What makes a Lean Hospital?

As I was running a series of programmes with the NHS last week and again earlier this week, I was asked several times 'When do we know we are a truly Lean Hospital?'

This is an interesting concept and combines factors such as the numbers of people who are trained as 'Change Agents' and their level of training, the broad awareness of Lean across a trust and a core of 'Practitioners' who have been involved in multiple events.

However, more than this, it is also about attitude, allocation of effort, leadership involvement and perhaps most importantly, achievement of results on an on-going basis.

Over the next few weeks I am going to write a paper on this topic and would welcome your thoughts which you can either post here or email me. Alternatively, if you would be interested in receiving a copy of this paper when it is written, please let me know by emailing me.

You can email me on markeaton(a)amnis-uk.com (replace the (a) with the @ symbol when you do it of course).

Sustaining Lean in the NHS

Lean has the potential to make a major impact on the performance of the NHS, if implemented correctly!

Sadly, the vast majority of Lean projects will fail to deliver the results expected, and in this wake will leave a terrible trail of misery, disillusionment and believe that 'Lean just does not work here'.

Building on over 250 Lean Events in the NHS, Manufacturing, Local/Central Government and the Armed Forces, we are running workshops throughout 2007 to provide people tasked with Service Improvement in the NHS with the skills to enable them to prepare for, implement and sustain improvement.

For further details visit our website at: www.amnis-uk.com.

Also, if you would like a free copy of our book on how to Integrate Lean, Six Sigma and Risk Management then sign up for our regular email.

Lean Healthcare v Lean Manufacturing

Having run major public programmes focused on delivering Lean improvements within manufacturing I became incredibly aware of the ability of Lean projects to go wrong or for even the successful projects to fail to embed themselves in the organisation and this led to in-depth research and analysis into the major causes of 'Lean Failure'.

Following my time with manufacturers, I spent a year working with the RAF delivering Lean and found that many of the same problems applied to them as well, and then around 18 months ago when I started working on delivering Lean into Heathcare I very quickly realised that many of the problems that prevented manufacturing programmes being successful were also clearly apparent within the NHS.

Research into the causes of Lean Burnout involving some 20 Trusts determined that the fit between the reasons for failure in manufacturing were exactly the same as those in Healthcare.

The other interesting fact that was noted about the causes of failure is that the vast majority of them were either due to a faulty implementation process or were visible at the start of the Lean project.

If you are interested in finding out more, I would love to see you at one of our workshops which can be found listed on our website www.amnis-uk.com. Alternatively, drop me a line and I will send you a short paper about the findings.

How do you recognise low-grade Lean support?

Recognising that 'Lean' as a concept is now well known, at least in outline, by a large number of people, but that the level of expertise in the market to actually deliver high quality support is still very fragmented, I put myself in the shoes of a typical organisation looking to engage a Lean Consultant and asked 'How would you know if you were getting quality Lean support or just average or worse?'

I will start by saying there are three problems that create confusion:

1. People have heard of Lean, therefore consultants think 'I can do that' and open up shop
2. There is no standard accreditation of Lean work that would allow comparison
3. People in organisations underestimate the breadth of expertise required to deliver Lean effectively, and therefore don't ask the right questions

It is fair to say that I believe there is a hierarchy of Lean expertise. For people who have led less than 20-30 'Events' (whether that is a pre-change diagnostic or a Rapid Improvement Event (RIE)) they are 'Users' - people who purely understand how to apply the tools in a limited number of environments. Even their exposure to the tools will be limited.

For people who have led 30-around 75-100 events, assuming this has been gained in high quality projects led by 'Sensei' (see below) rather than the typical 'learn by doing it yourself', they will be 'Practitioners' - able to demonstrate real improvements in a range of situations but lacking the breadth of expertise to deal with all situations and are not experienced enough to develop Users into Practitioners, although they are experts at developing and leading Users.

Most consultants have led something like 30-50 events so bridge the User/Practitioner area, but the reality is that the vast majority that I have met have not been trained by Sensei (see below) and have learnt 'on the job'. This means bad practices are repeated, new approaches are not learnt and the 'correct' (or most effective) way of leading improvements is not used.

For the small majority who have been trained by experts themselves, when they exceed 75-100 events they become Sensei, skilled at developing Users into Practitioners and Practitioners into Sensei - able to deal with any situation in most sectors and environments and possessing a strong understanding of the skills required to deliver improvements across the organisation (rather than at a single point in a process or a single value stream or project).

Therefore, the key to knowing whether you are buying a quality 'Lean Consultant' who will deliver value, rather than just invoices, is to determine how many events they have run, who trained them in Lean and what expertise they have in working at the highest (or Programme) level in an organisation, or whether they have been stuck down at the individual process level.

All of this is explained in more detail in my new e-book 'Lean for Practitioners', an order form for which is available by dropping me a line via our website www.amnis-uk.com.

I look forward to hearing from you!