Living Lean

Kondo Marie doing what she does best in helping others get red of the unnecessary things

Beyond the application of Lean in manufacturing, healthcare or any professional industry, the same principles of reducing waste and getting the maximum value with the minimum resources possible can and do extend to one's personal live.
A very famous expert on organizing homes is Marie Kondo, the Japanese lady (no surprise here) who wrote several books on the subject, with her NY Times best seller "The Life-Changing Majic of Tidying UP" , where she talks about removing waste from homes. Her approach (now referred to as KonMari method) is very similar to the known 5S approach of workplace organization, where you need to start by removing waste and anything that doesn't add value in your home (real value compared to sentimental value), then tidying up the rest in a simple and accessible way. I guess this has it roots in the Japanese culture in organizing living spaces to lead a more zen-like life.

A whole year's worth of trash from Bea's home can be put in a small jar!!!

Another leading expert in the subject of reducing waste at home to almost "ZERO" is Bea Johnson, with her famous book "Zero Waste Home", translated to 9 languages and showcased through  many international media channels. Her 5-step approach is also very similar to the 5S, with words starting with R instead: Reduce, Reuse, Recycle, Rot (only in that order). However, she adds to that the preventive first step of Refusing anything unnecessary that can turn into clutter from coming in our lives.

Both and many similar approaches highlight the life changing effects of minimalist living on the mental and psychological state of the residents, which resembles the positive impact of 5S on the workers in any work place.

I strongly suggest you to take a moment and browse the 2 related websites, the YouTube  videos, and learn some of these principles in de-cluttering your personal life.

Lean is for life!

Let's play Lean !

Completed figures representing patients who went through the system

In one of the regular workshop I have the privilege to run in my organization, we finish the day with a Lean simulation game to introduce some of the Lean concepts to the staff and hopefully make them intrigued to learn more about Lean.
The game is based on similar simulation games run everywhere by Lean practitioners, and I tried to customize it a bit to fit healthcare setting. It's based on the famous assembly vs pull/kanban production, where you compare the volume and quality of the final product, the remaining inventory or work in progress, and the productivity rate. Building blocks similar to Lego (couldn't find the right set of Lego that fits the  number of participants and allotted time) are used to build the final product, in this case it's a "patient", with the target of passing as many patients as possible through the system, with two teams competing. Here is how it goes:
1- Each team is composed of 5 members (can be modified according to situation).
2- Each player gets a set of blocks to complete a specific part of the patient.
3- The scenario simulates patient flow in an outpatient setting, with 5 steps of registration, reception, doctor's office, laboratory and pharmacy. Each member is responsible for one step.
4- The steps of the patient flow builds the patient part by part (e.g. making the trunk, adding legs, arms, head..etc), until the patient figure is completed at the final step, representing the end of the journey.
5- Sticky-notes representing Kanban is placed between steps.
6- The game is played over two rounds, each over 5 minutes.
7- The first round simulates the traditional assembly line system, where players do their part as fast as possible, regardless what's happening downstream (denoting push).
8- The second round simulates pull/kanban system, where the members work only if the sticky-note (kanban) before the next step is free of any unfinished pieces ( denoting pull by the downstream step).
9- At the end of each round, the following parameters are calculated: total# of completed patients, # of patients completed in a correct way, % of quality (# of good ones/ total #), WIP (pieces which are not fully assembled), and the productivity of the team ( # of good ones / minutes).
10- Usually, all numbers go up with the lean/kanban system except for the WIP that goes way down, which indicates the advantages of the Lean system over the traditional system, and the benefits on the customers and staff. This is done through open discussion about the figures, and how the staff perceived the differences between the two systems in terms of work stress, waiting patients, early detection of errors, and collaboration.
We found that this is a fun and practical way to introduce proper patient flow, supported by real numbers. The attendees often cite it as one of the workshop highlights.

Courage

Not the typical title or picture you see on a continuous improvement blog, but I believe courage is in the heart of it.
Courage is a quality that any keen continuous improvement professional should posses, or at least learn and grow with time.
Courage to name things as they are without sugar coating, calling a problem a problem, admitting that oneself, the organization, or the system is not perfect, especially in front of a board, a CEO, or other executives, is definitely something not very common nowadays.
Courage is to listen to others actively and attentively  without interrupting them to tell them something, or worse trying to downgrade or mask their point of view in favor of one's own. We, quality professionals always preach others about accepting other ideas and differing opinions, but it's hardly practiced amid heated discussions.
Courage is to give the chance to junior staff with less experience and professional level to speak up, even if that means disagreeing with us in the middle of a meeting, and to let go our egos and the fact the we know more and bring better ideas to the table, because we are senior !
Courage is to promote other people skills and knowledge and letting them shine without feeling threatened or jealous.
Courage is to stay persistent in the face of resistance, when the majority can't see what you are seeing, no matter who is resisting as long as the change is worth the try and is needed. Courage is to see things we started through, despite all the surprises and shifting priorities, because it's a commitment we made at the beginning to the customers and to the people who have spent energy and effort on it.
Courage is to speak up and say what need to be said without fear of failure, criticism or rejection.

Courage is not only about bravery in a battlefield or being fearless in an adventure, but it's also about raising the bar in the middle of comfort zones. True continuous improvement is a constant battle; so, how courageous are we?