Lean Healthcare

Waste Rules the Empty Spaces Between Us

By Jon Miller Updated on May 24th, 2017

The latest episode in the chronicle of the lean journey at Group Health Cooperative in Washington State is A Story from the Front By Dr. Wellesley Chapman. Dr. Wellesley writes about the experience of launching the lean transformation at the GHC clinic in Burien, Washington:

Because of Burien’s architecture, our teams work in isolation. Patients walk from team to team in the course of a visit, but our teams can’t see one another. Handoffs are invisible and lack standard communication. This is true for movement of flesh and blood patients and the data that precedes or trails them (electronic items and “old school” pieces of paper).
Waste rules the empty spaces between teams. It’s scary.

That last one is a powerful statement. It reminds me of the often used quote, “All that is necessary for the triumph of evil is that good men do nothing.” We can paraphrase to say, “All that is necessary for waste to fill our lives is for us to give it empty space.” Indeed there are many behaviors we allow which create empty space: the lack of clear and fair rules, lack of visible standards and limits, unclear responsibilities at boundaries and interfaces, loose connections and flows, vague purpose and priorities, weak discipline and and less-than-daily kaizen. These all give waste space in which to expand and rule.

Where in your organization are you allowing empty spaces to exist, giving opportunity for waste to creep in?

  1. Dan Markovitz

    October 13, 2010 - 2:54 pm

    This is a far more concrete example than you’re probably hoping for, but I’m astonished at the waste that creeps in due to the prevalence of. . . organizing tools. Yes, all those standing file racks, pencil holders, small office supply caddies, binder baskets, etc. etc. actually seem to motivate people to collect and store more junk. It’s like people think, “Well, gee, I’ve got this cool folder holder, so I guess I better fill it up with these papers.”
    I’d go so far as to argue that increasingly large file servers encourage the same kind of garbage collection. Without the pressure to pare our files, we end up holding onto worthless crap (2010Budget.v3finalfinal) that eventually leads to waste: waste of storage, waste of waiting, waste of looking for, waste of errors & rework, etc.

  2. Rob

    October 16, 2010 - 9:11 am

    The biggest empty space that typically see exist is between peoples ears, and its called complacency.
    One of my favorite Will Rogers quotes is:
    “Even if you are on the right track, you will get run over if you just sit there.”
    Wherever complacency exists in a business, there will be massive resistance to change. These attitudes of success and entitlement, “We’re good, we’re successful. Why improve?”, coupled with little real interest will create waste through errors and mistakes.
    The worst type of complacency is that which exists with senior management, as with a lack of top level leadership areas tend to attempt to sub-optimize their goals and objectives.
    What works well is if you can get senior managers to not only support with words, but with actions by participating in layered audits and in daily gemba walks. Much like MBWA or Management by Walking Around, gemba walks are an activity that takes management to the front lines to look for waste and opportunities to practice gemba kaizen, or practical shopfloor improvement.

Have something to say?

Leave your comment and let's talk!

Start your Lean & Six Sigma training today.