LEAN CONSTRUCTION Congress will be organized jointly with LEAN IN PUBLIC SECTOR (LIPS) Conference on May 3-5, 2021.
We are working hard to make the LCC & LIPS conference as successful as possible and announcements regarding programme etc. will be made soon!
Find out more here
Title: Recognising Global Innovation & Lean Practices with Public Sector
Presented by: Glenn Ballard from University of California Berkeley and Founder of Lean in Public Sector.
Presented by: Amr Abdel-Azim – Michigan State University
Date: 24th November 2020
Veygo is a spin-off of Admiral Group, the insurance company behind Confused.com (the first insurance comparison site in the UK). I visited them back in January, in Cardiff, to learn about their lean journey. My point of contact – and excuse for visiting a gemba outside France – was the head of Veygo and fellow Frenchperson Jean Baptiste Limare. Our gemba walk revealed how much Lean Thinking has helped the company. Last week, in the light of the recent developments with the Covid-19 pandemic, I decided to follow up and conduct a bit of a virtual gemba walk to see how the company was faring after switching to a remote operation.
Working from home may be shrugged off as a non-issue for a digital company. After all, remote coding is not new to the digital world, with expert teams often scattered across different locations. But is it really that easy? And can Lean Thinking help to make it work?
During our call, I also took the opportunity to revisit with Jean Baptiste the three points we had intensely discussed a couple of months back: knowing your customer, learning to deliver at speed and with quality, and developing autonomous teams.
Jean Baptiste started at Admiral a few years ago. His job was to design new insurance products, but he knew the company needed to adjust its offering to a market in which younger generations no longer buy a car but rather use a mobility service. Given the circumstances, the insurance world would have to follow suit and offer temporary insurance coverage for whatever scenario young drivers might find themselves in, from learning to drive with a parent to sharing a car or occasionally renting one. Such policies would have a duration that can vary between one hour and 30 days. As the company’s motto states, “At Veygo, our goal is to provide the best insurance options for drivers with no cars.”
Jean Baptiste also meant to demonstrate that insurance contracting and associated interactions can be digitized. Like most insurance companies, Admiral still heavily relies on mail and call centers to interact with its customers or would-be customers. JB was determined to develop a contactless insurance product. That’s when Veygo was born. It was mid-2016.
Four years later, the company is making more than half a million sales per year, customer reviews are very positive, and the assumption that there is a market for digital native on-demand motor insurance is confirmed – at least when it comes to Veygo’s insurance products (temporary cover and learner driver’s car insurances). Over time, the team grew from six to forty-eight people, between Q2 2017 and Q3 2018. It is now 53-strong.
“Lean has really helped me,” Jean Baptiste told me during our gemba walk in January. Jean Baptiste – or JB, as his British colleagues call him – took his first lean steps on his own, reading book after book. At first, he was attracted to the tools (aren’t we all?) and saw Lean Thinking as a sort of Agile 2.0. – a compliment paid to lean, I would say, since most “agilists” tend to consider it a thing of the past. Lean tools, JB reckoned, were going to provide the means to be less people-dependent and to eliminate waste, while helping to sustain a massive flow of new features for the website. Back then, JB’s favorite KPI was the number of releases that could be achieved over a given period of time. As Taiichi Ohno’s Workplace Management reminds us, we are all full of wrong ideas on how things work. And JB is very transparent about the topics he actually changed his mind on. And today he firmly believes that those changes of mindset continue to help him and his teams during the Covid-19 crisis.
The first such change required the help of an external sensei, who showed up at Veygo with a question: do you know your customers?
At the time, the sensei’s question had come as a blow. In a world of fast growth, digitization, websites, agile and millennials as customers, Veygo’s focus had been on sprints and fast delivery. At the time, the scrum teams were fighting for minimal management interference, so long as they delivered, and JB’s vision for the company was very much a group of technical silos he was trying to supervise and align.
Putting the customer back at the center and asking how to better grasp her needs, or what level of quality she perceived, was mind-boggling at first. How do you actually talk to customers when your entire business model is to design a “buy what you need, no assistance needed” website? The fact that no one had to talk to the customers was considered a success factor. And we of an older generation are not allowed to laugh either: in our time, we thought we could do the same with hypermarkets or shared service centers.
It turned out that five out of six members of the Veygo management team had actually never talked to a customer. Product owners thought out features without actually checking them with real customers. Additionally, if a feature had a poor impact on sales, it was unclear whether the idea was wrong in the first place or whether the execution failed to add value for the customer. “Either way, we were not learning,” JB sighs.
And indeed, I had seen during the gemba walk a major shift from that initial approach, with scripts of customer interviews, a takt time for those interviews, NPS or CES indicators. On the Veygo website, FAQs and Help Centre articles are flourishing, fueled by the conversations the team has with customers. Ever since the lockdown began, the live chat feature has become as essential mode of communication with customers.
