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My Mentors

2/27/2017

 
Today on the blog I want to pay tribute to three people whose vision and guidance made my Lean education possible. Of course, there are many others who deserve mention, but here are three leaders who had a lasting impact on my work. Read on below the graphic for more information and stories.
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Yoshiki Iwata

​Iwata was founder of Shingijustsu Company, Ltd. He was an original member of the Toyota Autonomous Study Group (a project team assembled from Toyota’s subsidiary companies), which first developed Toyota’s Lean production practices (the kaizen system). He and Nakao reported to Taiichi Ohno, father of the Toyota Production System.
 
When we began our Lean Journey at Boeing, we reached out to Iwata. We wanted to learn Lean techniques from the original source.
​Iwata had a deep sense of the power of continuous improvement. He once said, “We need both revolution and evolution. People will never get used to the idea of it. If we take small steps, it takes some time before people understand. Kaizen shows them real results.” 
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Yoshiki Iwata with Carolyn Corvi, Boeing executive who transformed how Boeing built airplanes with the 737 moving production line.

Chihiro Nakao

​Nakao, like Iwata, trained with Taiichi Ohno at Toyota. Nakao consulted us during our Lean transformation at Boeing, and later mentored me through my transition to consulting.
 
It was Nakao who first suggested the name “Wash Your Hands,” a JBA event where Lean students observe and participate in an RPIW on the factory floor. I told sensei Nakao that I was partnering with Genie Industries and would be starting kaizen events at Genie, requiring my clients to attend as part of their certification. He said, “Black-san, you should call it ‘wash your hands’ training because Toyota engineers doing kaizen washed their hands daily.” The implication, of course, is that their hands were getting dirty in the gemba.
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On a Boeing jet going to Japan. On the left is Mrs. Nakao, with Mr. Nakao on the right.

Bruce Gissing

 ​Gissing was my boss at Boeing. I initially prodded Gissing about going to Japan to understand what “world-class” really meant. It was Bruce’s vision, experience, and presence that made the trip happen. Under his leadership, all of Boeing’s top executives visited Japan in the early 1990s, beginning Boeing’s transformation toward operating according to world-class principles and practices, as well as implementing the Toyota Production System.
 
Here’s how Gissing described the culture at Boeing before Lean:
​“‘If it ain’t broke, don’t fix it’” was an underlying theme. We had gone through market cycles, but always came out of them bruised but not hurt. The “method of choice” for contending with the cycle was massive layoffs. The Boeing psyche when a consultant suggested that we could improve our operations was skepticism. Our retort was always ‘we are different’—simply put, we were arrogant.”
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Gissing speaking to Toyota executives on our first trip to Japan in 1990
​Gissing had the vision to see the writing on the wall and push for needed changes. After the Japan trip, Gissing put us on a rigid schedule to implement our action plans. The formation of the Boeing Commercial Airplane Group Strategy Council in February 1991 set the stage for a major full-court press focused on world-class competitiveness principles learned in Japan. I will always be inspired by Gissing’s courage to steer Boeing on a bold course to success.

Healthcare Needs a Vision

2/17/2017

 
​Some of the most brilliant minds and compassionate people go into healthcare. So why do we still see over 440,000 preventable hospital deaths every year? Question: do most healthcare leaders have a vision for their organization’s future? And have they “operationalized” it, as Dr. W Deming would say?
 
Vision separates “good enough” from “excellent.” Vision gives inspiration when the job gets tough. Vision makes the impossible, possible.
 
History shows this pattern: Vision comes first. Success follows.
 
In his research on the power of vision, Joel Barker came across a Dutch scholar’s work on successful civilizations. In Barker’s words, the scholar found this sequence of events, over and over: “First a compelling vison of the future was offered by leaders. Then that image was shared with their community and [the community] agreed to support it. Then, together acting in consort, they made the vision a reality.”
 
