Daily Kaizen

Like most organizations early on in it’s Lean transformation there are a lot of mid-managers and senior leaders in my organization that are not used to spending time in the gemba.  The traditional management system of the organization, like most organizations did not incentivize leaders to spend time in the workplace.  If fact, most management processes required the gemba to come to leaders in the form of report outs and status reports.  If you wanted to climb the career ladder it was very important that you got a job at the corporate headquarters far from where our members are served.   In most years executives probably only went to the gemba a handful of times and when they did they probably as uncomfortable as the teams they visited. 

As we have progressed on our Lean journey this has begun to change.  More and more leaders are spending time in the workplace.  While some leaders would probably rather stay at corporate I believe for most this change is really positive.  Most people that went into healthcare did so in order to help members and patients.  Something that the further you are away the harder it is to do. 

Yet, the transition to spending more time in the gemba is a difficult one for most leaders and is often short lived.  They are not used to working directly with front line teams.  They often don’t know the work nor do they know what to do once they get to the gemba.  Additionally, teams are not use to having their leader come to the gemba and for the first couple of visits there is often an awkward and uncomfortableness.   Often I think the leaders show up, they begin to ask questions, someone on the teams is brave enough to share a problem and the leader not knowing what to do immediately jumps into problem solving mode.   After a couple of rounds the leader has had enough and the gemba visits no longer appear on their calendar.  Sound familiar? 

Here are a couple of tips that I have provided to leaders I am working with that are spending more time in the gemba:

• Experience is very important for both the leader and the teams.  The first couple of times will be awkward for both.  Over time the leaders will get more comfortable and so will the team. 
• Always go to the gemba with a purpose.  Are they going to check on the progress of a critical improvement?  Are they checking standard work? Are they checking on quality, cost or delivery metrics?  It is very important that leaders are going to gemba to check on an aspect of the teams work.  Otherwise the visit risks either being perceived as micro-management or PR.
• Visual systems really help, especially early on.  They provide information and easy content for coaching opportunities.
• Never own the problems of the team.  Leaders are used to getting handed problems for them to solve.  I have seen countless leaders take problems away from teams even when they were the teams problems to solve.  The purpose of the walks is to check the work and coach the adjustment.  Not to take the responsibility away from the team.
• At first, bring the hierarchy with you.  In other words, if a senior leaders is going to the front line the mid-managers should go as well.  Mid-managers struggle the most during a Lean transformation and its only further complicated when their boss is coaching their teams.  This challenge will go away over time. 
• Be organized.  The team should know you are coming and the purpose of the walk.   Be careful not to overwhelm the team.  Watch your tone and your energy.  Take good notes and listen.  Always leave the team with one or two questions and/or next steps that would would like them to work on.  When you return to your office summarize your notes and send them out with a thank you message as well as reinforcing the questions/next steps you would like them to pursue.
• Always start where you left off.  Develop a knowledge management system so that you track your notes and requests from each visit.  Teams will be blown away when a senior leader shows up and remembers everything from the last visit and asks them how they are progressing on answering the questions that they left during the prior visit. 
• Finally, ask for feedback.  Ask the teams.  Ask a peer or a Lean consultant to come along and provide coaching.  

Anyone else have some suggestions?

PS–For those of you interested in learning more about the work that we are doing with our Medical Home Model in Primary Care you can find an interesting article at the following link:  http://seattletimes.nwsource.com/html/pacificnw/2008628080_pacificprimary18.html

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