Toyota collaborated with four children's hospitals to reduce a certain type of blood infection by 75%. They used production principles.

Toyota collaborated with four children's hospitals to reduce a certain type of blood infection by...

LEAN manufacturing principles can resolve a lot of systemic mistakes and eliminate a significant amount of waste in medical and public systems.

In some aspects I agree. However, my local hospital had to use LEAN principles, and they ended up doing stupid micromanagement things like timing how long it took people to go to the printer, things that mostly just decreased morale, from literally every person I've talked to.

If done correctly timing things, called a waste walk, can be very beneficial. As an example, if it's found that it takes a certain number of seconds to print something and then an additional number to walk to the printer, wait for the print, walk back to your desk, etc etc then the end result could go a few directions. Maybe the bigger issue is the speed of the printer and a replacement is ordered. Maybe there's more waste in the walk so an additional printer is installed closer to the workstation. It's not about the timing, it's about identifying inefficiencies and making adjustment to make things more efficient which as an employee likely means less stress looking for things, waiting for things, etc.

I work at a hospital that has used Toyota's principles for years and now we're one of the top hospitals in the nation! Its amazing how car manufacturing principles can be applied to healthcare.

I work in IT, saying "employees can have a 'not quite accurate' view of the problem" is the most polite way I've heard this said ever haha

Employee testimonials like this are typically completely unreliable because a lot of the time, they have no idea what they're talking about. I couldn't even begin to tell you how many times I've had users call in and tell us "My computer isn't working, it won't do anything at all". If we took their word for that, we'd be ordering them a new computer because it's completely non-functional. But about 99.999% of the time, what they actually mean is they aren't connected to the wireless so they can't get to reddit, and they are annoyed by that.

See, I get that, but at the same time, if an employee is experiencing stress or annoyance over things like that, you should be able to talk to them and find out that the printer is slow, or whatever the problem is. The example with Toyota and the pad is an excellent one of how observation can be vital in figuring out better methods, but having every tiny aspect of your job scrutinized and timed is an easy way for people to hate coming to work. It's been the main source of stress for everyone I've talked to, and I know for my local hospital, it's been criticized because it's had questionable results, while costing a lot of taxpayer money

Edit: I should clarify I don't work in healthcare, but know several people who do, so all my knowledge is secondhand.

The problem with only talking to an employee (and not doing timings // getting real data) is that the employees can have a 'not quite accurate' view of the problem.

Hopefully the timings/data back up the complaints of the employee, but often they dont.

This is why I am a Toyota fanboy. Not only are their LMPs badass, but they do things like this where instead of "yeah sure have some money" they actually go, help out, and actually make a significant difference.

It's not specific to car manufacturing.

It's hope from workers that things CAN improve. It's knowing that your voice is heard when you see something that can be better. It's a culture of an observed life, where things are done deliberately and all input is scrutinized for the benefit of all. It's the assumption that employees want to do a good job and that they will want to excel in what they do, harboring and promoting that innate desire for people to do good work.

The idea that "it's just how things are" or "changes never help" or "tradition needs to be upheld" kills culture and growth. They are excuses for people without hope. How things are might not need to be how things should be. Changes can help as long as the effort required to implement provides gains in the long term, sometimes that's not the case and is a consideration in good LEAN implementation. Tradition is important, but not for tradition's sake. Tradition becomes tradition for a reason and those reasons should be what dictates practice.

Worked in a LEAN facility, the place was dirty but they were more focused on how long it took people to move stuff from one side of the warehouse to the other on inadequate equipment (seriously, huge boxes of furniture parts on these little plastic squares with wheels, like the ones we had in PE! Rather than proper dolleys or pallet jacks). Damn boxes constantly fell off and wasted time but they'd rather invest in more self-congratulatory seminars for upper management than proper equipment.