Today we see the same thing happening. Watch this video, about the difference between Detroit after it began to deteriorate in the late 20th century and Hiroshima, which was totally destroyed in 1945 and has been completely restored today.
​Hiroshima emerged from tragedy because its leaders promoted a positive, forward looking vision for the city. As the auto industry declined, American leaders abandoned Detroit’s future and its decay followed.
 
Lean gives us the tools to start setting our visions for healthcare. Imagine a future with zero wasted medicine, zero wasted steps to and from supplies. A future where doctors and nurses are able to spend more time with patients and less time on logistics. A future where healthcare is both financially solvent for healthcare facilities and affordable for the patient.
 
We need leaders to present the bold visions that lead to huge transformations. Change happens step by step, and commitment to the goal falters without clear inspiration. Healthcare needs a vision.
 
This isn’t fiction—lack of vision affects healthcare around the world today. Consider the recent cutbacks by the NHS in England.
“An NHS body has suspended all hip replacements, cataract operations and other non-urgent surgeries for more than two months in an attempt to save more than £3 million…[the policy] will put about 1,700 people at risk of their condition worsening and leave many in pain.
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​Here’s the reaction from a U.K doctor about the rollback, and it’s spot on: “The CCG is trying to make short-term savings, which may have major consequences for patients. While patients wait for treatment, their conditions could deteriorate, sometimes making treatment more complex and costly. In addition, standing down surgeons and their teams is inefficient and a waste of scarce resources.”
 
Instead of doing the work to use their resources more efficiently, the NHS is making cheap cuts to their system, harming patients and employees.
 
So what would a positive vision for healthcare look like? I want to point you to the work of Atul Gawande, M.D., best-selling author of The Checklist Manifesto, Better, and Complications.
Gawande lays out the only sustainable vision for healthcare I’ve seen to date:
“We have a thirty-billion-dollar-a-year National Institutes of Health, which has been a remarkable powerhouse of medical discoveries.  But we have no National Institute of Health Systems Innovation alongside it studying how best to incorporate these discoveries into daily practice---no NTSB equivalent swooping in to study failures the way crash investigators do, no Boeing mapping out the checklists, no agency tracking the month-to-month results.”
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Our healthcare system has a good product; our doctors and nurses on the front line deliver the best care with the best medical technology available. But systemic waste gets in the way of their jobs. Healthcare leaders have got to invest in operations that streamline the care process with the priority of eliminating preventable deaths and mistakes with no compromise.
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Lessons from a Lean Leader: Ngaire Woodroffe Brown

2/3/2017

 
When I talk about Lean transformation, oftentimes I’m met with, “That’s too radical, too complex for our organization right now.”
 
In reality, Lean is just the opposite. Healthcare facilities, large and small, can use the Toyota Production System to make many simple changes that add up to huge gains in revenue and patient satisfaction.
 
One Lean Leader who really lives out this core concept of Kaizen is Ngaire Woodroffe Brown. As the director of the Wascana Rehab Centre in Saskatchewan, she shaved 15 hours of lead time from inpatient care delivery processes. Additionally, her team gained an extra seven minutes of face time with patients just by reducing the number of steps the staff had to travel to and from patient rooms and supply stocks.
 
In an interview with me in 2015, Woodroffe Brown emphasized the lessons from Wascana’s Lean transformation:

  1. “It’s not all about technology” Woodroffe Brown implemented no new technology—her team made more efficient use of the resources they already had.
  2. “Take it one step at a time” Taken as a whole, Lean can seem daunting. Taken step-by-step, the changes seem obvious.
  3. “People are the foundation” Your staff knows where the trouble areas are. Listen to them.
  4. “Keep it simple” Clean supplies. Manuals in the correct place. Never underestimate the power of the simple things that make sure personnel can flow without worrying about materials.
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Watch Woodroffe Brown's interview below:
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    About the author
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    John Black, President and CEO of JBA, has implemented Lean improvements for four decades, first with the Boeing Company and later as a leading consultant in the healthcare industry.


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