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Jeff Liker

Dan Jones: Goals and means to achieve superior performance

By Jeff Liker, - Last updated: Monday, January 11, 2010 - Save & Share - Leave a comment

Goals and means have to go together. Either one without the other does not lead to lasting improvements. To do this managers need to work together to dig down to the underlying root causes of the often vaguely defined performance gaps facing the organisation. Understanding these root causes helps everyone to focus on closing the vital few gaps that will make the biggest difference to the organisation, its customers and its employees. At which point someone can be given the responsibility for gaining agreement across the organisation using the evidence based, scientific method to implement and test the right countermeasures to achieve the desired results. This is how good doctors go about diagnosing and treating medical problems. Too often modern managers do not use the same rigor in diagnosing and treating operational problems.

At its core lean is about developing the skills and experience of every employee in using this evidence based, scientific method to solve the business problems they are responsible for. It also adds a critical, missing dimension to modern organisations, namely a focus on the horizontal flow of work across departments and organisations that creates the value that customers are paying for. It brings a very powerful framework and set of tools for redesigning these horizontal flows or value streams to eliminate unevenness, overburden and waste. The net results are better value and experience for customers, reduced frustration and wasted effort for staff and freed up capacity and the elimination of unnecessary costs for the organisation. Top management must match this with actions to use this freed up capacity and lower costs to improve the financial performance of the organisation. Turning separately managed activities into an integrated flow of work is the most powerful way of closing significant gaps in performance.

In Making Hospitals Work we describe just such a journey of a typical district general hospital which discovered that by improving the timely discharge and streamlining the end-to-end flow of emergency medical patients through the hospital they could reduce length of stay by 50%, eliminate errors, infections and waiting time and free up the capacity to treat 30% more (and more profitable) elective patients with existing resources. Prior to this their 80 plus rapid improvement events and more than 500 improvement projects were scattered across the hospital, were difficult to sustain and did little to improve the operational or financial performance of the hospital.

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