The internet is full of blog posts with productivity tips and advice about how to work smarter, not harder. There’s a lot of useful information about the best way to work, but we think it is important to keep in mind that the foundation for all of it is something called standard work. 

We've written about standard work in the past, but it is a subject that is often overlooked or misunderstood in the continuous improvement efforts of many organizations, so it's definitely worth spending some time on. If you’re in the process of implementing Lean, Kaizen, Six Sigma, or just trying to become more efficient at work, we strongly recommend making standard work a part of your process.

Dr. W. Edwards Deming is considered by many to be the father of modern quality improvement. Among other important insights into how businesses could become more efficient, reduce costs, and increase customer value, he popularized the PDSA quality improvement method. It is a four-step cycle used to achieve continuous improvement, consistent results, and resource maximization in processes and products.

The PDSA cycle of quality improvement, sometimes called the “Deming Cycle,” is based on the scientific method, which approaches problems through hypothesis (plan), experimentation (do), and evaluation (study). In business, the output of a successful PDSA cycle is a new standard work that institutionalizes the improvement. Once complete, the cycle begins again, and further progress can be achieved as processes move ever closer to perfection. 

We spend a lot of time and effort on this blog digging into the details of how to start, spread, and sustain a Lean culture. We think it is important to get very specific about the Lean tools and techniques that produce measurable results for healthcare organizations. So of course, we care a lot about technology solutions that bring it all together. However, sometimes it is a good idea to pull back and move away from the details. Once in a while, it pays to get the 30,000-foot view and remember why we are doing this at all.

What drives the Lean approach in healthcare and what fundamental values should drive each tactical decision?

These six principles of Lean healthcare arrived at by John Toussaint, MD, CEO emeritus of ThedaCare and CEO of the ThedaCare Center for Healthcare Value in Appleton, Wis., and Leonard L. Berry, distinguished professor of marketing at the Mays Business School of Texas A&M University, published in Mayo Clinic Proceedings are an excellent place to start.

DMAIC (Define, Measure, Analyze, Improve, Control) is a data-driven, structured, customer-centric problem-solving methodology. Each phase builds on the last to arrive at practical solutions for challenging problems. Define tells you what to measure. Measure tells you what to analyze. Analyze tells you what to improve. And Improve tells you what to control.

Each phase has particular objectives and is supported by a specific set of activities. Let's take a closer look at them.

Ecologists and other environmentally aware people often talk about a goal of "Zero Waste." We think that's an outstanding goal for business as well.

Eliminating waste is at the heart of the Lean business methodology. The purpose of Lean is to spend more of your time creating value for customers by reducing or eliminating everything that does not produce value (AKA the waste). To make it easier to find and eliminate waste in business processes, Lean practitioners identified the "7 Wastes of Lean." Some include an 8th waste, the waste of human potential.

Although the Lean approach originated in manufacturing, it is used in almost every sector. Strikingly the seven wastes are common across industries, including software development, construction, and education.

While some of the wastes are self-explanatory, others are more difficult to recognize. This post aims to help by giving a few examples of each type of waste in various businesses. Hopefully, they will help you think about how waste may be occurring in your processes. Of course, the people who are most likely to find and correct waste are the process operators, so it is a good idea to share these examples with them and provide a way for each employee to submit opportunities for improvement.

Hoshin Kanri, sometimes called "strategy deployment", is an approach that helps companies achieve breakthrough goals over a three to five-year time horizon.

The methodology is effective because it allows leaders to keep their eye on the long-term objectives that will change the game, without losing sight of the day-to-day improvements that can add up to significant benefits.

However, we won’t lie. Effective strategy deployment isn’t easy.

Too often, the strategic plan gets lip service but little else. If you are looking for help making sure that your organization arrives at “True North,” an X-Matrix might help.

Donald J. Wheeler, PhD is a world-renowned expert in continuous improvement. He's worked with W. Edwards Deming and wrote the classic book Understanding Variation. 

Wheeler once wrote and said, "Statistical Process Control is, at its heart, about getting the most from your processes. It is about the continual improvement of processes and outcomes. And it is, first and foremost, a way of thinking... with some tools attached." 

I’d like to thank him for providing the perfect quote for a blog about process control charts because measurement, control, and improvement are exactly what they are designed to enable.

On January 15, 1919, in the North End neighborhood of Boston, Massachusetts, a large storage tank owned by the Purity Brewing Company filed with 2.3 million gallons of molasses weighing approximately 12,000 tons burst. As a result, a wave of molasses rushed through the streets at an estimated 35 miles per hour, killing 21 people and injuring another 150. 

Like many other tragic disasters, this one was entirely preventable. As is often the case, no single decision of factor alone was responsible for the catastrophe that left Boston smelling like molasses on hot summer days for decades. 

A look at the circumstances leading up to the flood reveals that leaders at Purity Brewing Company made the same kinds of mistakes common in organizations today. 

The process you use to develop your strategic plan is as important as the plan itself. That’s why many organizations turn to the Hoshin Kanri approach, which focuses on creating a plan that takes into account both the daily management of the organization and the tactics necessary to reach those goals that will have the most significant impact. The result is a set of specific action plans and resources necessary to achieve your business breakthrough.

Although some organizations tweak the approach to meet their specific needs, most often the Hoshin Kanri planning process consists of the following seven steps.

I received an interesting call a few weeks back from Bahnsen Miller, MD. Bahnsen is an assistant professor of medicine at the University of Virginia Health System. He attended LSU School of Medicine and completed his residency training there. After residency training, he completed a quality improvement and patient safety fellowship at Our Lady of the Lake Regional Medical Center in Baton Rouge—this is where he learned about KaiNexus. Since then, Bahnsen has been working with residents and students on various quality improvement and patient safety initiatives.

He asked me if I had ever thought of using KaiNexus to help train physicians during their medical school and/or residency periods. It brought back a flood of memories from how my “improvement story” began.