my wife, I did start the regimen of medicine; she was sincerely worried about me.
The Phone Call
Let’s flash forward two weeks. I had now been immersed in my dual-diagnosis and subsequent prescriptions and was doing somewhat better at dealing with the environment I had been sentenced to endure. My production assistant, Ty, and I were getting read for the start of our shift.
“Ty, make sure you staff line ‘A’ with enough people tonight and make sure that you stay on top of them. I don’t want our rates to slip this close to review time (Managers tend to have short memories- I was becoming fond of exploiting this fact).”
“You got it boss” said Ty, “I will stick Derrick on the line as operator; he will put up big numbers.”
This is the drill that Ty and I went through night after night. He was one of the most effective junior managers I had ever met. There wasn’t anything I could throw at him that he couldn’t handle with ease. It is the best working relationship that I have ever had; it was the eye that existed within the cultural hurricane that was spinning around us. I taught him a lot and learned even more from him.
After about thirty minutes of this back and forth between us, we had the shift ready to go for the evening. Then suddenly, the phone rang. I didn’t recognize the number on my caller ID; usually I would send something to voicemail during work, but I decided to pick it up.
“Hello,” The unfamiliar voice responded, “Hi! This is Clark from UGA Recruiting. I have a client who is looking for an experienced operations manager to run a small plant. Might you be interested?”
I had about a thousand thoughts in my head during that short phone call. Should I be making a move? I really hate it here, but the money is good and the benefits are better? Can I handle more responsibility? Could I really run my own site?
I quickly gathered myself together and exclaimed, “Absolutely, can you call me back tomorrow around 8am. I currently work the night shift.”
“Sure, I will talk to you then, could you forward me an updated copy of your resume in the meantime?”
That was the fastest nightshift I ever had at work. I could literally taste the freedom.
3. first day, new job
I drove my Toyota down the hill from the hotel we were staying at and turned onto the interstate. I hopped of about three exits down and waited at the light to turn into the main entrance of the plant.
A vision hopped through my head of the interview that got me here. Waiting in a small conference room at the corporate headquarters. I pondered my resume for about five minutes. What kind of presentation was I going to make to the executives that would be handing me the third degree?
I was astounded to talk to a human resources business partner first. I new from that moment on that this was not going to be a standard interview. This went on for about eight hours. I cannot remember exactly what was asked of me until the Vice President of operations asked me, “What is your strategy for running a plant.”
I took a longer pause than I normally would take in an interview and finally answered, “I want to put systems in place to work myself out of a job.”
He looked at me quite a bit puzzled and said, “How do you make that happen?”
I thought about how miserable I was in my current role and I looked over the table and said to him, “I know how to create an environment to make people want to come to work and give it their all.”
I realize that was a bold statement, but, if I knew nothing else, I know what a negative work environment is. My thinking was that I would do exactly the opposite of that and we would be OK.
Back to the Stoplight
So there I sat after moving my entire family across the country waiting for the stop light to turn so I could show up to my new life. It finally flickered from red to green. I slowly accelerated to the gate surrounding the plant. “Good Morning!” the guard Marcos exclaimed.
Marcos was about thirty-five years old and had a permanent smile plastered about his face. I would come to appreciate his evergreen smiles over the next several months. The consistency and predictability of our “running conversations” made driving through the gate that much easier.
Leadership Learnings: Be that constant in your teams life. A lighthouse, if you will, always burns with the same level of intensity and consistency. Your team will grow to appreciate those traits in you.
Back to the Interview
“Do you have any questions for me?” the vice president asked.
I am accustomed to getting that question in every single interview I have ever been a part of. “Yes, as a matter of fact, I do” I retorted quickly “Why is the plant manager position vacant?”
The executive paused and then said, “Look, I don’t want to discourage you; the plant needs serious help. We let the previous plant manager go.”
He paused for a few additional seconds and continued, “The culture at the plant is atrocious; there is zero buy-in to any programs we put in place, productivity is down significantly, customers are unsatisfied and we just had a string of injuries over the last few months. I finally had to let the plant manager go. The production manager was offered the job, but he was afraid to step into a new role for fear of being fired.”
“OK, that makes sense. I have one more question and then I should be finished.”
Again, the executive looked puzzled and replied, “What is your question?” I paused for a few moments and asked, “Will I have 100% support for my methodology of improving the plant culture?”
I think my frankness slightly offended my future manager, but I knew I could not mince words if I was going to uproot my family and take on a challenge like this. I also knew that if he was being this vocal about the state of affairs of the site, it would be significantly worse than he was communicating.
“If you can turn the plant around, you will have my 100% total support; quite frankly, my job is depending on it, but I have dozens of other plants in my span of control.”
Back to Marcos
Based on the conversation I had with the vice president of operations, I had not expected the warm welcome that Marcos had given me. He verified my ID and proceeded to let me onto the facility. I drove up to the site and parked my car in the employee parking lot. As I walked passed the front entrance, I noticed a curious site; immediately next to the two disabled parking spots was a sign that read plant manager. That sign coupled with the VP’s statement about the site culture spoke volumes about how the previous person had run the site. I walked by the sign and shook my head in disbelief. I noticed few noses pushed up against the glass as I walked into the building, but they quickly returned to their respective computers.
As I entered the lobby I noticed two things. One, the lights were basically off throughout the building. There was some serious need for a spruce up. Two, the sign in sheet for the plant was blank for the last month or so. I signed my name into the book and rang the bell. Out popped a tall gentleman in his late forties with a company uniform on and a radio coupled to his ear.
“I’m George; I am the production manager here.”
“Awesome! Good to meet you,” I responded.
George proceeded to tell me that he had my office prepared and that all my on-boarding paperwork was ready to go to HR. I sat down in my new office for a few minutes to get my bearings.
I called George’s office and said, “Can you get the management team in here around noon for a meet and greet? Also, can you point me in the direction of a good pizza place; I want to go pick up some food.”
George sounded a bit puzzled or confused; he finally said sure, “We will be there at 12:30 in the conference room! The best pizza in town is from a place called Pacino’s. Do you want me to have purchasing pick it up?”
I still can’t believe I said this, I had heard all my managers in the military regurgitate this line, “Its OK George, I will get the food. I still work for a living.”
A few hours later, I drove down the way to pick up the pizza for the team and realized that I had absolutely no idea of what I was going to say during our first meeting. I would have a dozen or so people looking to me for answers and I hadn’t event been out to the floor yet.