"Share the Gain" for Sustaining the Improvement Culture

Spreading Learnings and Coaching Through "Share the Gain"

To showcase the numerous improvements performed by the empowered workers, and to allow them to understand their importance in the organization, it is important to design a reinforcing and sustaining venue for workers to share process improvement lessons with their peers.  

We hold monthly “Share the Gain” meetings as catalysts to set the pace of change that in 2009 after 4 years of Lean cultural transformation resulted in 536 documented process improvements accomplished. By not setting numeric goals, a 110% "improvement on improvement" was seen the following year resulting in an even more astonishing 1,128 process improvements performed in 2010 in the laboratories of Henry Ford Hospital alone. This "Share the Gain" public presentation with reinforcement of method and principle is a continual learning mechanism that has greatly assisted in establishing a change in the culture of work and worker involvement in that change.  

In year 2010, after 5 years of cultural transformation, more than half the "Share the Gain" presentations from Henry Ford Hospital laboratories were given by the workers themselves with the remainder contributed by the team leaders and managers. Two additional community hospital laboratories and an additional 29 outpatient clinic laboratories undertook the cultural Lean management transformation in 2010 resulting in 1392 total process improvements that year. The same pace of process improvements continues in 2011, with 900 accomplished by the 3rd quarter, signifying a stable culture of continuous improvements generated by an empowered workforce of 780 laboratory employees across the Laboratory Service Line.

We have set the pace for change by setting the expectation of one process improvement presented per month per team. These need not be completed improvements but can include progress updates of interventions in-process or even process improvement attempts that failed. These one-hour, monthly meetings showcase 8-10 workstation team presentations. We encourage attendees to participate in question and answer sessions to reinforce the work principles, rules and tools applied. Presenters are ‘shop floor’ workers who are given individual artistic freedom in presentation.  This forum allows the workers to not only share their improvements but to receive praise from their peers and become recognized and rewarded by leadership who attend each meeting. 

In this era of dwindling ability for leaders to provide economic incentives, it should be noted that employees are greatly appreciative of this form of recognition of their ability to contribute to the group's success. As a leader, through this reinforcing mechanism, you are also developing your next generation of leadership and solidifying your new culture.  

A successful Lean culture is predicated on Deming's management style and the value placed on the worker. Through this cultural change mirroring Deming's principles, reinforcing and sustaining structures can effect continuous quality improvements leveraged at all levels by the empowered workforce. The "Share the Gain" process lives out Deming's principle #14, for management to push and sustain this method of work to insure that the pace of improvement is rapid and the processes of work are ever-evolving and optimizing toward a more perfect state.

The White Board in Identifying Opportunities for Change

"Even a mistake may turn out to be the one thing necessary to a worthwhile achievement."

-Henry Ford

The primary role of team members is to reveal in real-time, to each other, and to their managers what is not working as expected, that is, to identify in-process defects and waste.

To this end, we place white boards in the workplace so that defects can be made visible by the workers themselves, in a blameless fashion. A white board is a work communication tool for the worker and manager so that “no problem doesn't become a problem.”

Why write it down publicly?  Simply, to collect factual information about less than optimal work and because lack of effective communication begets poor quality. Should you walk into a workplace and see white boards, describing defects encountered, you will understand this tool to be a visual reminder that in a true Lean culture employees are empowered to work differently, invested in and accountable for the quality of the work they receive or produce.

White boards are a simple tool to help the individual worker and the team communicate within and between work stations, connect work stations horizontally across the path of work flow (or value stream) and make the workplace visual for both those doing the work and those managing the reliability, consistency and stability of the work. White boards are only fully functional as visual workplace tools when leaders have created the enlightened culture that encourages blameless identification of mistakes, provides an organizational structure and reporting relationships that incentivize empowered workers to contribute to daily defect resolution. This is the essence of Lean- a continual improvement loop with a 'shop floor' focus by employees who know the nature of their work best.

The elements that may be captured on white boards to clarify the defects that arise in your workstation and facilitate your team's subsequent resolution are the following:

•                Date

•                Problem

•                Who identified

•                Action- short term (our rapid fixes)

•                Action- long term (our A3 based improvements)

•                Responder/Comments

•                Estimate % complete  (visual using a circle with quadrants filled in)

See if this Issues List described above from a White Board adapted from the manufacturing world helps you think about how to best to use your own white boards.

