“gemba walk” (lean thinking term) to go to the actual place where value is added + “walkabout” (Australian aborigine) a short period of wandering bush life engaged as an occasional interruption of regular work
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Jim Womack (opening comments)
- Now it’s time to try some hard things.
- We need to fix what is inside and outside of the black box.
- Let us not be overly-heroic.
John Toussaint (Keynote)
- Are we solving for the right problem?
- The rate of increase in healthcare expenditures is exponential.
- We can’t have a lot of confidence in Uncle Sam’s track record.
- Employers are using the data from Wisconsin hospitals, but patients are not.
- Lean work starts with Hoshin Kanri. Senior leaders need to do this work.
- Need to move away from “white coat” leadership (clinicians and executives).
- The purpose of the HCVLN is to help people learn faster.
Group Health Cooperative (Keynote)
- We had a start at healthcare reform, but we don’t have the process view.
- 2-32% of our patients are being harmed by the healthcare system.
- We need to move away from “management by objectives”.
- In 2009, the CEO declared, “we’re all in”. We are betting on the lean management system.
- We stopped budgeting at the department level, so much of it is waste. We lost our focus on the patient. The CFO realized this and led the effort.
- Our “true north” is “affordable excellence”. We previously saw these two goals as incompatible.
- Our board room is empty. We’ve (management) moved to the visual management room and to the gemba. We’re getting managers out of their offices 80% of the time. We invite our bosses into the work (gemba) regularly.
- We are inviting people to create their own work.
Dean Grunner (Keynote)
- Many people have purchased flat-screen TVS in recent years. Why? Quality has gone up, cost has gone down. There has been an increase in “value”. What can we say about healthcare in the last 10 years? Value has gone down.
- The golden goose has reached menopause.
- What are our choices? A) spend more, B) accept less, C) change the system.
- Lean is about a) leadership skills and b) lean skills.
- It’s important to have candor with respect.
- People come before Stewardship.
- We started to believe we could expand the triangle. We try to expand the triangle every time.
- Prefer to see the model as a fly-wheel, not as the 2 pillars (respect for people and continuous improvement. Flywheel starts with “respect for people”, which leads to “candor with respect”, which leads to “continuous improvement”, which leads to excitement about progress (joy from achievement), which goes back to “respect for people”.
- Three leadership challenges: a) candor with respect, b) collaboration, c) interdependence.
- Are people really your most valuable asset? What is the pace we can manage?
Jim Womack (Closing Comments)
- Are the last 2 days value or waste?
- People don’t care that you’ve been at a conference for 2 days. The only thing that counts is positive change.
- We now have “proof of concept”. Are we going to do this? How are we going to do it?
