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.

So Why Did Pascal Dennis Update a Classic Book?

I spoke with Pascal Dennis this past week and had the chance to ask him a few questions about the recent publication of his new book Lean Production Simplified, Third Edition: A Plain-Language Guide to the World's Most Powerful Production System.The two previous editions of this book have been very successful with Lean practitioners at all levels within organizations, and these books have proven to be the best introductory texts to Lean methodology on the market. Here are a few of the questions I asked him and his answers follow.

What motivated you to originally write the book Lean Production Simplified?

I wrote the first edition of Lean Production Simplified hoping to share what I’d learned at Toyota. It had been my blind luck to work with patient senseis. I felt that if I could explain things simply, then perhaps I had gained a certain level of understanding. During the past 20 years, I’ve been the sensei helping companies apply the Toyota system or Lean. My practice has taken me far from the Toyota shop floor – into hospitals, power plants, container terminals, and research laboratories.  I’m certain that I learn as much as I teach. And the more I learn, the more I think of Socrates -- "The more I know, the more I realize I don’t know."

Why did you write the 3^rd edition? 

We must learn the Toyota system – and not just in manufacturing.  Hospitals, banks, universities, software developers, government agencies and other service providers are also hungry for Lean thinking and methods. Customers will no longer accept substandard safety, quality, delivery, or cost performance. 

Who composes the audience for this book?

Leaders and learners at all levels in manufacturing and in the ‘undiscovered countries’ – healthcare, financial services, the process industries, software development, construction, universities and the public service.

What’s different about the 3^rd edition?

I’ve added many more examples from outside the factory (e.g. design, engineering, administration, etc.) and from the industry sectors I previously mentioned. I’ve also included study questions at the end of each chapter.  My hope is that this third edition will be a working book, and that I’ll continue to find in the gemba, filled with highlights and notes in the margin. My study of aikido had prepared me for the Toyota “way.” I understood that it was a "do" or path, and that the Toyota shop floor was a dojo -- a place where you practiced a profound art or worked on your technique and on yourself.  Indeed, before stepping on to the shop floor, I felt like bowing -- a sign of respect for my team, organization, and the art of management. I still feel that way.  

What are your thoughts on Pascal's book Lean Production Simplified? Did it help you understand the objectives of a Lean initiative and enhance a successful journey?