Lean Management Idea for Health Care

The Health Factory by Stpehen Spear [the broken link was removed, I wish people would publish useful thoughts on more reliably designed web sites that care about information for the long term], New York Times opinion piece:

Today, going to an American hospital seems about as safe as parachuting off a bridge. An estimated 98,000 Americans die each year as a result of medical error, and a nearly equal number succumb to infections they acquire in hospitals. Those rates are unacceptable in the world’s most medically advanced country.

To go from working around problems to identifying and solving them required hospital workers to change the way they worked, from the front lines to the senior levels. But the effects were profound. If the rest of the country’s hospitals follow that example, the national savings would be measured in tens of thousands of lives and billions of dollars every year.

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Consumer Idealized Design

Consumer Idealized Design: Involving Consumers in The Product Development Process

Interactive Design vs. Reactive “Focus”

A consumer design session is characterized by at least three features which distinguish it from a focus group.

(1) It requires innovation and interaction from participants.

(2) It is task-oriented, competitive and consensus-generating.

(3) It requires the articulation and design of the group’s notion of the ideal in a designated product or service category.

This concept is based on the idea of Russell Ackoffarticles by Russell Ackoff.

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NUMMI Plant Model

NUMMI plant a model for ailing car industry (site broke the link so I removed it) by Tim Simmers:

The historic NUMMI joint venture – the first of its kind on U.S. soil between a Japanese and an American carmaker – is something of an industry gem. Its secret to success, besides the common sense of building small cars and trucks that are in demand, has been its good labor relations and adoption of Toyota’s “lean manufacturing” techniques. Referred to as the “Toyota Production System (TPS),” it is steeped in Japanese business lore and terms that stress and lay out a road map for quality, efficiency and production advances.

NUMMI tour information [the broken link was removed] – NUMMI, Production System [the broken link was removed]:

A key factor in the production system is treating team members with trust and respect. They are expected to help solve problems and make decisions that affect them or their group. They are also held accountable for their work.

Related posts:

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Warren Buffett’s 2005 Shareholder Letter

As usually Warren Buffett’s Berkshire Hathaway shareholder letter is packed with good investment thoughts along with some management wisdom.

Too often, executive compensation in the U.S. is ridiculously out of line with performance. That won’t change, moreover, because the deck is stacked against investors when it comes to the CEO’s pay. The upshot is that a mediocre-or-worse CEO – aided by his handpicked VP of human relations and a consultant from the ever-accommodating firm of Ratchet, Ratchet and Bingo – all too often receives gobs of money from an ill-designed compensation arrangement.

Page 13.

Related posts:

  • Toyota Manufacturing Powerhouse “In a reflection of Toyota’s team-oriented approach, its executive pay is paltry by U.S. standards. Analyst Ron Tadross at Banc of America Securities estimates the total annual compensation of Toyota’s CEO at under $1 million – about as much as a vice president at GM or Ford Motor Co. makes in a good year.”
  • Excessive Executive Pay
  • CEO Pay: Obscene

Continue reading

Posted in Economics, Investing, Management | 6 Comments

Seth Godin Video

Seth Godin has a great blog on marketing. To me, his views put marketing within the context of the system (of the whole organization) rather than a disconnected “stovepipe” as it is often treated. This fits with my bias in favor of systems thinking. He has written several books on the topic:

  • All Marketers Are Liars: The Power of Telling Authentic Stories in a Low-Trust World
  • Purple Cow: Transform Your Business by Being Remarkable
  • The Big Moo: Stop Trying to Be Perfect and Start Being Remarkable by Seth Godin and many others

He recently spoke at Google: view via Google Video [the broken link was removed]. I found the video enjoyable and worth the 45 minutes.

Random comment: he needed some simple help from someone who spoke Japanese, he posted a message to his blog and a few minutes latter had two volunteers. I think that type of interaction is cool.

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Saving for Retirement


Our Financial Failings
by Neil Irwin, Washington Post:

Meet the typical American family.

It has about $3,800 in the bank. No one has a retirement account, and the neighbors who do only have about $35,000 in theirs. Mutual funds? Stocks? Bonds? Nope. The house is worth $160,000, but the family owes $95,000 on it to the bank. The breadwinners make more than $43,000 a year but can’t manage to pay off a $2,200 credit card balance.

That is the portrait of the median American household as painted by the Federal Reserve Board’s Survey of Consumer Finances.

Saving for retirement is not complicated, it is just a matter of priorities. Most people care more about a Starbucks coffee each day (or season tickets, or new shoes, or a new car every couple of years or…) today than saving money for retirement. In a capitalist society we believe in letting people make their economic choices. The choices most of us make (in the USA) lead to the results above.