But I think a lot of the problem is that LEAN is often adopted by organizations that want to "feel good" but don't actually want to do good. Someone up top goes to a LEAN seminar and then expects the alcoholic floor manager half a world a way to adopt the principals who doesn't really give a fuck, uses it to torment the GLs and it ends up just making everyone more miserable.

That seems to be the way Toyota does charity; basically they do consulting pro bono rather than just throw money.

I think the point of a waste walk isn't to be able to say "it took you 63 seconds to print that. You do that 82 times per day. If you ran to the printer instead of walked, you could do it in 45 seconds. Just... work harder ok?"

It should be

What are you printing 82 times per day?




Why are you printing them? Who needs to read them?


The boss makes me.


Hey boss, why is he printing this?


Because that's the way it's always been done.


Do you read them all?




Are we legally required to print it?


Yes. We need have the records archived.


Why can't it stay in the computer system?


Because I don't trust computers.


Tough shit. You are wasting time and resources, sometimes the printout gets lost, etc. We have an existing digital records system. Use it.

It's not like it's a one-way information exchange, either. I bet the Toyota engineers learn from working with hospitals, it's probably an interesting break from the normal work routine, and it feels good to know you are part of a charity effort.

Lots of little things, all common sense, are neglected chronically by human beings every single day to the detriment to their life.

Those things sometimes occur in professional environments and are only solved when someone raises their hand and says "hey, this doesn't make sense".

As an undergrad, you can probably evaluate your own day-to-day and find many "common sense" things that you simply fail to do. The difference is that your decisions have a far more limited effect on others.

Supply Chain Engineer working in the auto industry here.

I use LEAN manufacturing principles in my personal life as well as professional/business settings. Most recently I implemented SMED concepts into my relationships. Change over time went from 3 days now down to 3 hours. My Overall operating costs were reduced dramatically. I look to eliminate all forms of waste in my life. Most recently I severed ties with several companions. Life has never been better!

As someone looking to start a career in IT, I'm glad I can connect to the Internet and Reddit and gain some knowledge. It really does go to show the "Is it plugged in/turned on" question actually needs to be asked. Otherwise, as you said, everyone would get a new computer right away. XD

Not to be rude but isn't this common sense?

As an undergrad I would've known when you put a sterile object down on a random surface it's no longer sterile. Especially surfaces in hospitals aka homes to some of the worst infectious microbes

If done correctly

This is the hard part.

In my experience what happens they rearrange everything and give you 3 jobs to do where before you only had 1. Then they're surprised when defects increase because all their line workers suddenly have their attention divided 3+ ways, so they try to engineer out the possibility of making mistakes as much as possible. The result is you're doing 3 separate tasks that are designed to be as mind-numbingly repetitive as possible, you never move more than 2 feet in any direction, and you're not permitted to deviate from the standard process at all. You can suggest improvements; the engineer assigned to evaluate the suggestion will immediately say it can't be done. Sorry, feel free to suggest something else. 3 months later your idea is suddenly implemented as standard practice, except it's not your idea anymore. It's the plant manager's.

As someone in IT, run

Good ole Lean Manufacturing principles strike again. :) Kaizen!!

towards the job in IT.

Also an IT dude, I think it's totally OK as far as work goes.

Our scheme was much the same. We (the floor staff) had, over the years, ironed out more or less all the free 'gains' from the process, and the stuff we were asking for would cost money or would involve high-up change to policy.

Our middle management (who didn't work on the floor) came in and royally pissed everyone off by physically moving the equipment around. We ended up having to move it back again on the first day just to get that day's work finished by close. Other than getting rid of a cage of junk from the storeroom (which we'd been asking to happen before) and hours spent in meetings, that was all that was achieved.

Oh, and the managers (circa £45K each) got to participate in a poster competition at the end. I mean, for fuck's sake.


LEAN practices like this are meant to look at why things are being done a certain way, and try to determine more efficient or correct ways to do the same thing.

It sounds like the original complaint is that the poster's company saw some concepts used in LEAN manufacturing and applied them incorrectly to try to "save time" around the office. LEAN isn't just reducing time to do an operation.

