Tag: Government

Sharp Minds – On the Cutting Edge or the Cutting Board?

A wooden chopping board with a chef's knife.
Image via Wikipedia

I continue to be frustrated by the notion that the only way to reduce spending is by cutting services.  While the demand for change is high, few are willing to challenge tradition and conventional thinking to improve services and increase efficiencies that will enable us to do more with less, find new opportunities, and to create jobs instead of eliminating them.

On a global level, governments continue to grapple with increasing economic pressures brought on by the recession. Rather than demonstrating fiscal restraint however, governments have grown and spending has increased at rates that far exceed that of the public sector. The result is an unsustainable government and services that will either be cut or funded through newly created revenue streams.

Rather than challenging the infrastructure and systems that comprise the delivery of these services, the governments scramble to find new ways to reach further into our pockets to pay for inefficiencies, high paid union labour, and questionable entitlements.  In some instances, services have been abandoned only to be properly managed by the private sector.

For example, when we consider the delivery of health care in Canada, we find a system plagued by excessive wait times and ever rising costs.  Doctors and specialists continue to operate as a fragmented community of service providers, adding layers of bureaucracy, greater inefficiencies, and more cost.

These inefficiencies are further evidenced by patients who are sent into a frenzied schedule of appointments and tests in various locations without regard for the many inconveniences and disruptions they may incur in their personal lives.

On the other hand, emergency rooms do not present the same constraints and, though some waiting may be required, patients are examined and assessed immediately, a prognosis is determined, priorities are established, and resources are made available on demand as required.

Expedience does not jeopardize the level of care provided.  While the emergency room may not present the ideal case, it is radically different from “standard” care.

In stark contrast to the government-political processes that continue to insult our intelligence, I am always encouraged by the innovative and entrepreneurial spirit of individuals who prove that there is always a better way and more than one solution:

Where do we start?

The quicker we realize that truly radical changes are necessary, the sooner we can abandon traditional cost cutting practices and apply Lean Thinking to improve society as we know it, not cut it to shreds.  My simplified definition of Lean Thinking follows:

Lean is the pursuit of perfection and pure value through the relentless elimination of waste.

As every lean practitioner will tell you, the process begins by defining value.  Unfortunately, many governments and companies alike start by falsely assuming that they are already providing the value that customers want or need.  As such, they attempt to improve existing products or services by either adding features or making them faster and cheaper. From the perspective of Lean Thinking, the “secret” to making real change begins by finding:

“… a mechanism for rethinking the value of their core products to their customers.”

In this same context, consider how our desire to “travel from Point A to Point B in the shortest time” has evolved and transformed our personal modes of transportation / communication into the following “value” propositions:

  • Personal:  Crawl > Walk > Run > Tricycle > Bicycle
  • Roadways:  Bicycle, Motorcycles, Cars, Buses
  • Railways:  Passenger and Freight Trains
  • Seaways:  Boats, Ships
  • Airways:  Helicopters, Planes, Jets, Rockets
  • Telephone:  Phones, Faxes, Internet (email, social media)

Each mode of transportation presents a unique solution to address a shared common value:  “Short Travel Time”.  Although changing technologies is inferred, lean does not require an investment in new technologies to be successful.  To the contrary, Lean Thinking simply challenges us to consider the value our customers are demanding.  Accordingly, we must ensure that our infrastructure, business practices, and methodologies deliver that value in the most efficient and effective manner possible.

Only when we focus on “value” from a customer perspective can we offer a solution that truly meets the customer’s needs.  When we consider the premise for this example, the need to travel is implied.  It does not answer the question “Why do we travel?

If the reason for traveling is simply to “communicate” with friends and family, then we can see that the telephone becomes a viable solution to eliminate the need to travel at all.  From a similar perspective, fax machines and the internet were created to expedite data transfers and to communicate with the world in real-time.

The Challenge is On

It is time for all levels of government, business, unions, and society as a whole to acknowledge that our economy is in a state of crisis and demands real action. Real people are hurting at a time when others are pursuing their own agendas for self-preservation – all at the expense of society.  We can not simply assume that everything is “just fine – only more expensive”.

Lean Thinking is a requisite mandate for any company wanting to compete in today’s global market.  In this regard, the same challenges exist for governments and businesses alike to adopt lean thinking to deliver real value to the people they serve at prices we can all afford.