Discussing with customers led to some interesting revelations:
This new focus on customers has not disappeared with the Coronavirus crisis.
JB’s aim was to sustain business continuity while protecting everyone at Veygo. Preparation for a possible lockdown actually began as soon as the first villages in Northern Italy were quarantined on February 21st. It took Veygo 72 hours to plan and prepare for the switch to a 100% remote operation, with laptops and dedicated VPN for remote access provided to every team member. They also worked on the impact of remote work on each job and studied worst case business scenarios – including a lockdown of the Cardiff areas as a result of a local outbreak, with the rest of UK still operational and busy with its business-as-usual. They were ready by early March and switched to remote working one week before the UK enforced a full lockdown on March 23rd.
The teams were still battling with bad chairs and new remote tools when JB asked them what could be done to help National Health Service workers who may need a temporary insurance cover to go to work. Action was immediate: the decision to offer a 75% discount for NHS members was made on Wednesday, March 18 at 9 PM and the new feature was in production by 4 PM the following day. Not bad for a project driven and executed remotely! Within a week, they had 200 requests to benefit from this offer and many positive comments. This gave more meaning to daily tasks and routines and highlighted the importance of acting as a team. JB tells me of how people exchanged internal messages saying how proud they were of their achievements and to be part of the Veygo venture.
As he reflects on today’s situation, with developers and product managers no longer working in the same space, JB expresses a worry that output (deliver at speed) may once again overtake outcome (deliver value). The activity is lower of course – particularly on the Learner Driver insurance covers – but activity for Temporary covers has only decreased by 30%. And the feature release activity is flowing, unimpaired.
Initially, quality had not been JB’s prime objective. With Veygo celebrating the number of releases and never talking to customers, questions on current quality issues were spurring frowns, if not laughs, from the teams: “We’ll do quality when we have time” or “80% (or even 50%) of many things is far better than 100% of a few items”.
We get a similar response from teams when we ask them about kaizen – “When we have time,” they often say. Kaizen, like quality, is an investment in the future that Deming had perfectly understood. “The result of long-term relationships is better and better quality, and lower and lower costs,” he said. Deming also recommended we do away with final inspection and develop built-in quality. “No one knows the cost of a defective product – don’t tell me you do. You know the cost of replacing it, but not the cost of a dissatisfied customer.” This is food for thought: with the pandemic, new customer expectations are bound to emerge and those who fail to perceive and meet them will found themselves out of the market really quickly.
Veygo decided to have a go at quality in October 2018. They saw it as a quick bug-cleaning campaign at first; that couldn’t have been further from the truth. The team found they had many customer complaints, but few of them were visible and most were not addressed. Critical functionalities on the website didn’t work: for example, the confirmation of an insurance coverage went in a loop after signing up for it, leaving the customer in doubt as to whether she had actually purchased insurance coverage.
When the team tried to address and fix those issues, it turned out that they did not trust the reported bug backlog, that unit and integration tests were poorly designed (if not absent), and that test programming was an unknown notion. Developing code as quickly as product owners could pile up new features had been their sole motto up to that point.
They sat down and worked on it: developers shouldn’t be asked to choose between good or fast. Therefore, the product development culture was changed to include quality. Bugs were tracked in bug review sessions, a tool was secured to check difficulties encountered by customers on the website (tracking their behavior and highlighting potential frustrations with SessionCam), and developers were trained to develop tests. This quality intervention paid off and the conversion rate shot up.
Another positive side effect is that feature ideas now come from actual user problems: the decisions on new developments are consequently easier to make and more obvious to all, and consensus is reached more easily.
JB can see that new projects today are impaired by the difficulty to assess features with customers: what is the customer outcome? How to define success? “Brainstorming is harder to achieve remotely and, as a consequence, serendipity effects on innovation are less likely. Having a coffee with a colleague to discuss a problem in person is just not the same thing as doing so on video call. This is something we will have to pay attention to in the coming weeks.”
We don’t how long the lockdown will last or whether we are bound to see successive waves of lockdowns throughout 2020, as this will largely depend on how fast we can produce protection and testing for us all. In such a scenario, learning to work remotely effectively becomes imperative. But how do you actually develop team autonomy in such a context?
Veygo’s experience with this over the past couple years can teach us a lot. You don’t grow from six to fifty-three people in two years without a major reflection on the onboarding process and how to organize teamwork. There are several aspects to this: you need to create a reliable management team, align everyone around common goals, and foster collaboration on the delivery flow. This may also mean a complete change of behavior from top management.
Back in January, JB had told me the story of how they created standards for developers. When he started to go and see how developers worked, his actions were perceived as an audit and not much came out of it. Then he thought about developing work standards and tried to enforce them. That did not work either, as the teams became more and more defensive against any intrusion.