Your example is perfect. They start by looking at waste time, and discover the whole task is unnecessary and wasteful. By letting a computer automatically collect and file the hypothetical reports, it allows the hospital worker to use that time and energy for more value add tasks like patient care.

in your case, the hospital rolled out a great program in a bad way. They should have had some change management implemented at the same time.

I work for a funding/planning agency in health care, and LEAN can have exceptional benefits. However, unfortunately in health care some programs are rolled out poorly because the project lead does not understand how to roll it out successfully.

LEAN is just an idea and ideas are a dime a dozen. The implementation is what matters. That really sounds like you had a naive or tone deaf attempt to implement.

Executives do this thing where they go to a conference and hear about something, decide it's magic without understanding it, and then bring it back to their middle management to implement.

Those middle manager types often don't give a damn about whatever the boss is on about this week, so they half ass it or emphasize trivial bullshit. The net result is stupid implementations of otherwise worthwhile ideas. Name a concept in business and you'll see the same story get repeated everywhere. Idiots misuse tools, and ideas are only tools.


Kaizen (改善), is the Japanese word for "continual improvement ". In business, kaizen refers to activities that continuously improve all functions and involve all employees from the CEO to the assembly line workers. It also applies to processes, such as purchasing and logistics, that cross organizational boundaries into the supply chain. It has been applied in healthcare, psychotherapy, life-coaching, government, banking, and other industries.

The Toyota Way

The Toyota Way is a set of principles and behaviors that underlie the Toyota Motor Corporation's managerial approach and production system. Toyota first summed up its philosophy, values and manufacturing ideals in 2001, calling it "The Toyota Way 2001". It consists of principles in two key areas: continuous improvement, and respect for people.

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And that's what's really at the heart of the "go and see" mentality: you can think you know how something works (an assembly process, a hospital, retail logistics), but until you actually observe how it functions on a day-to-day basis you never truly understand.


Any company that cuts down on "wasted time" only expects more work.

That's kinda sad.

A few years ago I visited a motorbike factory - naming no names, but it was somewhere in Europe. What I found interesting was that the whole production process was designed around keeping the workers mentally engaged. They had only one production line for all their bikes, so if you were the guy who fitted fuel tanks, you had to know how to do it for at least a dozen different kinds of bike. And you never knew what was coming along the line next, so you had to check you had been provided the right part, check that the bike on the line is what you're expecting it to be, and so on. It kept what could be a horribly repetitive, mindless job skilled and interesting, which resulted in better work as well as happier workers. And they had all the process improvement noticeboards and so on too, with everything out in the open where anybody could read it.

Just seems like a more enlightened approach.

used Toyota's principles for years

Its a Japanese cultural value named "kaizen". This cultural value can be traced back to the Marshall Plan. It was developed by two American engineers to be taught in Japanese business schools.

Yeah, I think there is a limit. Generally LEAN is good at eliminating waste, but if you take it to the extreme it can kill morale. People aren't robots, and they don't like being treated as such.

My favorite was when they increased efficiency at a food bank

Its more effective as well apparently

It sounds like you run your life how I imagine a Supply Chain Engineer would.

I'm a nurse in a children's hospital... and if I'm donning sterile gloves to do a procedure, especially with a central line, I make sure that I have a sterile field for my equipment. I think that's being a nurse 101. Some issues that are not as obvious include having a fan at the bedside (it can blow germs around) and making the patient and parents wear a mask so as not to breathe germs on a sterile site. I can understand if someone misses these but not using a sterile field? Ehhh...

I am a nurse. I wash my hands literally hundreds of times a day. By the time I come home from work my hands feel like sandpaper. Please don't lump of us all into one terrible category.

As a black belt...couldn't of said it better myself.

People think that process improvement is about the having that great idea...that solves everything.

In reality, lasting change is the empowerment of people to change their own environment.

