Isn’t Lean Just Common Sense?

Nov 2, 2016

So what was it that we did to invoke such a question? The improvement was in a hospital where the team managed to reduce the time in the emergency department from admission to medical decision (to either admit or discharge) by two hours.

I’m sure you’ll agree it’s a great result for the patient and the hospital staff and was no small feat especially as this incurred no extra staff, no extra equipment and no extra facilities.

Whilst the team involved in the improvement tackled many great improvement solutions during the week, the primary solution that bought about the big impact was relatively straight forward. It involved bringing forward a diagnostic process to earlier in the process (shortly after admission) so that the information from this diagnostic was available to the doctor sooner (approximately two hours sooner).

This approach to reducing lead time is not new, many people who undertake project planning will be very familiar with understanding the critical path, or in military planning I have heard this described as “the longest pole in the tent”. Either way this view of what may be perceived as being obvious in hindsight is not always obvious at the time.

So how do we make common sense common practice.  In this instance we undertook a collaborative team based problem solving activity that followed the lean principles. The first thing was to understand “what is it that flows”? The answer in this situation is information, so the question is then how do we make the information flow quicker? So by removing waste and reorganising the way that value flows (i.e. the information and decisions) then we can make a big impact on the flow time.

But that is only half the answer, because then we have to be able to implement the solution and this is where a lot of common sense ideas fall over.  Most people go to work to do a good job and naturally protect the way they work; they may have already invested a lot of time, effort and emotion into the process and truly believe that they already have the best way.

So when someone from the outside comes along and wants to change the way they work, their natural reaction may be to resist the change. And it could very well be for well intentioned reasons – it’s not safe, we need more people, we don’t have space, it would take too long, it would never work, etc.

So the real reason why common sense isn’t common practice is that most organisations don’t have an effective way of managing change to work through these reasons for resistance and make the improvements that they are striving for. This is where you need a structured team based collaborative approach that can involve the people who do the work using the lean principles to positively change the outcomes. We all know that if we are involved with making the change happen then we are more likely to make it work.

This really does hold true but before we start empowering everyone to start making change beware of one final point

Yes, these improvement programmes should involve the people who do the work, but they should be structured and supported from the top. Clear direction, goals, resources and support are needed from the leadership to prioritise and lead the Value Stream focussed improvement efforts. Without a structured improvement process activity may at best be chaotic, at worst dangerous or counter productive.

So how do we make common sense common practice? By providing a structured process improvement methodology and involving everyone in the organisation.

For more information about how Castlefirth help organisations just like you to evaluate your improvement potential and then setup your improvement methodology to deliver outstanding return on investment please contact us at