Pascal Dennis' New Book -- Andy & Me and the Hospital -- Addresses Healthcare Challenges

One of the top Lean thinkers and coaches, Pascal Dennis, just published a compelling new novel titled Andy & Me and the Hospital: Further Adventures on the Lean Journey . Continuing the story established in his Shingo Prize-winning book Andy & Me, this latest book shows how Tom Papas and his sensei, Andy Saito, face perhaps their greatest challenge yet – a major New York City hospital.

I had the chance recently to ask Pascal some questions, so I’ll reproduce them here followed by his answers:

Why continue the story of Tom and Andy in a hospital/healthcare setting?

Health care represents Lean’s "undiscovered country." In fact, I spend much of my time coaching senior health care executives. In the book, Tom Papas calls health care a "dark realm" – full of risk, but also full of opportunity. If we don't get health care right, it could bankrupt us. But if Lean thinking and methods take root here, we’ll greatly improve people’s lives.

Given Tom and Andy’s background in manufacturing, how can they function in a major hospital?

Every industry entails a series of processes. Health care value streams, for example, typically begin with Registration and conclude with Discharge with various process flows in between. 

Flow depends on standards, connections and pathways – which Tom and Andy are adept at seeing. Their challenge is to learn the language, technology and culture of healthcare, and to translate Lean thinking and methods in a way that’s understandable and motivating for hospital leaders and team members. Translation is a central theme. What does Flow mean for an Emergency Department? What does Quality in the Process mean for an Operating Room or a Pharmacy? What does Strategy Deployment mean for a major hospital?

Why this book in particular?

I want to answer some basic questions. What does a Lean transformation in a hospital feel like? What overall approach should we take? What kind of leadership and behavior change is needed? How do we develop and engage people? How do we improve processes? How do we build a management system? How do we translate what Deming called the "profound system of knowledge"? 

At the same time, I want to provide a clear and simple guide to Toyota thinking and methods, how they fit together, and the spirit that animates them.

Why a sequel to Andy & Me?

Readers seem to connect with Tom and Andy. For me, they’re real people with problems, doubts and weaknesses. Transformation is hard, life is hard. Tom and Andy struggle with difficult problems and they only partially succeed. But that makes all the difference. Another of the book’s core themes is that the sensei has to grow and change, just as much as the deshi. Tom and Andy’s journey and relationship are hopefully a useful metaphor. 

For those who have read Andy & Me and the Hospital: Further Adventures on the Lean Journey: Feel free to post your comments.


Why Process-Improvement Initiatives Can Fail

An insightful new book titled The Basics of Process Improvement by Tristan Boutros and Jennifer Cardella just recently hit the streets. Process improvement, as most know, can be quite a complex topic, but this book shows organizations how to achieve success by fixing basic operational issues and problems using a broad and wide-sweeping process-based toolkit. 

I recently had an enlightening talk with Tristan, and I asked him: What causes many process-improvement initiative to fail? Here is his response:  

In the current economy, many process and quality organizations are looking for opportunities to elevate their departments to become true business enablers. Unfortunately, even the most sought-after business process improvement projects can fail. Here are four common reasons that these efforts fail: 

1. Lack of Management Support - Regardless of organizational size, attempting to initiate a process improvement effort without clear and publicized support from management can make improvement efforts challenging. As process improvement projects are often difficult, reinforcement from management that improvements are necessary and appreciated is critical to any team's success. 

2. Organizational Resistance – In many organizations, corporate culture can also make process improvement efforts difficult. Given the fact that process improvement efforts have the potential to uncover individual or system weakness, or even departmental challenges, it’s common to find resistance when improvement efforts are undertaken. 

3. Lack of Involvement or Representation – Improving a process without ensuring that all of those with a vested interest are represented during the effort is sure to bring hurdles. All stakeholders from each part of the process should be invited to participate, as end-to-end understanding is needed to properly make recommendations for improvement. 

4. Overemphasis on Technology - Although technology is playing a larger and larger role in process improvement efforts, the outcomes need not be about technology at all. In many cases, simple training, activity, or culture improvements are all that is required. Properly leveraging technology in ways that optimize a process is key towards true improvement. 

In any environment, taking slow and deliberate steps towards improvement can help ensure your project is a success. Ensuring leadership endorsement in place, being inclusive, ensuring your projects consider all areas of improvement, not just technology, while also ensuring the importance of your project is communicated throughout the organization can make all of the difference.  

I'd surely like to hear from those who have lead or participated in a process-improvement initiative and have stalled because of particular problems. Were they like those that Tristan described?