Lean HealthcareThe Dark Side of Lean

Lean Healthcare Plumbs New Depths at ?? Hospital

By Jon Miller Updated on May 15th, 2017

The news from Jean’s workplace, where consultants have been giving Lean healthcare a bad name, has gotten worse. Jean writes:
I think we, as a staff are beginning to feel like chicken pluckers in the Golden Plump Place where Faster is always better. The morale in our place of work has been sliding down and has recently picked up speed as the true depth of lean is being revealed to us.
Instead of holding themselves accountable for failure and practicing the “stop and fix” discipline that Lean thinkers do, these consultants are pushing their ideas without regard to how they are being received by the people most affected by them.
As it is failing in our place, the pressure to make it succeed lest the vendors of lean lose business selling the “concept”, the pressure to “do it” has increased so many fold that a day at work is like that picture “The Scream” for eight hours.
What self-respecting kaizen consultant or Lean consulting firm would put getting results ahead of morale and safety of people? Perhaps they are paid based on the results they achieve, or perhaps they have guaranteed results and faced with a failing project are now are in a pickle.
I do not know what Toyota does to halt the subliminal disconnect of hearts and body that is happening in our place. Last week a co worker said she felt like an evil black vapor was loosed upon our place. We are all good nurses and are dedicated to the healing arts. We cannot figure out what we did to warrant the pattern of abuse, in the classic description, that mocks what we have spent our lives preserving.
Even Toyota is struggling with this now as their quality suffers. Toyota has grown too fast, depending too much on “permanent temporaries” or “false contract labor” as it they are now being called in Japan. These long-term “temporary” workers have no stake in the success at Toyota, and their lack of ownership of the process is showing up in the hundreds of thousands of recalls which will cost Toyota millions. I believe Toyota people have the heart to learn from this, but we will see.
Yes, it is pitty pat to say that malcontents focus blame on something else rather than face up to the challenge of lean. I say that they simply do not understand what is happening. We all now would like lean to go away.
Perhaps the Lean consultants should go away, but it would be a pity if the spirit of improvement were to go away. Jean and the other front line caregivers have too much to contribute, if only Lean were being introduced correctly here. In the United Kingdom, hospital bosses are turning to the front line workers for ideas on how to cut delays in cancer treatment. They are being trained by Toyota in their suggestion system.
An article in The Scotsman quotes an NHS employee director:
“This approach is absolutely the opposite of the kind of initiatives where outsiders try and tell staff how to do their jobs with no real knowledge of the realities of life on the front line, as it were.
“This approach puts staff at the heart of spotting opportunities for positive changes for patients and making improvements happen. No-one has the monopoly on good ideas and the only way we’ll get real change that works for the benefit of patients is by everyone working together as a team.”

This reminded me of a comment Jean made a few month ago that as consultants “you all wear the same uniform”. Perhaps the consultants at her hospital all wear the same uniform.
Jean says:
There is no joy in the hallways, no laughter ( I suppose laughing slows down the Line), no one wants to stay late or do anything extra that use to come just from the joy of working in an Operating Room. I do not know where this will end. I only have three more years until I can retire. It is going to be a long three years.
If anyone has a clue who are the consultants who are making life so unpleasant for Jean and others at this hospital, send them the link to this blog entry. Or send me a hint. If they have any integrity they will change their ways.

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