It's a concept used on production lines that have to regularly change out equipment. The basic idea is to do as much work while the machine is still running so the changeover is seamless. Single-Minute Exchange of Dies.

You know that douchey guy that has his next girlfriend lined up before breaking up with the current one? That's SMED applied to relationships.

It's not rude--it was my first thought, too.

I honestly am surprised--though I completely believe Toyota's observations--but who the fuck thinks putting down medical equipment on a patient's blanket is a good idea?

Like, where the fuck is your head? Is it just that doing the same thing day-in, day-out makes you less "thoughtful" about just how germy hospitals are?

I didn't expect the solution to be "stop putting medical equipment on filthy hospital surfaces" to be the answer, like the constant admonitions you give a 3-yo in a public bathroom (i.e. "stop touching everything!").

Hahahaha oh god I can just imagine my half-alert supervisor going hard with the glitter pens trying to win a poster competition.

You know what? I didn't print stuff often, maybe once or twice a week. But that very short walk, 10-30 second wait, and walk back was a good interruption from the focus of my computer, a stretch, and a rest. I'd go insane if little breaks like that were taken from me in the name of efficiency.

But what if by cutting down on wasted time working, you gained an ACTUAL BREAK. Breaks and rests are critical to good work and are a critical part of a LEAN practitioner's tool kit.

I have dual green belts in six sigma, the DMV is especially maddening for me but I feel like everywhere I go there is so much improvement right at their fingertips and it's a mix of "that's how we've always done it" and "pshh that will never work" mindsets that keep everything so inefficient.

Have worked for multiple metric obsessed corporations. The issue is not with the act of timing, it's with the enforcers going to the employee saying "You're to slow" regarding menial tasks that some times take an additional moment to do the job well.

Work in a pharmacy now. In Oregon it is now against the law to badger your employees to fill scripts faster. I moved to Washington recently where it is not. The badgering has returned.

We're back in a situation where the metric is more important than the patient and patient care suffers. The exact opposite the metric was intended to do.

The implementation is what matters.

100 times this.

Shitty implementation is what does things in most of the time. But people (especially people who aren't "idea people") conflate "shitty idea" with "shitty implementation" and then a perfectly good idea is tarnished because someone tried to do a shit implementation of it.

Imagine if nobody ever made a movie with CGI because ONE movie with CGI sucked. That's how a lot of people react to good ideas executed poorly.

Having to account for 'waste walk' has led to employees not being able to just use the bathroom. Treating healthcare workers like robots moves the focus away from patients. It's really tempting to believe there is a set amount of time to do any task, but that's unrealistic. Each patient requires their own unique approach, they're so many factors to each case. I agree that there is wasted time, but I would argue charting for insurance is a larger drain on time.

Honestly it depends on what you do. I don't consider IT working a call center and reading knowledge articles IT. I call that reading for a living.

If you're in actual IT - setting up WAP, VOIP, home networks, business networks with switches and ordering/imaging computers and maintaining domain controllers I consider that pretty good IT work!

We studied Toyota Production System (TPS) in great detail in our MBA business management and strategy class. It's amazing how a car company can produce an efficient method that we can apply in our daily lives. Here is the break down of what i learned from TPS

1 - Eliminate useless waste

2 - Don't overburden

3 - Stay consistent

4 - Always think

5 - Do not waste time

The trouble seems to be the outlook of the employee or the framing from management.

Measuring metrics are often associated with worker quality and solely the person is being judged, but with LEAN it isn't the case. The worker is part of the equation as well as the equipment, order of operations, and location. Part of LEAN philosophy is that they assume that workers want to do a good job, and hindrances and inefficiencies make workers unhappy and even less productive due to their unhappiness.

The trouble isn't with the main bulk of the LEAN implementation, but the perception of it. Without hope that the management can make life easier for the employees, the employees will most likely have a negative view of LEAN. Without employee hope, you won't get employees that look for things to improve. When employees don't believe that change is going to happen and that it'll be better because of that change, we lose out on crucial ground level input that we can't see from above.

just avoid help desk like the plague it is

From what I understand "go and see" relates from one of Taiichi Ohno's principles of TPS (Toyota Production System)...