This prompted JB to think hard about what autonomy means and to introduce a completely new approach:
During the gemba in January, JB had walked me to a board showing a kaizen approach in six steps led by a scrum team, with support by JB and Simon, the other PPM. It was focused on smoke tests, which preliminarily simulate the would-be customer journey with the new code to detect potential failures. Some 40 hours were lost every week running smoke tests that do not work. The first pass on this kaizen identified parameters to be reworked, much to the relief of developers. Faulty smoke tests went down from 97% to 0.4%. In turn, this revealed new issues such as a slow process to release new features into production: they are targeting a 50% decrease and continue to work on it remotely. But JB thinks more work on this is needed: “Cleaning and sorting is one thing, but we need the scrum teams to further investigate root causes and find ways to prevent recurrence.”
Talk to your customer, work on quality, develop autonomy and teamwork: JB believes these major shifts in his mindset helped him to organize the new remote working setting. “The major advantage of lean, as I see it,” JB concludes with a smile, “is that we are learning much faster: we see our problems faster, understand our misconceptions quicker and change accordingly. That is a major advantage when you are trying to disrupt a market, and it becomes even more crucial when you are facing a crisis such as this one!”
FEATURE – A lean management system is necessary to effectively run a business. Can Art Smalley’s four types of problems framework help such a system to focus on what’s really important?
Words: Gustavo Adolfo Gomez Pineda, Plant Manager, Schneider Electric Colombia and Senior Advisor, Lean Institute Colombia.
I have studied and practiced Lean Thinking for the past 20 years, mostly learning by doing – on the job – and using our plant as a laboratory. It was our drive to always run experiments that led us, in September 2019, to try and implement the ideas contained in Art Smalley’s Four Types of Problems. The book had recently been translated into Spanish and, upon reading it, I was immediately impressed.
We set off to determine whether or not the lean management system that we had put in place in our plant could match Art’s categorization of problems. We began with a workshop we co-organized with Lean Institute Colombia. The (many) questions that came out of it were really our starting point to run this experiment.
The four types of problems Art Smalley describes in his book seemed very interesting to us, but we struggled to marry them with our management practices at first. There were clearly some common points, but overall we found it difficult to recognize the different types of problems in our context. Little did we know Art’s categorization would soon turn our management system on its head!
Not knowing exactly how to approach this experiment, we decided to look at the four types of problems in the context of the lean house, thus making the link to our lean practices (from standards and Kata to the Balanced Scorecard) more explicit. That way, we were able to create an interesting model that we integrated in our weekly management business review.
Before long, the walls of our Obeya (where the management review takes place) reflected the shift we were hoping to create with our experiment. By rearranging our boards on the walls to reflect the four types of problems, we changed the way we talked about issues at the plant.
Our weekly management meetings always start with the customer. We ensure they are satisfied and analyze any complaints we have received. Then, we begin to look at the different types of problems:
In its current form, the meeting lasts around two hours. We found that a weekly two-hour meeting is more effective than a monthly eight-hour one: it allows to get into quite a bit of depth while making it easier for my managers to come prepared.
As much as we lean thinkers see problems as opportunities, we cannot expect this to be the case for every single person in our organizations. In fact, it is often difficult to talk about problems. And even when they are openly talked about, people find it hard to do so in a structured way. Initially, at Schneider Electric, we encountered some resistance in the team: they didn’t see the connection between the four types of problems and their work. Nonetheless, we persevered, knowing that we couldn’t look at the four types of problems in isolation: they had to be built into our approach, from VSM to hoshin. The change over to the four-types-of-problems system was hard, but people have now interiorized it. It’s a routine for them, part of their DNA. It’s provided us with a common language, much like A3 and VSM had in the past.
As I look around, I see a lot of companies that are not able to identify what problems should take priority, and that’s because they can’t distinguish between the different types of challenges they are faced with. For example, there is a clear tendency in the business world to treat Type-1 and Type-2 problems as Type-3 or Type-4 (for instance, implementing an App as a workaround rather than truly understanding and fixing the problem at the gemba). What’s worse, many companies only focus on Type-1 and Type-2 problems, forgetting about the critical Type-3 and Type-4. It happened to me as well, but I think it’s important to move away from that – something Art’s methodology forces you to do.
It’s been incredible to see how the four types of problems have transformed the way we manage our factory, perfectly complementing the lean management system we have built over the years. The biggest contribution of this new approach has been teaching us the importance to try and foresee problems (proactive) as opposed to simply responding to them once they occur (reactive). I have found great value in starting to look into Type-3 and Type-4 problems, even though I have to admit that Type-1 and Type-2 problems often take up all of the time we have available.
