I had a very interesting visit to one of the organizations that has joined the Healthcare Value Network.  One part of their mission is research and it is doing some very impressive work indeed.  During the course of our discussions, some of the research leaders (they call themselves “investigators”) explained that they honestly did not see how lean thinking could possibly apply to their world.

After some time to tour and go the gemba to see everyone’s work (in the operations and in the research areas), I recalled this simple grid that I picked up from another visit to another organization more than a year ago.  This organization had a model for innovation and they were also doing work that might be considered the lean work (continuous improvement).  What they told me was that they do both - make things better and better - lean thinking (horizontal axis), and try to make things different - innovation (vertical axis).  They also told me that it helps to be ambidextrous in order to do both well.  This approach made sense and I have made a note to go visit them again.

So, I thought this was similar to the question that the researchers were asking at our new HVN member organization.  I modified this grid below.

Here’s the way I’m thinking about it.  The researchers are trying to build new knowledge.  They described their process for having lab meetings where they review the work, update their thinking, review their hypotheses, reform their plan and go back and try new things.  That sounds like the PDSA cycle to me.  Dr. Deming described the cycle (he called it the Shewhart cycle, named after Dr. Walter Shewhart) as a cycle for improvement, but also a cycle for learning.  The researchers have been doing this kind of work a long time and they have gotten really good at it.

The staff in the operations side of the business have started to learn and apply lean thinking.  I saw some terrific examples of this.  They identify the problem they are trying to solve, come up with ideas for making their processes work better, they gather data and study the results.  Based on what they see, they revisit their thinking (their hypothesis about how the process works and how it could work better, then they adjust their plan.  This is also the application of the PDSA cycle.

So, my advice to the company is to think about how the two arms of the company (research and operations) could collaborate and learn from each other.  Operations could see how research uses the PDSA cycle to build knowledge and they could get better and better at understanding how their systems work - not just making them work better.  I hear organizations say they want to be a “learning organization” - I think this is what they need to do.  The researchers could also learn from operations to see how their research processes and support processes could be improved.  For instance - how to do some things more efficiently and effective in order to make the best use of their grant dollars.  They could work to improve the grant-writing process, to increase the likelihood of receiving grant money.

The intent would not be to tamper with the creativity, curiosity and inventiveness of the researchers.  That would be like asking Picasso to follow a rote method for making a painting - like painting by numbers.  The intent (I think) would be how to unleash the creativity of everyone in the organization in order to add value to their ultimate customer.

I’m very interested to visit this organization down the road to see what they have done.