While Mark Graban and I were at the recent TVMA Convention and Expo presenting our Lean lecture a couple of weeks ago, a veterinarian came up to us and said that he routinely schedules each of his staff to spend 30 minutes several times each week to just observe procedures and flows around the hospital. In Lean terms, these are called a “gemba walks.” We, of course, think this is a great idea, and it reminded me of the story of Taiichi Ohno and his chalk circle (Ohno’s circle).
Taiichi Ohno was an engineer at Toyota in the 50s. He is considered to be one of “The Fathers of TPS” (Toyota Production System). The story says that when a new engineer was assigned to him for mentoring, he would take the individual to the shop floor (gemba), draw a four foot circle on the floor, near one of the processes of the production line, and “ask” him to stand inside the circle and observe for any improvements he could find. With no other instructions, Mr. Ohno would leave.
After several hours, he would return and ask the young engineer what he had observed. If Ohno was not satisfied with the response, he would again “ask” that the trainee remain in the circle and continue to observe, and, again, leave for several hours. Evidently, some of these “students” spent as much as an entire eight hour shift standing in Ohno’s circle and considered it an honor to do so; to learn from the master. The improvement they suggested could be as small as moving the pneumatic wrench two inches to the right, so it would be easier, and faster, for the worker to do his job. Now, you know there have already been several hundred (or thousand!) iterations of kaizen when moving a tool two inch is the only improvement you can find!
After several hours, he would return and ask the young engineer what he had observed. If Ohno was not satisfied with the response, he would again “ask” that the trainee remain in the circle and continue to observe, and, again, leave for several hours. Evidently, some of these “students” spent as much as an entire eight hour shift standing in Ohno’s circle and considered it an honor to do so; to learn from the master. The improvement they suggested could be as small as moving the pneumatic wrench two inches to the right, so it would be easier, and faster, for the worker to do his job. Now, you know there have already been several hundred (or thousand!) iterations of kaizen when moving a tool two inch is the only improvement you can find!
What Ohno was trying to demonstrate to these young managers is quintessential Lean. It is not enough to just “look.” One must truly “see”; to deeply understand the process and how it affects the value stream, the greater systems, the customer and the worker at the gemba. Even more importantly, he was trying to instill into their “being” the process of how to think, to analyze, to pursue perfection through continuous improvement (kaizen).
Now, I think most of us here in the west would consider Ohno’s circle to border on the “cruel and unusual,” but I celebrate the veterinarian I talked to for his vision, understanding and the investment in the long term effects of assigning “gemba walks.” I hope he is also carving out time for himself and the other doctors to observe the work that occurs around them. I think we, as doctors, owners and practice managers, act like we know everything that is going on in our hospitals (our gembas), yet we know that isn't true. We just put off dealing with it, and the problems keep recurring. When was the last time we went into our “waiting room” and just observed what was really happening? Might we be surprised at what we saw?
The other thing that I hope is happening at this vet’s practice during these “walks” is that everyone is stretching their comfort zones. In other words, the surgery tech should spend some observation time at the exam room gemba, the receptionist should go to the surgery gemba, the kennel tech should go to the reception gemba, etc.
After a few “walks”, I think it is important to schedule an additional period of group reflection (hansei). Did you discover something you weren't expecting? How did your idea(s) of how processes were occurring compare with reality? Did you find some opportunities for improvement (kaizen)? Were you able to see your value stream from your client’s point of view? How would your staff change things? Why? Use the Socratic method of teaching by asking questions, so everyone deeply understands, learns to think and create ideas for solutions.
After a few “walks”, I think it is important to schedule an additional period of group reflection (hansei). Did you discover something you weren't expecting? How did your idea(s) of how processes were occurring compare with reality? Did you find some opportunities for improvement (kaizen)? Were you able to see your value stream from your client’s point of view? How would your staff change things? Why? Use the Socratic method of teaching by asking questions, so everyone deeply understands, learns to think and create ideas for solutions.
“Gemba walks” are an easy, inexpensive, enlightening experiment into the Lean culture. Schedule them at your gemba, and then be sure to share your experiences with the rest of us by adding a comment to this post.