He is considered as the founding father of this system. As an example, one of his "methods" was the Big Red Stop Button.

How this worked....If any staff on the production line spotted the slightest defect or flaw, they would hit this button and the entire line would grind to a hault (this is a big deal in mass production).

Everyone on the shift would immediately stop in their tracks and "go and see" the problem. Including senior staff and supervisors. Everyone.

They would go and see, gather, immediately problem solve, and then power back up!

Continuous improvement.

This entire conversation reminds me of every conversation I've ever had with someone whose tech company tried to go Agile and totally screwed it up.

It's not always that simple.

Sometimes I have to use printers which are a minutes' walk from my office. Often I'll put off printing something non-urgent for half an hour because the coding force will be with me at that minute and I figure I'll find a stretch of the legs more rewarding later on. I actually used to have a printer in my office behind my chair, but I got rid of it as people kept printing to it by mistake and mithering me, plus it made an almighty racket and I couldn't hear anything on the phone while it was going.

Often on the way to or from the printer I'll bump into other people and catch up about ongoing jobs, or be reminded about something I've forgotten, so the distance does have some value beyond my comfort. The problem is that this value's difficult to demonstrate, especially if your bosses are rushing round in a flurry of process-map post-its.

What's more, at the last place I worked that (tried to) implement lean working (again a hospital), there wasn't a cat in hell's chance of any of the saved time being recouped as breaks. They were on the bones of their arses — hence a desperate efficiency project — and any extra time gleaned was going straight back into department capacity in the way of more work.

The problem with only talking to an employee (and not doing timings // getting real data) is that the employees can have a 'not quite accurate' view of the problem.

This very morning I experienced it. I'm a LEAN Specialist in a production facility and I was overseeing how people worked with labelling batches for later use. I noticed that they do not line their labels (cardboard cards) up in a numerical line-up on their rack (numbers were 5 digits long) - just in a mix of hodge podge array.

They claimed they had a system to it and that they were very fast. Luckily they're very competitive natured, so I challenged them to an innocent contest. Who could correct label 5 batches the fastest. Them with their own system and me with numerical line up.

I finished my 5th batch when they were on their 3rd.

Wow paging /sub/hailcorporate .... the comments in this thread....


Found the PMP...

Or alternately, "every time you want to print something you spend a minute walking there and back. You do that 9 times a day, times 6 employees in the area who print things. The company doesn't want to get another printer for the area because it'll cost more. But you're spending 9x6 = about an hour every day on walking to the printer, and you're paying employees to do that. They don't need to be doing it, but they have to print things so they have to walk there. Therefore, buying a new printer is justified and would pay for itself in x number of weeks because of the reduced waste."

And then hopefully the hospital buys you a new printer and you don't have to walk far away every time a file needs to be printed.

Employees might not even perceive what is the actual cause of an ineffectiveness because they've gotten used to it.

Observing is much more useful than asking. You should do both though.

Sometimes someone does something and doesn't think about it. But then they train someone else, and the trainee is an obedient worker and they just want to keep their job. So the trainee does their job just like the first person, then the trainee and he first person teach two more. Bosses aren't keeping track of them, they're too busy doing paperwork and pretty soon anyone who could've caught them are also doing the thing.

This is an unobserved lifestyle. This is a culture where the new and the low have no voice. This is the antithesis of growth.

LEAN fights the culture where "that's just how it is" is allowable. It fights the culture where whistleblowers are punished. LEAN is humility and striving for continuous improvement. Pride can be good, but only when it's because what's done is good. Pride can be bad when you think what you've done is good because it's yours.

It is more than this. What Toyota knew is that they needed to create quality at the source and that sending known defects down the line was going to cost more in the end when they had a non-usable vehicle that they couldn't sell, or a pissed off customer.

