Brick and Mortar Business Owners

I was eager to see the oft-reported sloppy assembly work, the poor-fitting doors, blotchy paint, and other manifestations of Tesla CEO Elon Musk's “production hell In fact, the Detroit Three, until about 15 years ago, routinely delivered cars and trucks with appalling gaps, often as wide as 8mm on one side, 2mm on the other. I don't think we'll hear healthcare success stories long the lines of, “I asked the hospital system CEO how they reduced patient harm by 90%: ‘I got all of the hospital directors in a room and told them they had six weeks to achieve consistent patient safety or they'd all be fired. I'm not sure that's the best approach, shaming healthcare leaders for patient safety problems, but here's what happened:

I'm going from memory, but I think this next section was about him and his attempt at uniform innovation in the late 19th century… look at the screenshots with closed captions that tell the story of Plan, Do, Study, and Adjust… One of the key principles, going back to Dr. Deming, is that we mitigate risk when attempt to make an improvement by doing a SMALL test of change. Modern-day Major League Baseball sometimes isn't great at problem solving, but they do generally test changes at the minor league level where they are, relatively, small tests of change. Other small tests of change include starting extra innings with a runner on second base as a way to shorten the length of games.

Speaking of the topic of “Process Behavior Charts” and metrics, I'm running a sale through the end of June where you can buy signed copies of my book for $24 including U.S. shipping. Dr. Low made a strong case for the use of control charts (Process Behavior Charts) as a way to better evaluate whether changes are really improvements. Maggie wrote three excellent blog posts that summarized a keynote talk by Dr. John Toussaint and two breakout sessions from Cleveland Clinic. Real-Time Lessons Learned from John Toussaint at the Lean Healthcare Transformation Summit Check out her posts, as she did a great job with those.

By ‘red, amber, green', we are referring to graphical data displays that use colour coding of individual data values based on whether this value is on the right (green) or wrong (red) side of a target value. The authors show, through an example, two different ways of visualizing data that beg leaders to react to the “red” data points that are worse than the target of 10. It looks like this: The authors correctly point out that all of those data points are below the “upper limit” so every data point is produced by the same system that has randomness or variation in its output. It is no more complicated to tell special from common cause variation than it is to tell red from amber and green.

This is an interesting article: I had a chance to visit the ‘Takaoka #1″ line in February 2018 as part of my tour with Kaizen Institute. The article does make an interesting comparison between the old Takaoka #1 line and the new Takaoka #2. The factory, of course, epitomizes the “kaizen” philosophy: “Like all Toyota factories, Takaoka II is built on the on-going “kaizen” improvements developed by its workers who want to make their work go faster, smoother, smarter. The hooks were something that I blogged about in 2014 when our guide at the Tsutsumi plant said it was her idea to put up those hooks… did the idea spread to other plants?

But, if we draw a run chart or a “Process Behavior Chart” that shows more data and more context, we might learn that the natural behavior of that metric is that it routinely goes up and down by 15%, 20%, or 25% in a typical month. In a shorter clip from the scene, the deputy chief engineer, Dyatlov, is told that the radiation reading is: “3.6 roentgen, but that's as high as the meter…” The number on the dosimeter WAS 3.6… but Dyatlov doesn't share the context of “that's as high as the meter will go. The video and the Chernobyl story show that “data-driven decisions” can be terrible if the data is faulty or if context is missing.

The mixtape contains news, blogs, articles, resources, and links about creating value, continuous improvement, innovation, and leadership in healthcare and industry – compiled and shared by Ryan McCormack The consulting firm that received most of the money, John Black and Associates, blamed the media and racism for some of the failures, and once said to himself after a meeting with healthcare executives, “If you're not dead (in 20 years), you're going to be in one of your health-care systems here in bed, with a tube up your ass and one down your throat. This is evidence of the common confusion between making things visual (information sharing) and visual management (driving behaviour). This excellent article from MIT Sloan Review discussed the challenges of building digital-ready culture in traditional companies and the need to discover what practices are helpful to preserve and which need to be prepared for transformation.

In the name of improving patient flow and outcomes for heart attack patients, they asked, “Why not have the EKG done in the ambulance? They also asked, “Why not send some patients directly to the cath lab if the EKG results indicate that? The centralized unit creates scheduling complexity – an increase in emergency patients or a delay in outpatient cases might hamper flow of patients from the cardiology unit. They asked, “Why not create a mattress cover that could be designed in a way that allowed it to be changed without moving the baby completely off of that super-heavy special mattress?

They are a great way to learn and practice methods related to “Process Behavior Charts. And, I'm accessible to give additional coaching and feedback when you get back to your workplace… that's included in the workshop price. In other cities, I generally partner up with a local host / coordinator, so let me know if you're interested in learning more about that. Please click here to learn more about the workshops and you can fill out a short survey below, if you like: Please post a comment and join the discussion.

I was invited to be a guest on a Detroit radio talk show that's hosted by Dr. Paul Reeves, a show called “Dr. Paul's Family Talk. That's the type of thing that helps create a culture of continuous improvement that leads to success for an organization, whether that's an auto maker or a hospital or a software company. There's a difference between an organization that's already doing really well and wants to keep improving versus an organization that's on the verge of going out of business. That's probably the most satisfying part of the whole publishing process, is when people find the book to be not just a good read, but something that's useful.