Standardized White Board

Although we have been using white boards for some years now, we have only recently standardized our own approach in the laboratories.  Below is our current iteration of a white board. The header is meant to inform and educate the workforce. It contains regularly used references to the defect resolution process of the Henry Ford Production System:

• The 7 Types of Waste
• The 5 Why's of Root Cause Analysis using an Ishikawa Fishbone diagram of common causes
• The 4 Rules of Work from the Toyota Production System that are often in violation when a defect is encountered
• The process improvement procedure methodology of the Henry Ford Production System
• The leader's quality messages, here, the Wednesday's Words of Quality that I write weekly

The board is segmented to capture detail about:

• Daily defects encountered
• The defects immediately resolved on the spot or those queued for further development as an A3 based process improvement that often requires a 'Go and See' or a customer-supplier meeting
• Communications for and between shifts and ongoing quality education topics and learnings

So, should you as the manager on a "gemba walk" through the workplace see a blank white board, you now have a visual of either a perfect workday (doubtful) or a workforce disengaged from their responsibility of contributing to continuous improvement. The simple white board functions for all levels of work engagement. 
 
References:

Ford H. Today and Tomorrow. New York, NY: Doubleday; 1926

Ohno T. Toyota Production System: Beyond Large-Scale Production. Portland, OR: Productivity Press; 1988

Rother M. Toyota Kata. Managing People for Improvement, Adaptiveness and Superior Results. New York: McGraw-Hill, 2010.

Spear SJ, Bowen HK. Decoding the DNA of the Toyota Production System. Harvard Bus Rev. September 1, 1999:96-106.

Go and See

Go and See

The Deming approach to quality and the PDCA cycle attributed to him were appreciated by the Japanese in the early 1950s as a "way of thinking and managing rather than simply as techniques."

In this strategic basis for improvement (the Improvement Kata described by Mike Rother), "Toyota later added the words "Go and See" to the middle of the PDCA wheel."

This act of 'going and seeing' is critical to observe actual conditions for yourself and not to fall into the manager’s trap of jumping to conclusions. This must be the beginning of understanding a situation before suggestions for change can be made effectively.

The 4 key points of the Improvement Kata, founded in PDCA, deal with scientific experimentation, discovery and learning. This is how the culture changes for people from one of hiding and blame to one of openness and learning.  At its core, this approach to problem solving relies on development of people with insight and process repair closest to the level of the actual work. The 4 points of this problem solving routine defined by Rother are:


1. "Adaptive and evolutionary systems by their very nature involve experimentation." 


There is no one right answer, no one fix to a problem, just many tweaks on the way to a target condition whose path is largely unknown. Just try something. Let the data tell you if it is with accepting as a change in process. Given the right leadership and organizational structure, the workplace is your experimental playground to figure out how to do the work better. In the Henry Ford Production System, this is the basis of your empowerment.


2.  "Hypotheses can only be tested by experiment, not by intellectual discussion, opinion, or human judgement." 


Don't talk, test! What you believe or think is less important than what you try, usually on a small scale.


3. "In order for an experiment to be scientific it must be possible that the hypothesis will be refuted." 


Never assume that the change implemented will work as intended and should be accepted as originally designed. That assumption will stop improvement and adaptation in its tracks. The fluid nature of continuous improvement is an adjustment for most who adopt this approach to work and problem solving.


4. "When a hypothesis is refuted this is in particular when we can gain new insight and further develop our capability."

Dr. Rother elaborates further on these concepts:

"We learn from failures because they reveal boundaries in our current capability and horizons in our minds. This is why Toyota states that 'problems are jewels.' They show us the way forward to a target condition. You need to miss the target periodically (again, preferably on a small scale that does not affect the customer) in order to see the appropriate next step. 

...This is a fascinating point when you consider how much we as leaders, managers, and executives try to make it look like everything is going right as planned. The main reason for conducting an experiment is not to test if something will work, but to learn what will not work as expected, and thus what we need to do to keep moving forward."

"No Problem" = A Problem

Rother also observes that "If there is no problem, or it is made to seem that way, then our company would, in a sense, be standing still... The idea is to not stigmatize failures, but to learn from them."

"We hear about Toyota's success, but not about its thousands of small failures that occur daily, which provide a basis for that success. Toyota makes hay of problems every day, where we tend to hide little problems until they grow into big and complex problems that are then difficult to dissect. Toyota has mastered the art of recognizing problems as they occur, analyzing their nature, and using what it learns to adapt and keep moving toward its target condition."

To some, the writings of Mike Rother quoted above may be just an academic construct that cannot be realized. However, the philosophy and reality of this manner of working is supported by what we have accomplished in the laboratories of the Henry Ford Health System through the management structures and culture of an empowered workforce we have created and the principles, rules and tools we have adapted from manufacturing to our own healthcare environment. Our own Henry Ford said it better yet-

“There are no big problems, just a lot of little ones.”    -Henry Ford

This is a different way of thinking. Find the little problems proactively at the level of the work and empower the workforce to resolve them, continually.


But do encourage those you have empowered to "Go and See".  This is an important early step of problem solving in order to move from assumption or accusation to an understanding of root cause. 

References

Rother M. Toyota Kata. Managing People for Improvement, Adaptiveness and Superior Results. New York: McGraw-Hill, 2010.