We had another publicly highlighted case from our health service last week. It would be nice to think that the ‘individual responsible’ will be offered any support to deliver his or her recommendations to improve this situation. The political response suggests that the problem lies with individuals and doesn’t seem to question the process.
So what is the process? Whether it is a 91 year old patient or any other person in need of medical attention, is our process getting better or worse? Are the measures we use in our hospitals centred around patient care and patient outcomes?
I had the pleasure of listening to David Fillingham in Cork recently. I learned that he had worked at Pilkingtons in St Helens (the location of my first post with Courtaulds in the UK) and joined the NHS in 1989. He spent 6 years as Chief Executive at the Royal Bolton Hospital where he introduced ‘lean’ principles to empower staff and involve patients to improve quality of care. I visited Bolton hospital a few years ago and spoke to staff involved in their lean programmes. Through Value Stream Mapping staff transformed outcomes for stroke patients. Collaborative work with new mothers helped re-design the maternity unit. Lab staff reduced the wait on test results from 24 hours to one hour to deliver quicker decisions on outcomes and release precious beds earlier.
Interestingly, David said that a lot more process engineering went into producing a windscreen at Pilkingtons than into the patient processes in the NHS. Unfortunately, the hard-working staff in our HSE are working with little support or budget to develop their processes. My view is that the best solutions to most issues come from the staff engaged daily in the processes in any organisation. They need a safe environment and supportive leadership to deliver great outcomes.
“A lot more process engineering went into producing a windscreen at Pilkingtons than into the patient processes in the NHS”
Learn more about Lean Business and current supports available at a free workshop in Dublin next Monday. The Lean Business Programme is run by Skillnets under the ManagementWorks initiative.
Monday, 16 November 2015 – 09:30 to 12:30
Talbot Hotel Stillorgan, Dublin
A FREE introduction to Lean Business and current supports available
Give your staff the right training and tools to deliver great results
Make a start with a Lean Business training programme
The Lean Business Programme is run by Skillnets under the ManagementWorks initiative.
ETAC will deliver the Dublin programme. The company delivered over 40% of the QQI/FETAC awards in Lean Tools in Ireland in 2014.
Participants reported significant impact on teamwork, quality and waste within their businesses and delivered an average return of €15,000 per project.
Register for the workshop
Lean Thinking: This question often comes up in Lean discussions. I think it has been best answered by W. Edwards Deming.
He’s maybe a little harsh in saying that businesses may not know what they are doing. However, we would argue that without being able to describe what you do as a process, your clients are probably having a different experience of your product or service depending on who they are interacting with.
Imagine being recommended the roast duck at Emilio’s by a colleague when visiting her town. After relating your mediocre experience next day, she said, “Oh no, you should have waited until Thursday. That’s when Emilio himself comes in and he can make a mean roast duck”. Marvellous!
There’s also been much talk lately about ‘process’ in sports. If any team is unsure of the process, then improvements are simply trial and error as opposed to building on what has already been established as best practice.
So, can we describe Marketing as a process? Finance? Purchasing? Retail? Hospitality? Healthcare?
Lean Thinking in the Business
Our argument would be that any function in any business needs to be understood as a process.
The individuals in that organisation need a baseline process and those individuals need to be supported to improve that process.
Errors, Complaints and Accidents should all be viewed as feedback and opportunities to strengthen the process.
Staff should be encouraged not to accept errors. They should be encouraged to highlight when they are unable to perform their tasks effectively. Everyone should be encouraged not to pass on problems.
This is a brave undertaking for any management team, but it is the start of the Lean journey for everyone!
The ETAC Solutions Team
We were working with our call centre client and looking at the task of processing claims. Unfortunately, in Ireland, many claims in this particular sector are submitted on paper forms. Our task was to map the process of approving these claims. We broke the process into small element steps and were in the process of timing a number of claims with the claim approver, Jenny. As is the norm with paperwork applications, we encountered a number of errors and missing information. This required Jenny to either make a phonecall, write an email or send a letter by post.
It was while Jenny was sending a letter that the absence of a reliable supply system came to light. Jenny was out of A4 envelopes and apologised as she now had to walk about 100 metres to the stationary store to get some more envelopes. Amazingly, in an office of over 200 staff, she came back empty handed and red-faced. “There are no A4 envelopes in the store – they’re due in tomorrow!”.
Luckily, Clare overheard the conversation and came to Jenny’s rescue. “You should have asked me. I’ve plenty under my desk” and she produced a pile of A4 envelopes. Later on, Paul, who sat beside Jenny, returned from a break. Jenny told Paul about the embarrassing episode with the envelopes (which increased the process step timing). “That wouldn’t have happened if I had been here” said Paul. “That has happened to me before – I always keep a store of envelopes under my desk”.
The thought occurred that there were probably more envelopes in that office than would be consumed in months. Anyone who had lost time in the past had now created their own ‘store’ in the absence of a reliable system. As soon as those envelopes come in tomorrow, Jenny was going to create her own store.
The solution was to implement a 2-bin kanban system. As most of the staff needed to print letters before using the envelopes, the 2-bin kanban ‘stores’ were located at each printer and serviced twice a day by the stationary suppliers.