Luy and Ethel discover gemba

Lean training for our senior executive group continued apace this week. As always, a segment was a return to gemba, the place where work happens and value is created for the customer. Here, SVP for Health Care Quality Ken Sands visits with radiology staff members Michael Hogan and Caitlin Buchsteiner to learn about what visual signals exist in the workplace that give a sense of the status of the pace of diagnostic radiology exams. One part of the Lean theory is that it should be easy for staff members to get at-a-glance information on the status of a given work flow or process.

The classic example of a system in which the workers are disconnected from the upstream aspects of production system is found in this episode from the I Love Lucy show. How many examples of this can be found in your hospital? We find them all over. As always, this is not a case of ill-intentioned people working in a bad environment: Rather it is the all-to-common case of really good people working in an environment that has not been designed to reduce waste. The result is work-arounds, wasted effort, errors, and staff who go home more tired each day than they really need to.

Simply stated, the goal of Lean is to train people to see these examples and also to have the team learn how to address them in a comprehensive and thoughtful way. The idea is not to solve for the complete perfect solution all at once, but to be "very good at getting better."