This is a higher level of thinking than most American assembly lines through the 1980s that looked at assembly line uptime as a KPI type metric, without ever considering the second and third order cost impacts of having a vehicle reach the end of the assembly line without a steering wheel, a part installed backwards, or unable to start, whereas a Toyota andon cord temporary stop to fix a problem actually leads to less cost.

I know the feeling, but the straight up honest answer to this is that most people are hilariously bad at doing basic research. Most of the times, the people who do think to google first can't figure out what to google to get relevant answers and then they give up. Or in some cases, they do find something but look at the directions and they feel it is too technical for them to handle.

A lot of the support side of IT work is really just having better google-fu then the average person.

You'd be surprised. Often it is just management looking for a magic increase in productivity.

When my wife was in icu the nurse on duty would use sanitizer and then grab a bottle of lotion from her purse and use it.

I made her do it again. It really made things uncomfortable with her and I saw her do it multiple times.

What I'm amazed by is that people don't think to google things on their phone or another computer if they have access.

My little brothers have issues with their computers all the time they ask me to fix. All but one time they had a problem that I was able to figure out with a quick google search. They think I'm great with computers but in reality I have no training and I don't know anything beyond how to use google and things that I learned from using computers a lot myself.

I think most companies savvy enough to look into and implement LEAN practices are wise enough to know the benefits and importance of breaks for employees.

people trained in management techniques use reddit too

You save time on inefficiencies in work and gain an actual break. Work time become some spare time just to relax and stand up, instead of being obligated to do so to pick something up.

Breaks and rest is critical to include in a LEAN practitioner's tool box.

Honestly doctors and nurses are terrible at simply washing hands. If you have a vulnerable family member who is at higher risk of infection - ask them to wash their hands first if they're going to be touching sensitive areas (like checking or replacing an intubation tube)

They might be annoyed but I really do wonder how many deaths and extended stays are because of an infection that likely could have been prevented with hand washing

This is one of the harder things to come to terms with when adopting LEAN principles. That although your own way might be effective, it might not be the most effective way. But if you can keep an open mind and be willing to try new things, you can see waste and inefficiencies that were always there but thought necessary when they actually aren't.

The one thing that helps is to continually emphasize that you're examining and trying to find ways to improve the process and procedures involved in getting work done. It's not about finding the weak links in people. It's all about the process.

This is a really good example of the wrong way to do it. I feel like the intent of timing in LEAN should almost always be to make the process more efficient, not to punish workers. If scripts are being filled too slowly, they should find better ways to organize and expedite the process. Not say "do this faster"

"that's how we've always done it"

That's the dirtiest thing you can say in the english language.

They refer to it as "kaizen" and interestingly enough, this cultural value can be traced back to the Marshall Plan.

Toyota production engineer here. We dont literally stop the line when we find a inefficiency in our process. The line will stop if one step or station is over cycle and somehow holding up the rest of the line. We only stop the line for glaring quality defects in the product, or an inability to preform the planned function. 90% of the time it will be cause of missing parts or things not fitting. Unless it's a major delay, we tend to just keep running. There are entire stations dedicated to repairing minor defects that occur regularly, but aren't worth stopping the line for.

The data is collected at the end of each shift. This allows us to highlight problem areas of the shop and drill down on root causes that can be properly approached and corrected. The thing about auto manufacturing is that it's mostly a solved problem. We have most of the kinks worked out.

This is why we like to go out and volunteer kaizen activities for charity work. It gives our engineers experience with other environments and new problems, but also allows us to approach a fresh, un-optimized system and learn how to tackle applying TPS to a completely "raw" process, and understand how we go from chaos to a smoothly flowing system.

The problem is, even the best system can be ruined by idiots at the helm.

Jesus fuck, this is pretty much how my company is pointing now (thank god I'm getting out!)

