In 1987, my company, United Electric (UE) initiated an ESL training program to support our continuous improvement efforts.  The idea came from a factory supervisor who noted,  “If we really want to create a continuous improvement culture we need to give our employees an opportunity to read and speak English.”  Over nine languages were spoken in the plant and while many employees understood enough English to get by, few spoke or read English well enough to get ahead.  In order to discuss problems and share ideas, it was essential for UE to invest in ESL learning for its employees.

With funding from the Massachusetts Workplace Education Initiative and under the guidance of a gifted ESL teacher, UE’s HR department established an ESL curriculum that was astounding in its impact.  Employees attended classes during the workday and curriculum was thoughtfully constructed to support their particular jobs.  Ironically, as UE adopted concepts from TPS over the next several years, Japanese words were added to ESL student’s lessons. Employees were learning English, but also Japanese words like Kanban and Poka-Yoke, concepts that now were part of their second language.  The difference in the work environment was notable almost immediately.  Persons who might have previously been considered “difficult” were actually just frustrated at being unable to describe the problems they faced in their work.  ESL had opened the lines of communication, changed attitudes and unlocked creativity. What had been a virtual Tower of Babel was developing as a rich multi-cultural team.  The proof of the transformation showed in UE’s 1990 award of the Shingo Prize, heralding its excellence in quality, productivity and customer service.  While this was truly an honor, perhaps a more meaningful recognition was yet to be bestowed.
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On January 28, 1991 in midst of the first Gulf War, another war was being waged by then First Lady Barbara Bush.  At the invitation of the Massachusetts Commonwealth Literacy Campaign, Mrs. Bush visited UE to celebrate with ESL students from our 1991 class and promote the critical importance of adult literacy.  The day was extraordinary on many levels.  First, due to the Gulf war, security was extremely tight.  Parking was cordoned off for two blocks around building and bomb-sniffing dogs scanned the factory and offices. Because we were advised only a few days earlier that our site would receive a visit from Mrs. Bush, cleanup activity in the plant was frenetic.  Workplace organization, which was normally very good, achieved new heights.   Halls were given a fresh coat of paint and floors were buffed.  Even the elevator, which was normally used only for freight, was painted red, white and blue.  We were honored that the First Lady and number one advocate of adult literacy would visit our site.

Shortly before 2:00 p.m., as an armada of state and local police cars could be seen in the distance escorting the First Lady’s party, the excitement was palpable.  After formal greetings in the lobby with management, Mrs. Bush proceeded to our ESL classroom to attend a class and meet with students.  In preparation, each student had written a short story or letter to Mrs. Bush, and ESL compiled these into a booklet entitled “Short Stories and Letters,” a tangible memento and testimony to the power of ESL.  A letter from one of the students, a gentleman who emigrated from Aleppo, Syria summed up the sentiments of the class:

“When I first came to America, I felt stupid because someone talked and I looked at their faces and never did I understand. It is important to have ESL in the workplace because now I can understand the blueprints and the order papers.  I understand what my supervisor says.  I am starting to read the newspapers and write my own checks.  I can take care of my family shopping and my home. This month, for the first time, I wrote down two valued ideas to save the company money.”

Following the ESL class, Mrs. Bush accompanied students to the Gemba where students proudly demonstrated some of the many improvements they had made to their work.  I am absolutely sure that none of these stories would ever have been told without the investment made in our employees to learn English as a second language.   Having the opportunity to offer this testimony directly to the First Lady of Adult Literacy was a powerful moment.
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After Gemba, Mrs. Bush and an entourage of secret service, political dignitaries and labor leaders boarded the red-white-and-blue elevator to attend a meeting in the cafeteria for speeches and photo ops.  I was asked to provide a short speech of no more than five minutes about the value of ESL and its impact on our company and our employees.  I recall that this was the one and only time in my career that I wrote a speech down, memorized it and presented it verbatim – exactly five minutes in length.  Several other five-minute speeches followed including one from our Governor Bill Weld.

