Lean + lack of communication + "one size fits all" = poor outcomes

I was at a gathering recently at which several health care professionals were in attendance. They were discussing the lean initiatives taking place at several large clinics and hospitals in the area. A couple of comments made me question both the quality of the implementations and the consultants.



First, the perception of the staff at more than one of the respective facilities is that the lean initiative is solely to "speed up things." Not to eliminate waste, not to improve processes and quality, but just to speed up tasks. As such, there is a lot of resistance to the changes being recommended, questioning of the validity of those recommendations, and an attitude of this is just another "flavor-of-the-month" idea on which management spends money.



Little time has been spent educating the staff as to the purpose and objectives of the intiatives. Little time has been spent involving operational staff in analyzing work flows, doing value stream mapping, and addressing organizational change management issues. The consultants, for the most part, are doing all the work and making all the decisions.



The second set of comments concerned the recommended changes in one of the clinicial labs, microbiology to be specific. Micro is very much like a job shop or HMLV manufacturer in that it deals with a wide-variety of speciman types and tests and has multiple workcenters doing very different types of tasks. It also has its "runners," "repeaters," and "strangers." The consultants demonstrated a lack of understanding of the process requirements of Micro in two ways. First, their recommendations centered on trying to move every speciman through the same process flow. Second, and even more concerning, was a recommendation to increase the temperature of the incubators so that the "bugs would grow faster" (not a scientifically-valid recommendation). Besides making poorly-conceived process recommendations, the consultants were making totally inappropriate recommendations concerning the medical operation of the lab.



I think these two situations are good examples of why lean implementations can fail to deliver all the possible benefits they promise.