The beauty of this approach is that by consistently focusing on those Type-2 pain points, you are gradually building a smoother operation, which in turn will give more time to focus on more strategic issues. At Schneider Electric Colombia, we are seeing things we didn’t see before and we are attacking problems in a more effective way, whereas before we often mixed things up and didn’t deploy the right response to our issues. There is no doubt that we are now looking at our work in a more complete way, using a more logical structure for our work as managers. We are more confident in our ability to tackle whatever challenge we might face.
We have even seen a slight increase in productivity over the past nine months. Having reduced the number of Type-1 problems we experienced, people can now contribute more to the advancement of the plant. In fact, the majority of the problems we have now come from the outside – for instance, a supplier not sending parts due to the pandemic.
Whatever your hoshin plans were for 2020, you likely had to go back to the drawing board. I believe that this is the perfect time to integrate the four types of problems into your activities, not least because in a crisis we tend to stick to Type-1 and Type-2 problems all the time. But the fact that the present is tumultuous shouldn’t make us forget about our future. Firefighting alone is not enough to get yourself out of the crisis.
Type-3 and Type-4 problems are about getting to better levels of service and reinventing yourself respectively. Both things are now more crucial than ever. Faced with Covid-19, many organizations have appeared paralyzed, uncapable of taking action (any action). But when things get tough is precisely when you have to try new things, run even more experiments than before.
The modern manager has to work with the four types of problems in mind.
Interviewee: Brad Brown, Assistant Chief of Administration, Grand Rapids Fire Department – Michigan, USA
Roberto Priolo: Grand Rapids is undergoing a city-wide lean transformation. How does the lean journey of the Fire Department fit into it?
Brad Brown: The Fire Department is really at the forefront of the city’s lean initiative. We started around 10 years ago with A3s and looking at the ROI for making systemic improvements. Once we started to see some results, we went to the rest of the city and began to lead the lean transformation. We regularly teach other city departments how to think and act lean.
RP: Ten years on the journey! Can you take us through it briefly?
BB: It is incredible to think of the many things we have learned in the past decade… and of all the mistakes we have made!
We started during the economic downturn of 2008. We were not in a good place back then: we had to lay off firefighters, we were having trouble answering our over 20,000 emergency runs a year, and our infrastructure was crumbling. We were outstripping our resources. The city then reached out to a group of private-sector business professionals and asked them to help them implement lean thinking. They started with the A3 problem solving tool, one of our favorite methods to date.
Unfortunately, it was still a push system: the city was telling the department directors they had to use lean. At the time (I had just come out of fire suppression), my job was to ensure the lean mindset would “trickle down” to the troops, who didn’t want it. There was a lot of turmoil. It was only after several years of working on projects that improved our people’s every-day lives that we were able to switch to a pull system. I am really happy to say that today we have great leadership and great labor management relationship: we are all sitting at the table to solve problems together, union workers and senior leaders.
There’s more. At first, tools and techniques were at the heart of what we did, whereas now we are focusing more on the cultural side of our transformation.
RP: How has the context around you changed in the past decade?
BB: According to the US Bureau of Labor Statistics, Grand Rapids – a city of just under 200,000 located in West Michigan – is one of the fastest growing economies in the country. That means we have a lot of buildings going up at the moment, which means increased risk of fire and a higher call volume for our 11 stations and 200 firefighters. We are no longer doing lean to cut costs; now we are doing it to increase our capacity and keep pace with the environment.
RP: How did your approach to developing capabilities change over time?
BB: At the beginning of the journey, we relied a lot on outside expertise (the Lean Enterprise Institute was among those who helped us). It was a good first step to get exposure to the ideas and principles, but we realized it wasn’t sustainable. So, we decided to look around the lean community in Grand Rapids and found that our local college offered a nine-month lean certification program. It was harder than my Master’s degree, I have to say! That’s when we started to grow our own people, and now we have seven lean champions within the city. Grand Rapids is a unique environment, where firefighters teach lean to city employees (I, for one, am teaching A3 thinking) and where the transformation is pretty much self-sustaining.
RP: What can you tell me about leadership in the Department?
BB: In the past, a lot of the support to the transformation came from middle management rather than from the top. Around a year and a half ago, a new Chief came in and he is really getting involved directly. People understand that if this is important to him, it should be important to them as well. That’s when the tide turned for us, which goes to show how important it is to have leadership involvement.
RP: How did your process change?
BB: We have implemented several different processes. From a tool perspective, we ran 5S projects around the stations and applied value stream mapping for a lot of our administrative processes. But we were still disconnected with our men and women on the street. So, a few years ago, we started a daily huddle via Skype that gives all of our 11 stations 10 to 15 minutes with the Fire Chief.
Each individual work area has its own stand-up meeting as well. There are three important questions that we ask every day: What did you learn yesterday? What are you doing today? Do you need any help? As firefighters, we don’t ask for help and we are used to being the ones people call to solve problems, so we have had to learn to be very explicit in asking these questions. Coupled with the Chief being more and more visible, this has given us more than all the monetary savings combined.