The Globe And Mail featured an article titled “ What Ottawa can do to help manufacturers excel globally – Globe And Mail” href=”http://www.theglobeandmail.com/report-on-business/economy/manufacturing/what-ottawa-can-do-to-help-manufacturers-excel-globally/article2060854/” target=”_blank”>What Ottawa can do to help manufacturers excel globally” that cites feedback for improvements from manufacturers and businesses in various industries. Unemployment in the United States is hovering at 9% and, as this video “Focus On Jobs or Spending Cuts” demonstrates, the challenge to deliver new jobs is also in jeopardy.

Unless government spending is brought under control and services are delivered effectively and efficiently, the system is sure to implode.  It’s time for an extreme make over, engaging the best and sharpest minds to bring us to the cutting edge in business and technology, not to the cutting board where nothing remains but shattered hopes and dreams.

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Until Next Time – STAY lean!

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Hanging from a thread – Lean Healthcare

A light blue ribbon is the symbol for prostate...
Image via Wikipedia

Background

It seems that Lean Healthcare is getting a lot of exposure here as of late.  I will qualify this by saying “in practice” rather than “name”.  The Toronto Star published yet another article, Sunnybrook cuts wait for prostate diagnosis down to 72 hours, that once again demonstrates that improvements can be made if we put our minds to it.

The Need to Change

The need to change is premised on this excerpt from the article:

“But after the needle biopsy . . . it was like my future was hanging from a thread. It was hell.”

And later …

“Men have waited too long,” says Dr. Robert Nam, a Sunnybrook uro-oncologist who is spearheading the accelerated prostate protocol.

“They wait two to three weeks. And two to three weeks knowing that they could have a live-altering disease is something to me that is not acceptable.”

Why – Beyond Reducing Wait Time

Aside from the emotional strain, hidden from view or otherwise, cancers are always best treated when they are detected early:

While many prostate cancers are slow-growing – some are left completely alone — others are aggressive and benefit from immediate treatment.

“There is a big misconception that prostate cancer is such a slow-growing disease that we don’t need to rush into anything,” Nam says.

How did they do it?

The goods news is that they already had a model to work from:

In a new program that mirrors one launched two years ago for rapid breast tumour diagnoses, Toronto’s Sunnybrook Health Sciences Centre has now pledged to give men the results of prostate cancer biopsies within three days.

They also procured new equipment and found efficiencies in the way that results were processed:

The diagnostic acceleration will be accomplished mainly by “finding efficiencies” among hospital pathologists who examine the biopsied tissues and determine the presence and severity of the ailment. Nam says any priority shift in the hospital’s pathology department – which expects no staff increase — will not mean other forms of cancer get shorter shrift.

Room to Improve

As mentioned earlier, Sunnybrook had a surrogate model to follow but there is still room to improve:

Men will still have to wait three times longer for their results than women, who are promised a breast cancer diagnosis within a day of being biopsied.

It’s NOT about the money!

I share this information on the premise that we are continually reminded, at least here in Ontario, that we simply don’t have the resources or the funds to improve health care.  I become increasingly frustrated by the misconception of our government that we are already as efficient as we possibly can be.

“We made it cost neutral and . . . we did not jeopardize any other program within the pathology department,” he says.

I am thankful that Sunnybrook Hospital staff have demonstrated yet again that real opportunities for improvement can be made without incurring additional expense to the system.

It’s the Culture

The significance of the effort here is not just the idea itself but the culture that allows these ideas to flourish.  Sunnybrook Hospital clearly supports improvements from within and outside the hospital and is also quite eager to share them as evidenced in our previous post, Lean – Sunnybrook Doctors Benefit from Gaming Technology.

I am currently reading “Toyota Under Fire” by Jeffrey K. Liker and Timothy N. Ogden where once again it is confirmed that Toyota’s culture is at the very core of it’s resilience and ability to adapt and change to meet the current crisis at hand. Clearly, the economic crisis we still find ourselves having to contend with is cause to pause and reflect on how we can indeed adapt and change to meet our every day challenges in our personal lives, business, industry, and governments alike.

There is much to be learned and so much more to be gained.  We must learn to watch and listen and at the very least acknowledge that there is always a better way.

Until Next Time – STAY lean!

Vergence Analytics
Twitter:  @Versalytics