Currently, we just finished a week-long poster contest, in which my friend/former boss encouraged everyone to put as much time into it as our sister facility. I don't care, I'm on my way out anyway, what are they gonna do, can my ass? So my intern and I put in the minimum, really office space that shit.

This company started off ok, but in the 16 or so months since I've started, it's declined heavily.

1) Both locations are encouraged to innovate, but the moment my facility does, we're told it all has to be the exact same as what our sister facility has, and their way is to be treated as gospel.

2) I'm salary, and likely legitimately exempt (others around me not so much). We budgeted 3 months for a project, with myself, my boss, and my intern, and they've both essentially been pulled now to work on things other than this "highest priority project". I'm literally being told I'll have to put in 80-100 hours per week for MONTHS on end to get this project done on time. They keep telling us we need to do more with less, but it's becoming obvious that he expects everyone to put in more time for just as much money, to the detriment of everything they do outside of work.

3) I'm "absolutely vital" to the future of the company, but I get paid worse than most entry level developers, despite being able to build things no company has available on the market. So I'm salaried, exempt, and I get paid garbage.

4) The CEO has such a raging hard-on for punctuality. Punctuality is fine and all, but if you're a minute late, literally a single minute late, you will be sent home without pay. He says constantly "If I paid you a million dollars to show up on time every day, you'd do it." Except... you aren't, so don't expect us to act like you do.

5) Lots of falsification of hours, because "overtime is never approved", meanwhile, they're asking employees to work extra hours. That's approval, idiots.

6) There is this massive thing about company culture, but our stated beliefs ('constantly improving', 'acting in humility', and 'living a life of servanthood') do not match the culture we have. The CEO is one of the most pompous, self-serving, two-faced sacks of crap I've ever had the displeasure of meeting.

7) The CEO has yet another hard-on for telling people they should come to work for more than a paycheck. The paycheck is literally why I work for you, dude; if I didn't have a fiance to take care of, I'd be doing waaaaay more interesting shit than working for your selfish ass.

Coincidentally, my boss, poor guy, is the ONLY office guy in our sister facility right now, because the entire admin/mgmt staff went to a Lean Summit this week. On a day's notice. He's sick from an extended task he had to put three days straight into last week, but can't call out because then no one can answer phones. Also, I'm still waiting on his responses to stuff I asked for weeks ago because no one will let him do his job.

Lean is all about valuing employees and making them feel valued and safe. If you can't pull that off, you're going to fail.

Hurricane Sandy relief

They did it for as well. Lean makes a huge difference when done properly.

This is where the term Monday cars came from... On Monday hes hungover and ends up slapping on the wrong parts for the wrong bike.

You want a Wednesday car since they had all day Monday to get over the hangover and Tuesday to get the kinks worked out.

Most organizations have a shitty culture combined with stupid as fuck management.

The managers mimic the methods of successful companies like Agile or LEAN, but in the end they don't understand that they, the managers, are the whole fucking problem to begin with.

To be fair, this'll give you a very jagged impression as the only things that are upvoted on TalesFrom subreddits are the 'person X is an idiot, it made my life hell, here's how I fixed it/it got more fucked up'

It's like reading a diary if you cut out everything remotely happy.

Not completely true. The value existed with the Zaibatsu before World War II (how do you think Japan became such a manufacturing powerhouse in the first place?). It's just that the two engineers made it more explicit.

That's what they teach in most of the implementation classes of different organizational frameworks. LEAN, AGILE, SCRUM, Six Sigma, ITIL, ITSM and most others. They all teach that it has to be done from top down and everyone has to be working on the same goals otherwise it turns into a micromanaging shit show.

but who the fuck thinks putting down medical equipment on a patient's blanket is a good idea?

It's like when the person making my sandwich touches stuff around the shop with a gloved hand. You just touched the wall when you were coming around from the back? You just answered the phone/touched the cash register with a gloved hand?

Well, now you'd contaminated your glove by touching everything in the store... and now you're going to make my sandwich with that gloved hand.