Finally, the great lady spoke, culminating the eventful day.  She spoke first of the importance of literacy to our country and our families, relating the goals of her literacy foundation.   Mrs. Bush then addressed the ESL students, thanking them for their diligence and applauding their efforts.  She then turned to Mr. Weld, quipping  “perhaps the State of Massachusetts could learn something about continuous improvement and problem solving from these students.”  The room erupted with laughter as the Governor nodded in agreement.  After a short reception, the magic day was over and we all got back to work, grateful to have had the First Lady of Literacy in our midst.

Thank you, Barbara Bush.
O.L.D.

A blog post by Bruce Hamilton; Subscribe at www.oldleandude.com

Last month I joined Eric Buhrens, CEO at Lean Enterprise Institute (LEI) to host a leadership team from the Tel Aviv’s Sourasky Medical Center.  They were on a study mission to many of Boston’s fine hospitals and were winding up their week in Boston with a visit to LEI.  Early in the discussion one of our guests asked, “In a few words, please tell me what Lean is.”   Eric fielded this question concisely, explaining “Lean means creating more value for customers with fewer resources.”   He then asked me to relate the following story, a bit more long-winded, to amplify the concept:

I had a recent sojourn of more than a few days at one of Boston’s finest hospitals affording me a rare opportunity for extended direct observation of the process.  In Lean lingo, I was observing from the point of view of the “object” of improvement —  the part to be worked on.  In a factory, the object of improvement is a piece of material, a part being progressively converted by agents of improvement into a finished product.

Clinicians bristle at this analogy.  People, after all, are not widgets.  Of course, I agree.  Patients are each of them unique, and the task to make them well is anything but standard.  Caregivers must often make split-second decisions based upon years of experience and practice, spanning an enormous range of different potential conditions.  They are indeed agents of improvement, operating singly and as a team, with a passionate commitment to making the patient well. From scrub techs to cleaners to docs, surgeons, nurses, and administrators, these caregivers adroitly shift gears from one minute to next, at one point calming a delirious octogenarian who is screaming in the middle of the night for a pepperoni pizza and then a minute later resuscitating a gentleman in cardiac arrest.  As one of their recent customers, I extend my gratitude.

But, as I note in the Toast Kaizen video, “continuous improvement is not so much about the work as the things that get in the way of the work.”

Therefore, please allow me to offer an example from my extended observation.  For a period of days, I was tethered to an IV connected by about six feet of plastic tubing to an infusion pump and IV solution bag.  The dosage rate required the bag containing the elixir to be replaced approximately twice per day.  I say approximately because the flow of medicine was interrupted on average once per hour by a pump fault – an airlock in the line. When an airlock was sensed the pump would pause and alarm.  A nurse would then come by to adjust the tubing above the infusion pump, clear the fault and continue the infusion.  Depending upon the level of activity on the floor, wait time for the nurse ranged from a minute to fifteen minutes.  Oddly, if the fault was not attended to in the first five minutes the alarm grew much louder.  This I am told is a countermeasure to “alarm fatigue”,  a condition which occurs when there are too many alarms to handle at one time.  My sense is that the increased loudness did little more to alert the nurses; it was just an addition to the ongoing cacophony of alarms sounding throughout the floor.  In my own case, however, the increased loudness caused me to hit my call button.  This sent a signal to the nurse’s station that, after hearing from me that my infusion pump was alarming, would summon the beeper my nurse was carrying.  Depending upon the level of the many non-standard things that could be happening on the hospital floor, this might elicit an immediate response – or maybe not.
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When the pump alarmed, I understood that my need was not the most critical, but felt compelled to ask my nurse – actually multiple nurses over a period of days – what they thought might be done to reduce the incidence of airlocks in the line; for example, did they think the problem was caused by equipment malfunction or set-up or the viscosity of the solution, or perhaps a software issue?  Had they investigated the problem?  I was struck by their responses.
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First, every nurse assumed that my questions regarding the pump were motivated by my own wellbeing. “No,” I exclaimed, “I’m not asking for myself, I’m inquiring on your behalf.  Your time is so valuable, I hate to see it consumed by these kinds of headaches.”  Still, the response was a long-suffering “we do whatever it takes to care for our patients.”  In the minds of caregivers, clearing pump faults was just an inevitable annoyance – part of the job.  The mindset, while admirably focused on the patient, was also resigned to the status quo of common annoyances.  “At what point does an annoyance become a problem?” I asked one nurse.  She responded simply “its hard to make changes.”  Then, pausing for a second, she reflected, “One of our technicians showed me a trick a while back that he said would reduce airlocks in the line.  Let’s give it a try.”  With that, she repositioned the tubing above the infusion pump.    Subsequently, the pump did not alarm for hours – not until a refill solution bag was needed!  The breakthrough here was not so much in the deployment of a potentially better method, but the realization by one caregiver that what she had considered an annoyance was actually a big problem.