I remember an anecdote that shows how much things have changed. A couple of years into the journey, as we were launching our system for managing for daily improvement with our huddle boards, I remember one of our colleagues (a fire engine driver) walking into the station and saying, “Boy, if I just had one hand grenade I could take care of this place.” He was standing just outside the office I shared with my then partner. He looked inside and said, “I am talking about you two.” Fast-forward a few years later, and this is the same person who asked for a white board to go up in the apparatus bay, so that he can better keep track of his fire engine, what he needs, and transfer that information to people in the other shifts. I have at least 20-30 stories of big detractors turning into ambassadors for lean. But that didn’t happen until we started to fix their problems – not ours.
RP: How does information and knowledge travel across stations?
BB: A lot of it happens organically, even though we have 11 stations and three shifts (which really means 33 different work crews, plus 15 rigs out on the streets). When crews travel around and see something working in another station, they want it – no matter what management says.
RP: From a practical standpoint, how has your ability to fight fires improved over time?
BB: We are one of 239 accredited fire agencies in the world through the Center for Public Safety Excellence, and lean helped us to accomplish that. One of the major things we do (which happens in manufacturing all the time) is looking at critical tasking and takt time. It’s important for us to understand how quickly we need to perform certain tasks to meet customer demand. Through a lot of system mapping and critical task analysis, we now know that we can save 96% to 97% of a property if we can deploy seven rigs with 19 personnel to the fire in less than ten-and-a-half minutes 90% of the time. All this has been tested and validated over thousands of runs. Before accreditation and lean, we never would have thought to break the process down like that. The bell would go off and we’d run to the engine, drive to the fire and work hard to mitigate it. We would still do a great job, but now we have data and we can see the waste and opportunities for improvement in the process.
RP: How do you define success?
BB: In the past, success was very outcome- and metric-oriented, almost to the point that the focus was on how much money we were saving. Now I view success as people asking me to help them. Giving people the tools, coaching them and seeing their smile afterwards is what success looks like to me, and it’s a great motivator.
RP: Is it beneficial for the Fire Department to be part of a wider environment that uses lean?
BB: It is hugely beneficial! Within the city, lean practitioners have access to any department. We can call people up at any time and go see. Every few weeks, we have a different group of people coming to our gemba. Lean is very widespread in Grand Rapids, even outside city government: it’s not uncommon for me to walk down to the hospital once a month to see some lean friends over there, or swing by a manufacturing plant. It is fantastic, and we are very fortunate to have so many lean practitioners in West Michigan.
RP: Can you share some figures with us that show the impact of the lean transformation on the city’s finances?
BB: When we first got into lean, the city was running on a deficit of tens of millions of dollars. Thanks to the diligence of our Chief Financial Officer and to lean thinking, we have not only recovered, but also built up cash reserves as a city. It was a long road to get here, but now we have a sustainable model and we are ready to weather the next economic storm. It’s a great place to be, but we are only here thanks to the hard work of our employees and the support of our citizens.
The Borough of Vestre Toten, “kommune” in Norwegian, is home to one of Norway’s largest industry clusters located in the town of Raufoss. Inspired by the companies in the cluster, the director of the borough, Bjørn Fauchald, initiated a lean transformation back in 2011 to tackle the out-of-control costs and deficit.
The transformation began in the elderly care centers, which were offering an increasing number of services with little extra funding. The first pilots focused on the development of the nurses’ technical skills using visual management and standardization, and they were a resounding success: the care centers were now able to deliver more and better services with the same amount of resources. Their sister organization – home services, providing elderly care for people still living at home – consisted of two departments that started their lean journey in 2012 and 2016. In 2018, they eventually merged.
Maj Britt Karlsen was asked to lead the re-organization. Having previously led a lean turnaround with good results in a different service area, she again turned to lean and started to work closely with Kari Bjørnerud, one of three internal lean coaches in the borough. During our visit to their offices with a team of students from Los Norges “Learning Organization” training program, we were able to closely observe their Obeya support systems and the team’s visual management boards, interview nurses and other healthcare workers, and deep dive into the learning culture they are trying to develop. As with the elderly care centers, more responsibilities and new tasks – which of course require new skills – have been transferred from the hospitals to the home care department.
As part of our gemba visit, we also had to chance to discuss the transformation in detail with Maj Britt and Kari. One of the first things we noticed was how clear their hoshin was, “leva lenge hjemme” – which translates into “live long at home”. For the kommune, such an outcome should mean happier citizens and cheaper service (a person that stays at home one year longer saves the borough about NOK 600,000 per year – around €60,000). Regardless of what cost reductions might be achieved, however, it was clear that the lean principle of “customer first” was very much the focus of the department. Even though their 7.5-hour shifts are packed with work, the teams still take the time to deliver high-quality services to the elders living at home. In the event of an abnormality, deviation, issues or at worst accidents, the problem is quickly posted to the visual management board and discussed the following morning. If necessary, appropriate countermeasures are introduced and the learning is shared with colleagues.
