My first job in the Lean Enterprise Research Centre was to understand how to apply an operations management methodology, which had originated in manufacturing, to that of a service environment.\u00a0\u00a0 I shadowed my colleague Ann Esain on different healthcare projects and Ann helped to open my eyes to the potential for Lean Thinking within the NHS.\u00a0 We worked on one project looking at Lab Services and, following Lean Principle number 1 \u2018Who are your customers and what do they value?\u2019 I went to interview lots of the internal customers of Lab Services – GPs, Doctors and Consultants.<\/p>\n
Everywhere I went I asked \u2018if you had a magic wand, what would be the one thing you\u2019d change about this service\u2019 (great question by the way when on an improvement mission) and everyone said \u2018please stop printing out the test results \u2013 the computer system works fine and it costs us money to destroy the paper results \/ file them etc.\u2019.\u00a0 Indeed, some of the people I interviewed were literally surrounded by piles of printed lab results waiting to be \u2018dealt\u2019 with.\u00a0 This was an early project for me so it brought me some delight that I had found out something useful – I could feedback to Ann and the project team something that could be easily improved. \u00a0Result!<\/p>\n
However, it was not so easy to turn the printing off. We certainly didn\u2019t achieve it in the duration of the project, and as I understood it, it took many years for that printing to finally stop – even though it sucked up people\u2019s time, energy and money to do the printing and the posting …. plus the time, energy and money to deal with the printed results at the ‘delivered end’.<\/p>\n
It was my first major lesson in how hard improvement actually is.<\/p>\n
Why was it so hard to stop doing something that no one needed or wanted?<\/p>\n
First it was nearly impossible to work out who had the final say on whether this part of the service could be stopped. Which person? which group? which board? No-one knew. This might be a scenario where some kind of \u2018ask for forgiveness not permission\u2019 situation might come into play, but with something as serious as medical results, it felt far too dangerous to \u2018experiment\u2019 \u2026 no one wanted to be ultimately responsible for \u2018turning something off\u2019 and then getting in trouble or worse, something terrible happening as a consequence.<\/p>\n
Frustrating when you can see that things can be better but you don\u2019t know how to get the permission and, critically, the aircover<\/strong> from senior management, to try new things.<\/p>\n I have spent many years working in both public and private organisations and to me, there are just as many talented, hard-working people in both contexts – the biggest difference I\u2019ve seen is how easy it is to find the people who can make decisions – how willing they are to make them, and how encouraged you are (and enabled you are) to make decisions yourself. This ability tends to come easier to private organisations as opposed to public, I suppose because of the extra responsibilities that public sector organisations tend to have. (I know that there are some private organisations who are very cautious about making decisions and some public organisations that are fab at making them – I generalize here in an attempt to make a point!)<\/p>\n I think that the ability to make decisions quickly, and learn from those decisions, is one of the most important ingredients of successful organisations<\/strong>.\u00a0 And it\u2019s not just me who thinks this\u2026 this is an abridged extract from successful entrepreneur Steven Bartlett\u2019s interview as part of the How To Fail With Elizabeth Day<\/a> Podcast\u00a0 \u2026<\/p>\n \u201cthere are some decisions which you have to make and make them as quick as you can and be at peace with it because most of the time in life the greatest cost isn\u2019t the outcome of the decision, it’s the procrastination of the decision\u201d \u2026 \u201cObama said this to me \u2026 \u00a0\u201cI get to 51% certainty and then I’m at peace with that\u201d … \u201cyou know in life generally whether its relationship decisions or business decisions you’re never gonna get to 100% and the endeavour to get to 100% is going to potentially cost you in more significant ways than being wrong at 51%… so \u2026 you get to 51% and then you are a peace that you made the best decision with the information you had at that time and you move on\u201d.<\/p>\n \u201cWorking with clients you see very, very clearly, from a birds eye view, the cost of dithering and procrastination. I’ve got two clients in mind, both part of the same family business, one of the clients, I\u2019m going to call them Client A, they make decisions so unbelievably quickly, sometimes they’re wrong but they at least find out if they are wrong or right so fast that they can at least make another decision and I\u2019ve seen their business just absolutely explode\u2026.probably the fastest growing business in their category. Another business within the same family, I also work with them and if I approached them with the same idea, it could potentially take 9 months, of trying to get it through 12 different people and all of the red tape, blah blah blah, and their business is dying and I know why because they are just procrastinating on these decisions and it\u2019s the procrastination, and the lost opportunity that comes with that, that\u2019s costing them\u201d.<\/p>\n