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Cease Mass Inspection for Quality

Comment in response to, Re-Discovering W. Edwards Deming, a partial quote from that post:

Not all of the Deming approach is part of core TPS thinking. In particular, Deming advocated a statistical sampling approach to quality inspection, while Toyota focuses on 100% inspection or eliminating the need for inspection through via the concepts of Poka Yoke and Jidoka. As much as I admire Deming and his philosophy, I agree with the Toyota innovation that it is better to prevent defects from occurring, or at least preventing defects from reaching the customer.

Thanks for your continually interesting blog. I think some might read this post and be confused about what Deming thought about sampling and inspection.

Deming’s point 3 is “Cease dependence on inspection to achieve quality. Eliminate the need for inspection on a mass basis by building quality into the product in the first place.” (Out of the Crisis, 1982). I think Toyota’s improvement of the system to build quality into the product is exactly what Deming had it mind.

Deming believed in improving the process, and doing so using process measures (which often may involve sampling) to guide improvement efforts. He did not believe in using inspection to select out the bad products, which is what inspection largely was before Deming.

He also talked about inspection of incoming material from suppliers – see Chapter 15 of Out of the Crisis.

He also did a great deal of work with sampling to improve population estimates for the US Census Bureau and others as well as on surveys and the sampling involved in surveys.

More on Deming’s thought on Inspection.

[Added to this post, new link: Inspection is too late. The quality, good or bad, is already in the product.]

Posted in Data, Deming, Lean thinking, Management, Process improvement, Quality tools | Tagged , , , , | 4 Comments

The Power of Purpose

The Power of Purpose by Rebecca A. Morgan:

Constancy of purpose means that quality decisions are not situational. End of month quality is the same as beginning of month. It means that the long term benefit of the organization is not sacrificed to hit quarterly targets. It means having your eye on the competition, whether it is in your industry or coming from elsewhere, with plans to stay ahead. Constancy of purpose doesn’t require the threat of a customer leaving to implement corrective actions based on root cause. It means that while your team may argue about how best to accomplish it, no one is confused about the commitment to deliver reliable quality.

Deming’s Fourteen Points, point 1: Create constancy of purpose for the improvement of product and service. With the aim to become competitive, stay in business, and provided jobs.” source, Deming Institute [the broken link was removed].

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The Skinny on Lean

The Skinny on Lean [the broken link was removed] by Peter Bradley

The pursuit of perfection and obsessive attention to detail that characterize Toyota’s lean model are reflected in Menlo Worldwide’s 278,000-square-foot Brownstown facility, known as the Great Lakes Lean Logistics Center (GLLLC). Look around, and you’ll notice process maps on the wall of a room off the main warehouse. You’ll see taped outlines on the floor and walls to indicate the precise location of every cart, every tool, every barrel—often with photos showing what goes where. While leading a tour of the facility, Meaghan Diem, a Menlo Worldwide logistics manager, nudges a barrel back between its taped lines. “Some people think this is organization overkill,” she says, “but it makes it almost impossible not to make it right.”

Though it encourages employees to offer ideas on an impromptu basis, Menlo Worldwide also solicits suggestions through a more formal process: its continuous improvement program. On a regular basis, the company assembles kaizen teams—teams formed to root out waste and inefficiency. Rivera reports that employees at every level participate in these teams, which may also include an engineer and a customer. The teams spend three to five days collecting data, identifying targets—called SMART targets—and preparing an implementation plan. Consistent with the Toyota protocol, their plan must fit on a single sheet of A3 paper. (That’s an international standard for paper about 11.7 by 16.5 inches, or more precisely, 297 by 420 millimeters.)

The lean program’s results speak for themselves. Menlo Worldwide reports that warehouse productivity improved 32 percent between January and November last year, measured by gains in lines per hour. Defects, measured as the error rate, dropped by a whopping 44 percent. The on-time percentage for shipments was north of 99 percent in every one of those months, hitting 100 percent in eight of 11 months.

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What is Lean Six Sigma?

What is Lean Six Sigma? – slides from a presentation [the broken link was removed] at MAQIN [the broken link was removed] (Madison Area Quality Improvement Network). FYI, I manage MAQIN’s web site [make that, I used to manage – I wouldn’t have allowed broken links to be created if I was still responsible for the site] and author this blog – John Hunter.

I rarely link to slide presentations, but when the slides seem interesting enough I do link to them occasionally, as in this case. Still since slides are designed to act as supporting material to a presentation they leave much out. The following links provide articles with much more detail on this topic, via the Curious Cat Management Improvement Library:

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