People tend to think that gloves are to protect themselves. Which that's only half of it.

You'd be surprised by how many "common sense" mistakes are made systematically in large organizations. Some of it is thoughtlessness, but most of it is because it takes a bit of effort and organization to get over the barrier of developing and implementing a better solution.

In the example, it is very possible that an individual nurse might recognize the threat of putting down an object on a nonsterile surface, but the process does not allow him/her to do otherwise since they need both their hands for something else and don't have access to a sterile place to put down equipment in the rush of the moment.

The individual nurse may not realize this problem is common among their colleagues or leading to infections and, even if they do, might be ignored if they attempt to elevate it since their need is one of many competing needs for resources and attention, and management does not have the capability or bandwidth to prioritize needs without a more thorough investigation.

A Lean exercise allows these vulnerabilities in the process to be identified and elevated to someone who can do something about it (such as develop or purchase equipment which can be used to keep objects sterile in such a specific, yet apparently common situation).

It's definitely not a rude observation, but a problem you will come to understand as you enter the working world.

I'm assuming black belt doesn't refer to martial arts here.

If you pick employees at random, probably. About a quarter of everyone I've ever worked with were hopeless for various reasons and were being carried along by the other three quarters. It had somehow become ingrained in most of them that all change was bad, to the extent that you could've given them a free week's leave and they'd have found some complaint with it.

On the other hand, though, pretty much every department I've ever worked in or with has had one or more 'star employees', who everyone else knows know the job back-to-front. Talking to these employees should indeed be done with this kind of thing, and it's a matter of a couple of questions to find out who they are.

That's pretty unfounded, and is part of the reason why processes like LEAN, or Agile, or whatever buzz word blanket system is trying to be implemented are greeted by moans and cheers. Some companies are, some companies aren't and not identifying the fact that it isn't some universally great thing for employees is mildly infuriating.

Yeah I'm sorry but this is a story of woeful training/adherence to extremely basic procedures, i'm not impressed by any of it. But then again the 'surgical stop' was back to basics and worked pretty well too.

I was an Army medic, and we were trained to do surgical procedures outside in the sand, wind, and mud, but in a hospital setting, I would never have put sterile equipment on a dirty blanket. It makes me wonder what else those nurses are doing to their patients

Some people are okay with "that's just how it is". That's how these things happen.

LEAN is not. LEAN is a culture of hope and humility. Understanding that even the lowest worker can find the key to improvement and that there can always be improvement.

Read the article . Dont go by the comments. it wasnt about time savings. Toyota also has specific ways of problem solving that they used to cut down the infections.

Nurse Aide here, the facility I worked at had this amazing Aloe handsanitizer, I could practically bathe in the stuff and my hands'd feel fine. Then they switched to generic Purell since the good stuff was more expensive, hence my hands started looking like /u/rebelmusik 's.

Basically hospitals etc. need to recognize that spending a little more in the sanitizer department for those of us who use it a million times can have wonderful dividends down the line.

EDIT: It's McKesson brand sanitizer if anyone wants to know

Lean/lean manufacturing (Wikipedia)

Former Toyota employee here. Every person knows about kaizen, although it's fun to hear it said with a southern accent whenever we worked with the southern plants such as Mississippi and Texas.

Sounds like the issue isn't the process but how it's being carried out. Also, needs buy in from employees, doesn't matter what you do if they're not on board things are bound to fail.

A century of corporate policies steadily slashing break time say you're fucking wrong.

I know a guy who got fired because his breaks were undocumented and considered skipped work. The kicker? There was no official "break time" form so he couldn't document them and it became a 'I told X I was going on break and they said OK'-argument. Other than the managerial, or higher, staff; the place had an insanely high turnover rate.

I'm sorry your wife was ill. If you ever see something like that again consider going to the charge nurse with your concern.

The problem is, sometimes people just want to stand up.

Wow my dept doesn't do any of those things