Murphy’s Law, Poke-Yoke & Lean in Hospitals

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Lean in Hospitals - Waiting Time

5-Bullet Friday Lean Newsletter

Welcome to this week’s 5-Bullet Friday where we share insights, learnings, tools, and tips on making changes happen.

The majority of our certified learners all claim that earning a Lean Six Sigma certification gives them a lot of perks. They not only confirm particular expertise and capabilities but they also help to establish them as highly marketable professionals.

Investing in yourself is the best investment you will ever make!

Lean in Hospitals - Waiting

The worst “waste” from a customer perspective must be waiting: waiting for an appointment, waiting for a reply, waiting for a plane that is delayed. Waiting for just about anything. Waiting is painful because it feels like a waste. We all value our time, and we know when we are waiting.

Hospital Visit

This morning my son was, unfortunately, having an operation at the hospital. The procedure was planned for 8 am, and he arrived in good time. At 9 am (after waiting for one hour), the nurse informed us that they needed a specific doctor to give their final approval. The operation had been planned three weeks earlier. Therefore, the nurses were waiting for 9 am for the doctor to arrive on shift so they could sign the final authorisation.

Once the doctor had signed the approval, it took another 90 mins to prepare everything before the operation got underway.

So what’s the customer impact?

1) The issue (cause) was that someone failed to get the approval done ahead of schedule. It was just missed.

2) Because the approval was not complete, no one could prepare the equipment/medicine in advance, leaving the nurses to scramble things together at the last minute (increasing the risk of errors).

3) The impact was 60 minutes waiting for the doctor to arrive on shift so they could sign the approval, followed by another 90 minutes waiting for the operation to be prepared.

From a pure customer perspective, the result is a 3 hour planned visit taking 5 hours 30 mins due to a minor process failure that feels like it could have been easily avoidable.

This is an example of how minimal process failures can significantly impact your processes and your customers. And there may be a knock-on effect throughout the day.

Lean in Hospitals - Waiting Time

Why do we all fail to identify our productivity limits?

Today, everyone is pushing their own and their team’s productivity. We are looking to do more with less. We are trying to squeeze in as much as possible. And many of us will be taking on more than we should be.

Our golden figure for productivity is 85%.

If you are above that, not only do we find that your overall output drops, but the quality of that output drops as well, causing more issues and reducing the overall production.

The same is valid with teams. Productivity close to 85% is the maximum managers should be expecting as once teams go above this, quality drops, and overall output drops as well.

If you are cooking and you put too much in the pot, it will not come out well.

The same is true of your time and effort.

If you have over 85% of your time committed to projects, the results will not come out well either. It is precisely why at 85%, you need to have the guts to stop taking on more and protect yourself and your team.

How to Lie with Statistics

“The truly genuine problem … does not consist of proving something false but in proving that the authentic object is authentic.” – Umberto Eco

If I am learning anything from the Covid Anti Vaxers at present, bad news travels faster. It is shared more often and by more people than good news.

And we can see this with the recent Facebook whistleblower case – more sensational stories and anecdotal evidence are easier to spread than good news and get more engagement.

Driving change in organisations requires the ability to move away from anecdotal stories towards data-led decisions. And for that change to take place, we all have to be more comfortable with data.

Come and join our webinar next week, “The Average is Always Wrong”, where we will have a look at some of the key statistical concepts that can help us all improve our decision making.

Why is the Average Always Wrong

How to Get Funding

Over 60% of our past participants have been reimbursed for their Lean Six Sigma Training. While we can’t guarantee it, many companies provide employees reimbursement through a budget for continued learning.

To help you get started, we have created a couple of email templates you can use to share the idea and get buy-in from your manager.

There is no guarantee, but hopefully, this article here will help you see that asking for financial support for training is similar to any business investment decision. There is a cost, and there is a return.

So when pitching to your manager, we must look at both. And we do say that training is an investment – if your company only sees training as a cost, then it might be tough to get much support.

> Yellow Belt Email Template
> Green Belt Email Template
> Black Belt Email Template

To make it easier to get funding approved, we have also introduced one-off fees for all courses.

Murphy's Law - The need for Poke-Yoke

Recently, we have been helping a client review the quality of data within their systems. The system is heavily reliant on manual data entry, so there was a considerable emphasis on training and more training to ensure data quality.

The challenge to this approach comes from Murphy’s Law – “things will go wrong in any given situation if you give them a chance”, or in the more common phrase, “whatever can go wrong, will go wrong.”

Poke-Yoke is a Lean Manufacturing process that helps to avoid things going wrong in the first instance. Its purpose is to eliminate product defects by preventing, correcting, or drawing attention to human errors as they occur.

Training is essential, but if “quality” is essential, you have to design your systems to stop things from going wrong from the start. Don’t rely on superhuman effort.

Deming’s teaching is that 94% of the problems or defects in an organisation are caused by “the system.” The traditional management mindset is that errors and defects are caused by bad employees or employees who just don’t care.

5 Step Training Program

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