Day 4 - ELP - Boston, MA

I have to say that the stamina is impressive of our group! 4 nights in a row of heading to bed after midnight, getting up by 6:30am for breakfast, and spending all day in class and studies! This is hump day for our week - 3 days down, 3 days left before a break.

Today we had 4 case studies and a mid-week evaluation session. It was a packed day, including studies of Benihana, Toyota Motor Company, Sealed Air Corporation, and Aqualisa Quartz showers. One of the good things they do here is to vary the professors, so we had three different people leading the sessions today.

Benihana is the quintessential assembly line restaurant. Ever thought that way when you've been there? Here is the secret: cycle time. From the time you walk in, they are creating a way to have you matched with enough complete strangers to create a table of 8 people, ready to watch a show that has been highly orchestrated to enable you to enjoy yourself for exactly 60 minutes, and then get out. The design of their locations takes you from station to station, a total of 8 of them, on their schedule, with little cues that move you to the next station. Everything is purposeful, without being too obvious (I think). By the way, when the chef finishes the tower of flame after cleaning the grill, and turns the lights off, that's the cue to leave. So leave, and don't forget the big tip!

Impact on My View of Management:
I need to spend more time improving my knowledge of our "cycle times" and on finding and working the bottlenecks. And, we have to remember at all times what the step or actor in our process is the most valuable, and maximize its value and minimize its waste.

Actions I Can Take:
We need to work to improve our reception areas to be focused on the needs of our members and patients that they find will add value, not what we want them to do. They don't want to sign up for kp.org, or take surveys, or receive education and training. So, we need to discover that value-add and make it the key part of our member's visit time.

One could spend a whole two weeks studying Toyota. We did a fly through in 90 minutes of their plant in Georgetown. The key: empower the front line to do the work, manage the workflows, determine the optimum way to build a car, and have managers serve as teachers and helpers, not as bosses over the team's capability to do the work. The lessons learned from our study and discussion included that process is the foundation for execution, that we must understand root cause when problems occur (asking Why five times), that the front line has the best knowledge of the work we do, that managers should set the tone and support the team, and that growth quickly amplifies the complexity of a situation.

Actions I Can Take at Work:
- should we think about using Vocera as our "andon" cord? That's the cord that the Toyota worker can pull to bring attention to their part of the assembly line to analyze and improve the workflows.
- we need to analyze our work flows and follow the four rules from Toyota:
1. all work is highly specified in its content, sequence, timing, and outcomes
2. each worker knows who provides what to them, and when, at every station along the process
3. every product and service flows along a simple, specific path, with minimal waste and effort to improve or perform the intended action at each station
4. any improvement must be made through the scientific method (hypothesis, test, etc.), under the guidance of a leader, done at the lowest possible level of the organization

Sealed Air corporation owns more than 90% of the market for packaging materials that are put in boxes by companies when they are shipping their products. They make bubble wrap, foam sheets, packing peanuts, paper, the new air pockets, a foam based solution that fills the space that it is squirted into, and any number of customized containers (like the trays for fruit in grocery stores, etc.). But, the business case showed that they faced a moment a few years ago that defined their survival - they weren't sure what they were, either a coated bubble wrap company (which was the bulk of what they did), or a packing materials company. They chose correctly! And the lesson - we need to put every choice through the filter of "What business am I in?" and "How do I define the quality of the work that I do?". Invariably, when people and companies lose their way, they've forgotten those 2 simple questions.

Our last case of the day was a story about Aqualisa, a shower equipment supplier in England. Notoriously known for having the market leading shower head, they created a new product with an electronicly controlled pump that increased the water pressure by 6 to 7 times what was available coming through the pipes. They bet the company on the new product, and then it didn't sell. They were able to figure out their issues, and found the following keys that we can incorporate into our setting:

- Innovation requires not just a product, but it has to have a marketing plan
- Companies expect experimentation and false starts with Research and Development, but they should expect the same thing with Marketing - it isn't right the first time most times
- One has to constantly evaluate consumer, channel (selling), and corporate behaviors and recognize that products (or services) have to change with those behaviors change; miss the clues, and pay the price
- Discover who in an organization is blocking progress, and engage them in creating alternatives that meet their needs and expectations

Our last session of the day was a debrief about our impressions so far. We all commented on the need to further connect our lessons here with our day to day lives at Kaiser. Amy did a great job of reframing our expectations, and that we shouldn't be disappointed if those connections aren't clear now - they will be by the time we are done!

Becuase we also have 4 cases tomorrow, there was no going out tonight. More studying and more discussions about how we can improve our own areas of the organization. My apologies to everyone for the dryness of this post. It's 1:30am and time to go to bed!