The home nurses, divided in groups of 25, work closely together in shift divided into 5-6 people, and of course start their day with a daily huddle around their visual board. Every morning, they meet with their teams to inform, organize, coordinate and discuss the work to be carried out that particular day. As mentioned, the daily huddle also gives them an opportunity to raise issues and highlight deviations that have occurred the previous day. This allows the teams to follow up with both customers (patients) and support systems, share vital information and discuss and coordinate on specific patient needs (for example when, for whatever reason, someone needs special attention in the form of medication, a doctor’s visit or just a bit of social interaction).
Lean has also helped with standardizing work procedures with a focus on quality and predictability for the patients. For example, an issue was discovered with variation in how wound care was carried out. There was no agreed upon standard, with different practices and ways to complete the work leading to different outcomes. As a countermeasure to this problem, the teams turned to classic job breakdown analysis and held a discussion on how wound care should be provided to ensure the possible results every time. Supported by the specialist nurse in the unit, the teams developed a standardized procedure for wound care resulting in less issues and better care for the patients. In some cases, hospitalization was avoided.
To give you a better idea of how Lean Thinking is applied at the borough’s home care service, we’ll look into what happens from the beginning of the process. When a decision is made to deliver a certain type of care to a person at home, the first thing the home care team does is to validate that decision. Is this the right type of care? Should there be more or less care or should there be a different type of care altogether? In true lean fashion, this first evaluation is carried out at home with the care receiver – right at the gemba. Once they are satisfied with the decision, the team involves the patient in the planning process and in setting targets for the outcome of the care. The standardized processes allow for flexibility and individual adjustments to ensure that each patient’s unique situation is taken into account.
Another example of this patient-centric approach is the way in which the teams systematically work with patients in need of rehabilitation after operations or accidents – what they call “ordinary day rehabilitation”, meaning going back to normal. In these instances, they use the team boards to follow the progress of each patient individually. They track every-day things like getting up from a chair and going to the toilet on their own, getting the mail, cooking or cleaning. By following each patient closely – they even measure the speed of wound healing with data (mm/cm) and pictures – the teams can quickly make adjustments if progress is not satisfactory and reflect on the reasons why it is not as expected. This in turn allows them to adjust their approach for future cases. If someone experiences a breakthrough with a patient (for example, when a patient prefers to pee in a basin rather than going to the bathroom but a nurse manages to motivate her to use the toilet instead), this is discussed and analyzed among staff members to better understand what happened, why it happened and how the right conditions can be created that will lead to more breakthrough moments.
Lean Thinking has made a lasting impact in the home services in Vestre Toten: the teams have a better structure to support their work, patients see fewer nurses than before, and the borough has learned that people can live longer at home when the emphasis is on their needs rather than on those of the borough itself. There is no doubt that the biggest impact has come from the development of people. Since the home services started working with lean, the teams’ skills set has become much stronger, which has led to better quality services. Additionally, the job of home nurses has become more interesting as they can now carry out procedures at home that were previously considered possible only in hospital.
Lean starts with the customer, and in public services the customer is the one receiving the service. Once we start to put patient care at the heart of our work, we begin to generate benefits for all parties involved. Lean tools are there to teach us how to make the work easier for our front-line people so they can easily do what they do best – create value for patients.
And indeed, in Vestre Toten, the sum of the improvements and changes made also had a remarkable side effect: people in the final stages of their lives are now allowed to stay at home until the end, with good care and support. Just a few years ago, when the focus was on getting people into elderly care centers, this was considered utopian. Then again, lean has been known to prove the impossible possible.
The Lean Movement is gaining popularity in the construction world, and with good reason–it’s about cutting out waste and increasing value-added activities. Who wouldn’t want that?
Among a myriad of other benefits, removing waste from the process drives greater profits, reduces risk, improves safety, shortens schedules, and improves relationships. Some types of waste as defined by Lean including: 1) Excess Transportation, 2) Inventory, 3) Unnecessary Motion, 4) Waiting, 5) Overprocessing, 6) Overproduction, 7) Defects and 8) Under-utilized Talent. A previous post covered this topic greater in depth.
In addition to tackling these wastes with typical lean processes such as the Last Planner System, 5S, Value Stream Mapping, etc., how can you leverage technology to reduce waste? Below are six categories of technology that you should be looking at.
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A recently completed research report studies ten projects that all used multiparty agreements and Lean practices1. The conclusion? Integrated Project Delivery (IPD) motivates teams to collaborate and Lean provides the means to achieve it. IPD is sometimes seen as onerous and complex because it demands that owners and project teams negotiate contract terms such as the shared risk/reward pool and terms of fiscal transparency.
