The words that bring dismay to any Lean practitioner – we’ve done Lean or we’ve been Leaned. Aarrgghh, no you haven’t! You’ve used a couple of tools in the corner of a work area, but failed to understand that Lean is a philosophy, a way of thinking and a way of acting. It is continuous improvement. The clue is in the title. It’s a continuous journey not a destination.
The 9 wastes of modern day lean
To help gain more understanding, I’d like to introduce you to your new best friend – Tim A. Woods. Tim works as an acronym and it’s his job to help you remember the 9 wastes of modern day Lean.
- T is for Transport – moving stuff.
- I is for Inventory – too much stuff.
- M is for Motion – of people, unnecessary walking, moving, bending or stretching.
- A is for Automating a poor process – like buying new automation or IT in the hope it will make you more efficient, when in fact the problem is your poor processes.
- W is for Waiting – for stuff, for people, for decisions.
- O is for Overproduction – this includes repeating tests before next test is due, batching samples, tests and information; ‘just in case’ blood tubes drawn from patients but not used.
- O is also for Overprocessing – duplicate and/or inappropriate testing, duplicate data entry, duplicate checks.
- D is for Defects – stuff that’s not right and need to be fixed.
- S is for Skills – your staff not being recognised or used correctly, staff ideas not listened to, skilled staff doing unskilled work.
If you remember from my previous blog the 2 main pillars of Lean are removal of waste and respect for people & society. So that s 2 pillars & 9 wastes.
There are also some other numbers that are key to Lean including the three fundamentals for improvement, the four Ps of the Lean philosophy and the five principles of Lean. You can read more about them in my latest white paper.
We can’t really talk about waste without first understanding what is meant by value. From a Lean perspective, this is all about the customer and if you’re in the heath sector – the patient and the clinical teams that care for them.
What is it that they require from your service? Not what do you think they need or have decided they are going to get. Yes, they may be misusing your service, but is that because you have never made the effort to communicate with them about the best way to use your service. You need to get out of your silo and go and talk to the customer. I’ll talk more about this very important principle of Lean in a future blog.
For now, I’ll leave you with a few pieces of advice I’ve learned over the years:
- Don’t ASSUME you know how all your processes work – you need to walk the pathways (value streams) of your processes and talk to the experts – the staff who work in the value streams.
- Don’t ASSUME you know what’s wrong with them – you need to collect data on what is going right and what is going wrong. Analyse the data, what is it telling you?
- Don’t ASSUME you know how to fix them – Ask the staff to help you map the value streams and using their expert knowledge and the data, work through the issues and identify potential solutions. Implement the changes, monitor the effect and adjust as necessary. Congratulations! You have just completed a PDCA cycle. Plan, Do, Check, Adjust – the underlying driver for Continuous Quality Improvement.
- To ASSUME will make an ASS out of U and ME – pretty self-explanatory.
And when you do walk the value stream (otherwise known as going to the Gemba), I’d advise listening to the words of Toyota Chairman Fujio Cho: “Go see, ask why, show respect”.
David Hamer is a biomedical scientist and a quality improvement consultant.