In tumor removal, a doctor must be highly
trained in histology to be able to identify how deeply cancer cells exist
without inflicting too much harm on healthy tissue [1]. With the increasing
popularity of organizations beginning to implement lean six sigma techniques, a
similar need for identification has begun to arise: After what point do we
begin to stop cutting waste and start cutting quality?
The following image is from the Integrated
Enterprise Excellence Volume III Improvement Project Execution: A Management
and Black Belt Guide for Going Beyond Lean Six Sigma and the Balanced Scorecard
[2]:
The iceberg analogy is appropriate in illustrating
the unrealized potential dangers and losses from implementing blanket waste
management techniques without understanding full impact on a company’s
processes. Process improvement companies, due to the nature of their industry,
often only focus on success in immediate savings rather than considering future
costs and lost returns. A process improvement team can not only provide lots of
immediate savings, but also many unanticipated costs once they have left a
company to fend for themselves.
Worse than unrealized costs, often in
companies it is not the implementation of the new protocols and techniques. but
rather than continued utilization after the consultants have left. This summer,
I had the opportunity to visit a few radiology centers as a part of my summer
internship where we were studying the usage of a specific medical software
designed to increase quality of patient records and medical billing procedures
in health systems. However, as we continued to speak to different customers, we
found that after the point of implementation, many radiation technologists
started to revert back to their old ways of information and data entry to save
time or if they were not being trained properly. Illustrated below is a chart
detailing a study tracking process improvement technique implementation at a
company:
The chart depicts the natural tendency of
employees to follow new guidelines for a short ramp-up period and then return
to original practices which can be much more dangerous after “waste” management
has been put into place [3]. In a hospital where certain practices have been
implemented to allow nurses to see more patients, and then the amount of nurses
on staff has been cut – if nurses return to their original patterns the
hospital is suffering an even more critical loss to patient care than before.
When considering returns to natural behavior
and unmitigated risks in lean management and process improvement, is there a
way to factor them in to process improvement techniques?
Would process improvement companies be better
suited continuing using their current practices and it should be the company’s responsibility
to account for these possibilities? Or, would they benefit from doing more in-depth,
company specific process improvement cost analysis and strategic “check-ins”
and re-training at companies where they have been hired?
References
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