Improving Processes through Observation

When you come across a story that involves process improvement in both education and healthcare at the same time, you have to share it.

The education part is the Executive Master of Public Administration: Concentration for Nurse Leaders program at NYU’s Robert F. Wagner Graduate School of Public Service. (Let’s see you fit that on a business card.) For their Capstone project, the six people in the program decided to analyze how much time nurses spend getting the equipment they need to get their jobs done.

They carefully observed nursing staff at New-York Presbyterian Columbia University Medical Center. They wrote down how much time nurses spent with patients. They photographed rooms after patients were discharged. They watched what nurses did when they weren’t with patients and they discovered that nurses had to get supplies for each patient from a central storeroom. It wasn’t a quick trip and it took them away from patients, which meant nurses tended to get everything they thought they might need to avoid return trips. Once supplies are brought to a patient’s room, they must be used or thrown away. If they forgot something or needed more supplies, nurses had to return to the central storeroom. They were often…

The 3 P’s: Starting Points for Integrating Baldrige

Where do you start? You want to make your organization more competitive, better able to meet customer needs, less inclined to mistakes, but you’ve been doing things the same way for years and you’re not sure where to begin.

When I get this question, I suggest starting with one or more of the 3 P’s: processes, people, or planning.

Start with Processes. The Baldrige model is a process model because the work of an organization is done through processes. Organizations that haven’t taken a formal approach to process management usually spend way too much time firefighting because their processes are out of control, or they blame people when their processes fail. Neither is a prescription for long-term success.

You can develop a process orientation by first identifying your key work processes, which Baldrige defines as your most important internal value creation processes. If you’re not sure where to start, look at what products and/or services you provide to your customers and figure out the internal steps that design, produce, and deliver those products and services. Then consider the support processes that make these customer-driven processes possible, such as your key processes in sales, marketing, finance, human resources, IT, etc. Once you’ve identified your value…

The Golden Rule in Business?

Treat others as you would like to be treated. That may be the Golden Rule in Sunday School but it’s rarely passed the lips of a business executive. Too often, the business world is one of cutthroat competition, doing anything to get an edge, being obsessive about your secrets, and winning while others are losing.

Zappos takes a different approach. The online shoe company has grown from startup to $1 billion in annual gross merchandise sales in ten years. It’s doing something right. I’ve written about Zappos before in “Zappos and a Sustainable Culture,” which looked at how Zappos developed a culture that gives it a competitive advantage, and its amazing return policy in “Do You Trust Your Customers?” It turns out the company takes a fresh approach to supply chain management, too.

In “A Lesson from Zappos: Follow the Golden Rule,” Tony Hsieh, who was hired when the company started to lead its merchandising team and is now its CEO, talks about Zappos decision to create alliances with its vendors in which “partners aligned themselves to the same vision and committed to accountability, knowing we’d all benefit from achieving our goals.” (HBR, June 4, 2010) Zappos acted on this decision with processes that are…

Ask What, Not Who

Several years ago I did a Baldrige assessment for a well-known service company. It was quickly apparent that a siege mentality permeated its offices with leadership blaming the production facility for problems and production blaming leadership and everybody blaming the customers, who generally disliked the company. When I presented my evaluation of the company’s management system, I told leaders they had a “culture of blameology.”

The most common question in response to any problem was, “Whose fault is it?” As a result, people kept their heads down. Nobody took initiative. Everybody avoided responsibility. Unhappy and unmotivated employees spent more time looking over their shoulders than focusing on what was in front of them.

So the first task was to change the question. Instead of asking whose fault a problem was, the more effective question is, “What’s the process?” W. Edwards Deming and Joseph Juran liked to point out that 80 to 90 to 95 percent of an organization’s problems are problems with the system, not with the people working in the system, so if you really have to blame someone, blame the people responsible for the system. Blame leadership. That won’t solve the problems but at least you’ll be holding the right…