Of course, this just a single point of observation, an anecdote.  I didn’t see the nurse again to thank her or ask her what trick she had applied.  I wondered who else on the floor knew about this trick and how many pointless interruptions to their incredibly valuable work could be reduced if the trick became a standard.
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I concluded my story to the management team: “Your caregivers are your most valuable resource.  Management’s job is to create an environment in which the ‘things that get in the way of the work’ are exposed and corrected, enabling caregivers to fulfill their missions with more time and greater focus on making the patient well.”
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What do you think? I’d love to hear from you.
O.L.D.

Attendees of GBMP’s Northeast Lean Conference will learn how to translate Lean transformation to both top line and bottom line growth.

Newton, MA, April 6, 2018– The GBMP conference, coming October 10-11, 2018, to Providence RI, will focus on identifying and sharing the causes of successful Lean transformation and how excellent processes should consistently create compelling profit. 
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“Investment in Lean should have a greater return than many organizations have seen.  This is why we chose Profit from Lean as the theme for our 2018 event, “said GBMP President Bruce Hamilton. “For most organizations embracing Lean, the need is as it was originally for Toyota:  To be profitable.  This need may come from rising labor costs or from declining sales.  Or, it may be caused by the expense of new product development or needed infrastructure enhancements.  The causes of flagging profits as well as their solutions are present in every corner of business, from marketing and engineering to production and supply chain.  Lean systems and tools offer targeted solutions to a myriad of business challenges.”
 
Yet, over the last four decades, few organizations have gained the benefits seen by Toyota.   Many, whose gains are moderate and barely keeping pace with customer expectations, continue to search for an elusive secret ingredient; perhaps a value stream map or an A3, or improvement kata.  Others focus on cultural transformation, the people side of Lean, to give purpose the work and create alignment. 

Added Bruce Hamilton: The question for most remains, “How can we profit from Lean?”   Regardless of an organization’s vision or purpose, the need to make more money than it spends is universal.  As Stephen Covey says, “no margin, no mission.”  

The Northeast Lean Conference attracts more than 500 passionate Lean implementers every year, from the manufacturing, healthcare and service industries. Lean practitioners from the front lines to the back office attend with the goal of networking, benchmarking, sharing and learning all things continuous improvement and Lean – to get the tools, knowledge, inspiration and confidence they need to bring their organizations to higher levels of operational excellence.  Registration is open & an “Early Bird” discount is in effect through June 15, 2018.
The annual event is ideal for executives and managers who play a role in driving Lean transformation and provides exceptional educational benefits to front line team members, CI champions and change agents from all functional areas of any organization.

Featured keynote presenters include Jim Lancaster, President of Lantech & author of the book “The Work of Management: A Daily Path to Sustainable Improvement”, and Orry Fiume, former CFO of The Wiremold Company and co-author of the book “Real Numbers: Management Accounting in a Lean Organization”. Bret Watson, Owner of Jotul North America and Raye Wentworth, CFO & Plant Manager at New Balance Athletic Shoe will also keynote.

There will be more than 40 breakout sessions in five tracks: Lean Leadership, Strategy & Culture, Driving Momentum with Tools, Increasing Value Throughout an Enterprise (Lean isn’t just for the shop floor anymore), Employee Success, Growth & Empowerment, Developing Change Agents & Lean Facilitators.  There is also a dedicated track for Applying Lean in Healthcare. The final agenda is expected to be released in mid-April. To be notified when it is available, follow GBMP on Twitter, Facebook or LinkedIn, or subscribe for updates on the conference's officie website, www.NortheastLeanConference.org

If you would like more information about The Northeast Lean Conference and/or GBMP, please contact Lela Glikes at 617-969-1396 or email at LGlikes@gbmp.org. Exhibitor and sponsor opportunities are still available. Download the prospectus here.