Video on Kanban in Healthcare that You Need to See
My experience is that good definitions, descriptions, and case studies of effective kanban are hard to come by. It’s the same with takt time…everybody knows the formal definition and is happy to repeat it but not many seem to want to go past that and give illustrations and examples that help instruct and enlighten.
So, I was particularly happy to stumble across this video about the use of kanban for ob/gyn supplies in a Sasketchewan hospital. It’ all below the fold, so watch the video first, then read my thoughts on it.
OK, here’s the video. It’s ten minutes long but it’ll be the best ten minutes you use today, I guarantee.
There’s a lot in that video, so let’s go over it.
Notice first that the whole system was designed by the people who actually use it. Not a consultant or the hospital “lean champion”. That’s not an indictment of such folks; it’s meant in the spirit of support. Too often, consultants and lean champions are held accountable for figuring out and implementing lean tools in the organizations for which they are working. That’s bogus. Teachers can teach but, necessarily, the folks who are embedded in the work systems and processes must design and implement the changes to those systems and processes. What if they just aren’t very interested in making the necessary changes? Well, then nothing the consultant or “lean champion” can do is going to work. Believe me, I speak from experience on this one.
Second, notice that the team spent a week putting the basics in place, and still a good bit of ongoing tweaking, correcting, and improving has been necessary. When it comes to implementing pull systems, there’s no such thing as getting it right the first time. There’s no such thing as “plug and play” in any lean initiative. It’s too complex and it represents too big a change from legacy approaches. Just look at all the details the team at the hospital has had to consider. The number of bins. The colors of the bins. The bar codes on the sides of the bins. The size and design of the racks. The layout of the store room. The quantities of each of the many materials in each kanban. The development and documentation of new procedures. The development of training. And on and on. It takes time and energy. And we wonder why there is resistance to change at times.
Third, I’m always all about visual factory and the video makes clear the importance of those methods in the successful implementation of the kanban. It’s not just the colored bins. It’s the page hanging from the rack that lists everything on the rack. It’s the “user friendly” training format. It’s the layout of the room. Even I tend to think of visual methods as being mostly about labels and lines on the floor. As we see in the video, there’s a lot more to it than that.
All in all, we see that kanban works well but implementing it isn’t for sissies. The team (as well as its sponsors) must commit to lots of work before implementation and lots of work after.