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ur company applied Lean techniques to hurricane planning and preparation in advance of the 2017 hurricane season, which turned out to be one of the most active and destructive hurricane seasons of all time. The teams involved followed a Lean process: plan, do, check, adjust. The result was a host of lessons learned that were applied to planning efforts for the 2018 hurricane season.
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Kato-san is the president of Avex in Japan and is very conscious of the heritage his father and grandfather bequeathed to him: “I would summarize it as know-how (grinding and machining small parts with high accuracy), the art of craftmanship (monozukuri), and the absolute need to develop people (hitozukuri) to ensure the company will last 100 years and more.”
Kato-san had to learn his job from senior workers, as his father died when he was still a student. Yet, the heritage has held strong for 70 years and three generations. You can see traces of it everywhere in Avex. Take craftmanship as an example: Avex prides itself of having an in-house approach to feeding machines, maintenance and building IoT. The daily cleaning of the machines is done with both know-how and care.
Today, I am visiting Avex’s Tado plant, which manufactures auto transmission valves and is a tier-2 supplier of Toyota and of other carmakers.
Life for Avex hasn’t been a bed of roses. “In fact, the work we have now will someday disappear, as the car industry moves towards hybrids and electric vehicles,” says Kato-San. The company knows this and is prepared for it, because it happened before: Avex actually started making with parts for sewing machines, until the market shrank and production moved overseas; then they turned to small parts for 8mm projectors, but those too disappeared when video came; then they manufactured brake parts, but the industry switched to resin.
This is why, instead of focusing too heavily on the products (which keep changing), the company concentrates on the technology and know-how so they can be used in different markets. They are already testing out new opportunities: they have started to produce parts for the Mirai (hydrogen fuels), while also looking at agriculture and co-generation (converting gas into electricity). Kato-san smiles and tells me: “Competition in Japan is fierce. Younger generations are also losing interest for cars. And, by the way, our 40-cent auto transmission valve is installed in cars that range in price from $15,000 to $200,000.”
The resilience of Avex is unbelievable. The 2008 crisis had a big impact on their sales but they recovered quickly and without any lay-offs. No wonder Kato-San keeps an eye on all external threats. “I believe that my role, as President, is to split my time between customers, both to understand their needs and to seek opportunities for diversification, and the gemba. My job is to go and see.”
By the way, external threats are regularly shared with employees: twice a year, all plant members gather to learn about the company’s situation and, every month, the President explains the results and the long-term vision in each plant.
As Kato-san tells me this, I am impressed: to me, looking at threats without blinking and preparing for them, and relying on a strong heritage and common values to steer the company towards a bright future is an art. Avex shows the way and gives meaning to what each Avex employee does every day.
“We constantly strive to produce a good and reliable product and we try hard to be a company that serves society, through job creation and taxes,” Kato-san says. He is thinking of Toyota’s famous equation of Profit = price – cost and confirms to me that his role is to make Avex competitive in Japan. He refuses to offshore production or part of it to a lower-cost country to stay in the market.
Avex employs 400 people today (it was 100 in 2008), with two plants and a Techno Centre (created in 2012 to improve the cutting/grinding process for hard materials with low tolerance – linear solenoids, + or – 2 microns). In addition to longer term threats, the immediate challenge for the company is simple to understand: the automotive business requires 1 to 2% productivity improvement from suppliers every year. Kato-san has therefore summarized it in a simple internal challenge, whereby everything is to be halved: the tolerances on the products to improve accuracy, the costs, and the lead-time. “We have to kaizen all the time. Everyone must have the sense of kaizen, the sense of urgency, of challenge.”
And this confirms, as we start our gemba walk, that the most critical topic for the company is the development of people (after all, machines don’t kaizen and don’t perceive urgency, threats and competition).
As a supplier eager to satisfy its clients, Avex listened carefully over the years to the values and concepts Toyota promoted up and down its supply chain. “Respect for people” particularly resonated with the leaders of the three generations of Avex.
The Tado plant is not close to any major urban area (although, arguably, in Japan a major urban area is never too far away) and recruits people who wish to stay in the area, as their elders did before them. As the Japanese workforce decreases, competition gets fiercer among would-be employers, which makes it very important for them to offer an attractive workplace. So, how to find a balance between ambitious work challenges (the sense of urgency Kate-san was talking about) and a rich life with their family? What needs to be done so that employees find joy in their work?
The Kaizen activities we see on the gemba are an answer to both. As Avex employees improve their work environment and reduce defects, they both keep Avex competitive and experience autonomy and pride.
Trolleys are designed by the technicians themselves and adapted to their needs and height. Parts coming out of a machine fall softly on a turning table and this is the result of a kaizen, to prevents parts from falling on top of each other and thus generating scratches.
