‘Implementation’ is a contentious word in Lean. It can sound as if Lean is a one off implementation, like introducing an IT system (and as anyone who has been involved in a new IT system will know, you can’t implement an IT system and walk away in any case!).
Larry Rubrich’s 2004 book, ‘How to Prevent Lean Implementation Failures‘ isn’t falling in to this trap. It’s a sensible, measured discussion of some of the reasons that companies trying to apply Lean methods can run in to problems.
Rubrich identifies ten possible problems in his book.
- Lack of Top Down Management Support
Senior staff need to champion the work. Rubrich suggests that they need to create a shared understanding of challenges, and explain it clearly and repeatedly, in order to encourage urgency in response. This is an idea associated with Kotter, and to which Kotter has returned several times, including in his book, ‘A Sense of Urgency‘.
Rubrich also links this to ideas associated with Lean management, and the concept of Hoshin Kanri. He includes developing a vision of a future state, and the clear communication of this vision and strategy to all the staff. He also emphasises the need to convey the idea that staff members have the power to make changes, and will be supported to do so.
2. Lack of Communication
Along with the first cause, Rubrich sees this as one of the causes most likely to scupper the whole project. He argues that better communication reduces rumours – which are rarely if ever positive – and helps to produce the sort of alignment necessary to avoid the first cause of problems, above. I agree with Rubrich that this has to include making it clear that a problem with a process does not mean that the individuals operating that process are seen as failing: it is the process that needs to change, and their input will be essential in identifying and making changes.
Values, and the communication of values, are important in this. Rubrich argues for a straightforward commitment that no one will loose employment as a result of improvement work.
3. Lack of Middle Manager / Supervisor Buy-In
Few failures arise because front line workers block them, Rubrich argues, but failures because of people in management layers refusing to budge can and do occur. This can also be very difficult to identify, without being in the workplace, the gemba, regularly.
It is common to have people nod, smile and agree, and then go straight back to their staff, and tell them ‘but we’ll keep on doing it my way‘. One of the really tricky things about this is that these may be managers who were very good at working in a pre-Lean system, where firefighting and constant decision making were required. They will often have little experience of a coaching system, and of devolving decision – making.
Rubrich suggests that tackling people who find a new system difficult is important, and that doing it quickly is essential, so that any damage they cause does not drag on month after month. This has to involve being very clear on what behaviours are expected, and on what will happen (for example being moved to a different post) if they are not able to adopt thee required behaviours.
4. Not Understanding That This is About Your People
You can’t do Lean to people. Your main asset is staff. The aim in Lean is to engage the active efforts of this resource in improving quality, safety and efficiency in their service. As Rubrich queries, ‘do you want 6 – 7 people improving the company, or 400?‘.
To do this requires clarity on aims, teamwork, delegated authority, shared accountability, and openness.
5. Lack of Customer Focus
This is a very useful concept in health and social care. The whole point of these services is to provide for a need. Aligning around what delivers value in a service is a powerful leaver in reducing conflicts between services (‘it’s all their fault‘) and in relentlessly tackling waste reduction.
6. Lack of Improvement Measures
‘No baseline, no measurement – no improvement‘, Rubrich suggests. It is important not to interpret this as an indication that more measurements are better than fewer measurements – what you need are the right measurements. I spoke to a hospital doctor recently who was worried about lack of read across from Government performance targets to, well, real life. How, they wondered, could improvement activities be conducted in the face of a blizzard of mandated measurement?
Rubrich is working in an industrial concept, but his two recommendations – tie the measurements to companies goals, and visually communicate measurements so everyone can see them – make sense to me. No one, outside of TV dramas, can really focus on 27 things at once. (There’s a discussion of this in the sports coaching book that I wrote with Don McNaughton – there’s evidence that coaches giving players too many things to think about at once just doesn’t work, and I’m pretty sure it’s exactly the same in business.)
For the things that matter, however, you really do need to know your baseline, and the results of any changes. It’s very common in health and social care for people to think up a plausible sounding change, implement it, and assume it has worked – what a colleague of mine calls Plan – Do – Do – Do. This might be good for your ego, but it means you loos all possibility of identifying what has worked and what has not, and where more work may be required. It’s okay to have things that don’t work. A coach from Tees, Esk and Wear Valley NHS Foundation Trust told me they felt a team had made a breakthrough when the team members were pleased with a PDSA cycle that had produced no improvement, because it meant they had learnt more about the process.
7. Lack of Lean Leadership
Lean takes effort. Rubrich argues for identifying internal resource to support Lean work. He’s not suggesting that you have a group of staff who are the only people who are ‘allowed’ to ‘do improvement’, but rather than there are people who have time to undertake training, organising and coaching.
8. People Measures Not Aligned to Goals
There’s a truism in the risk literature, that people pay attention to what you do, not what you say. So, if you react to a threat as if it’s really dangerous, but say it’s nothing to worry about, people tend to believe more in how they see you act.
Similarly, in Lean, if you have a traditional structure that aligns with a command and control approach, then it can produce conflicts with other messages. This often applies to HR processes as well.
In a large, public sector organisation, it is difficult to switch quickly from one approach to another, but staff at least need to see that the organisation is making an effort to e-align its processes.
9. Using Improvement Events as the Sole Improvement Mechanism
I’ve written previously about this issue, including in a chapter in ‘Practicing Lean‘. It’s easy to persuade people, inadvertently, that only big, set piece events can improve processes. This isn’t the case. Rubrich points out, as most people find, that change in events if straightforward if you follow Lean processes – the difficult part if maintaining and improving after an event. Rubrich also includes example of how not to use events – such as having managers make changes without involvement of staff.
10. Bonus Pay Systems Based Only on Company Profitability
This is less relevant to health and social care systems, but the principle is relevant. Rubrich argues that, in industry, bonuses should be tied to things that affect profits – like reduction in waste, increase in productivity – rather than directly to profits, to align reward with value adding activity. The health and social care equivalent is being clear on what type of work is valued. It’s not work for its own sake, it’s the quality and added value of the work that matters, and that helps service users.
Overall, there is lot of value in this brief book (117 pages including index). It is out of print, but turns up second hand from time to time. It shows a lot of common sense, and hard-earned experience. I found it a worthwhile read, and if you come across it, is is well worth picking up and reading.