Friday, May 4, 2018

Andon Cords and Practice Environmentalism

One of the innovations that Toyota put in place on their assembly lines is the "Andon Cord."

As the picture below illustrates, it is an actual cord (or button) that any worker can pull, which then sounds an alarm and even stops the production line if the problem cannot be resolved quickly. The alarm (blinking lights and chimes) immediately brings (to the gemba) the team leader (supervisor) to address the problem and mutually decide how to fix the issue in real time. If there are recurring problems, the team leader would then help with root cause analysis. This is important so that the same "fires" aren't being put out over and over.

Photo courtesy of Mark Graban
This demonstrates several basic precepts of the Lean philosophy. One, quality is built into the processes. Two, quality (and safety) is part of everyone’s job description. Three, problems are handled where and when they occur. And, four, creating and maintaining an environment of respect and mutual trust between the workers and the leaders.

Now, I am not suggesting that physical ropes be hung throughout the practice, or that alarm buttons be placed in every room. Although, a practice I worked for used a software management program that dedicated one the Function keys so, if pushed, it would alert all of the other computer stations that help was needed in the room where the key was activated.

What I am suggesting, however, is more metaphorical. Our practices need to be a place where anyone feels comfortable speaking up and symbolically "pulling the Andon cord!"

Lean, as much as anything else, is a culture. It is a culture that allows for mistakes and defects to be brought to management and other staff without fear of embarrassment or retaliation. And, to be handled by everyone with a stake in the process. Nothing else about Lean will ever have a chance without this concept being firmly in place and fiercely protected.

I know of a case where a young veterinarian mistakenly amputated the healthy leg of a dog, despite being informed by the surgery techs prior to surgery that this was about to happen.

This veterinarian, however, had very little respect for the staff and had created an environment around her of intimidation and fear. The staff did not feel comfortable in stopping the surgery (pulling the proverbial andon cord) when the patient was prepped incorrectly and placed on the surgery table with the improper limb draped in order to verify if it was the correct leg to remove and everyone was on the same page.

Leadership and management are the practice “environmentalists”; protecting the practice environment from all “trash and pollution", such as egos, jealousy, fear, detrimental internal competition, etc.

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Hear ye! Hear ye!

Please mark your calendars for Monday, May 7th at 1:00pm ET when I will be giving a webinar for KaiNexus with host Mark Graban. The title of the webinar is:

From Pets to Vets: Applying Lean In Unexpected Places

Please join us! You can register here.

and you check out a preview of the webinar here.