As we move over, we see many such examples of feeding or downloading equipment that are a clear Jidoka concept, where the machine should have full autonomy and not require a human resource to stay over, watch it, feed it and collect the parts. This is also a result of the “respect for people” ethos the company has, by the way, and the importance of giving human beings value-added work to do, if only to retain them and make them happy to come to work.
Forty collecting machines have been installed to collect the parts form the grinding machines, thus freeing up the technicians and allowing them to perform other tasks, such as maintenance, or designing and building other feeding or collecting machines in the Jidoka promotion section.
At Avex, kaizen is managed through Quality Control Circles (each with 4 or 5 team members). This is demanding because each has to perform his or her work and attend the QC circle, but this is the point – to make the daily work easier. As we now know, kaizen and QC Circles aren’t only meant to solve problems (0 defect) and improve work (0 muda). They also contribute to the development of skills in terms of presentation, communication, collaboration, and leadership. As we stand close to the QC circle board on the floor of the 90 grinding machines, we can see that each QC Circle member actually self-assesses against the above skills to see whether they are making progress. One of the underlying objectives of kaizen activities is to promote teamwork!
Kato-san is clear on this: “I often go to the gemba to see the kaizen, a simple form of recognition for the work done. And if the kaizen is successful, I praise the people responsible for the result.” In addition, formal kaizen presentations are held every year, which top management attends to advise and praise. Avex has designed a one-page sheet to present the kaizen that details the “why”, the current state, the factor analysis, investigation and measures, a check of course, a new or changed standard and reflection on what they learned and what the future steps could be. The first objective of those presentations is motivation, of course, as workers get to discuss with management, and incentives are granted to the teams (never to individuals). But also yokoten (rolling out the results of the kaizen to other departments), as everyone can learn from the experience of others. By the way, kaizen presentations are not limited to workers, but also supervisors and Sales and Administration staff.
The average age at Avex is 30 and the 6% turnover ratio is in part represented by those young people leaving because they don’t see a future. “HR development remains one of the key challenges in our hoshin,” sighs Kato-san. Consequently, in addition to kaizen, the company is developing a career plan for each team member.
Talking about challenges and difficulties is one thing, but we should remember that Avex knows its TPS inside out. No bad parts are passed on to the customer, with the customer ppm at 1 to 2 defects per 10 million parts delivered! As the internal defect rate can be higher, a final inspection of parts is done systematically. As our gemba walks continues, we see that the collecting of parts is now being done by in-house robots. When we reach the final inspection area, we see robots in use there, too: they can inspect more items than the human eye. True to the craftmanship heritage, Avex sent operators to university to learn how to design and maintain machines, and they are progressively adding an IoT know-how to their skills.
They work with their Toyota Tier-1 customers in a pure Just-in-Time way. “Just-In-Time,” says Kato-san, “is a system to develop human skills and to connect across the supply chain.” The order is received the day before, kanbans are printed and the entire production is pulled (Avex produces 84 million parts a year). Do not ask Avex what happens if they are late to complete one of the two trucks they have scheduled per day. They are never late. Their buffer inventory in finished goods is just one day and this means that, if a machine breaks, they need to have enough skills to repair the machine within 24 hours.
Again, true to the craftmanship heritage, Total Production Maintenance is a well-honed process in Avex, which means they can buy second-hand machines and reuse them, thus achieving an 80 % capex reduction versus a new machine. Every day, operators spend 10 minutes cleaning their machines. By the way, operators in Avex are called technicians and there is no dedicated maintenance team. Technicians do far more than operating machines. Parts are 100% guaranteed: operators therefore need to understand their machine very well. “My machine is my child” is their motto. As it often happens in Japan, Senior Operators educate Junior ones. Two days are dedicated to preventive maintenance every year, with all the technicians involved.
Just imagine the second floor of Tado, which houses 90 grinding machines. The company is gradually moving from one operator per machine to one for up to five machines, with a target to get to one for ten machines. With the idea of “respect for people” and the “no lay-offs” policy, the role of the human is more and more to design, maintain, kaizen machines – rather than to produce parts. Today, 70% of the company’s employees work in production and 30% in non-production functions (from management to logistics and maintenance), whereas in the future this will probably be reversed.
As I raise the question of production flexibility, Kato-san smiles: all machines are on wheels to allow reconfiguration. The Tado plant is dedicated to the high runners and mass production, so one machine is dedicated to one product. But the Nagoya plant is designed for smaller series and does many change-overs during the day.
With external threats like the obsolescence of your products or the need to find new market opportunities and new customers, those who can offer the best know-how and the flexibility to start small series of parts on demand will survive. Avex seems well prepared for both.
THE AUTHOR
Catherine Chabiron is a lean coach and member of Institut Lean France.