Visual management can take the most unlikely of forms. Done well, it should show you enough details at a glance so you can decide whether to look further into the situation.
Major bands get riders, often part of the contract stipulating what the venue will provide the band to make them comfortable on the road. This can be sofas, champagne, beer, food cooked to a certain standard or even a curry take-away flown in from a specific restaurant in Wales. Some of the items on the riders are tiny and we’d consider them petty, but major stars have lived up to their diva reputations by blowing full-scale tantrums at not having their riders met.
No Brown M&Ms
One of the most legendary of these was the American hard rock band Van Halen. As a rock band they had a reputation to uphold; raucous, fun-loving, tolerating no nonsense. They also through tantrums when their rider was met entirely even down to minuscule details. The most popular of these details was a requirement that they would be provided with a bowlful of M&Ms with all the brown ones removed. If they walked into their changing room and saw a brown M&M in the bowl, then tantrums ensued.
The interesting thing for us is that the presence of brown M&Ms was a form of visual management. As mentioned by the band’s lead singer, Dave Lee Roth, they used a lot of equipment in their tour and they needed to know whether the requirements for the tour, e.g. a stage that could support the weight of the equipment would be available on the night, whether the electrical supply was to specification, etc. All of this was in the band’s contract with the venues. Buried amidst all these technical requirements was the brown M&M clause.
On walking into the dressing room, the band could immediately tell if the venue operators had read the details of the contract. That was visual management. If there was a brown M&M in the bowl, then there was a high probability that other more potentially dangerous omissions had been made in conforming to the contract. Those omissions could have risked the safety of the band, the crew, the audience and the venue itself. So a quick check of whether the venue’s organisers had read the contract and applied it was a useful point for the band’s management.
As for the rockstar tantrums in response, they were just keeping up appearances and it didn’t hurt their reputation. So having the band perform the check in a rockstar style was genius.
Snopes has a great overview of the rider and implications.
Yesterday, I presented at #Leanconf 2013 in Manchester. It was the first Lean Conference covering Lean Startup in Europe. There was a great energy to the 2-day event with a variety of planned and unplanned talks plus lots of opportunity to network without the usual tradeshow conference feeling of being stalked by sales managers.
I don’t think I’ve seen a community spirit like that in a long time; every attendees helped someone else no matter how far along their own ideas were.
In the spirit of the energy that I encountered at the conference, I’ve placed the slides on slideshare. If you download the presentation, you can read the notes which will help you make more sense of the slides. Hopefully the video will be online as well soon. When it is available, I’ll update and post a link to it. The slides are at bottom of this article.
Background to the Programme
The programme I discussed in the presentation was a 2+year programme with a large city council in England. The programme was internal to the portfolio that handled Adult Social Care. It had a £1m+ budget with a team ranging from programme manager, business analysts, data analysts and communications officer, plus a governance structure and other associated stakeholders.
The aim was to make Adult Social Care more efficient, by removing waste, focussing on flow and reorganising around the value to the customer. All typical lean concepts. We did this with a mixed method that I’d developed specifically for this client. The method merged elements of Lean with Lean Startup with DSDM and Theory of Constraints, all under a typical local authority governance framework using Prince 2.
The scale of change was to alter the way of working of 200-300 social workers/care managers, their team managers, their business support plus associated teams. Most were involved in the change and took the opportunity to steer the change in ways that would benefit their service users. Additionally partner teams (e.g. those responsible for 1000+ support workers within the council, NHS staff, payments and contact centre staff) were brought into the process and contributed to the changes where possible.
Customer Development in Social Care
Due to the time available for the talk, I didn’t discuss Customer Development. I’d like to address that here. Firstly, my customers and those of the programme, were the workers on the frontline of social care. However, we also had a duty to their customers, i.e. the service users of the city and, wider still, the overall population of the city.
We used common Lean and Six Sigma techniques (e.g. Kaizenblitz, Voice of the Customer, Gemba plus interviews, workshops, etc) for understanding the wishes and activities of the frontline workers. The default position was always to go and visit the workers where they worked including a visit out to service users where possible and where permitted. There was no “ivory tower” mentality and as little desk-based research as possible.
I did want to get to the wishes of the end user, i.e. getting the answers to what mattered to the service users. We were able to do this through a service user forum and similar activities. Just to clarify, the forum is actually a real meeting, not an online forum. However the typical customer-development approach of “get out of the building” isn’t necessarily a good idea in this case. The reason is that any change has to be ethically sound; it can’t introduce discrimination nor can experiments (or MVPs from Lean Startup) that make the situation worse for those on that trial path.
The ethical dilemma is exacerbated further when you consider the concept of equitability in that any change has to be able to be applied to the entire population of service users if appropriate to them. So if you make a change to services in October, you’d better think about how you’re retrospectively going to apply those changes to service users referred back in April onwards. That could be as simple as a rule stating that they’d change at the next review point or it could be a specific project to apply it now.
A good example of the fundamental ethical issue can be found in the simple concept of asking customers “what can we do to improve?”
I love that question; it encapsulates the whole point of speaking to customers about what they want without biasing them towards a particular solution. It usually turns any negatives about current experiences into positive actions for change.
However, frontline staff wouldn’t want to ask that question of their service users in all circumstances, e.g. those with a current likelihood of being violent, those recently bereaved or in any situation where the service user or social worker is likely to come to harm. That means that the results from a survey of such a basic question would already be biased.
Similar nuances were found in almost every typical method for achieving customer development, whether phone surveys, online questionnaires, paper-questionnaires, focus-groups, questions tagged onto the end of a visit, etc.
Now, as mentioned in the slides, greenfield opportunities such as those found in newly-commissioned projects whether within local authorities or within NHS CCGs (Client Commissioning Groups) are ripe for Lean Startup and may benefit from a more thorough application of Customer Development.
What Messages Can you Take Away from the Presentation?
That you can successfully apply Lean Startup in the public sector
That if you can do it in local authority (which is about the worst-case scenario for successful implementations), then it should be implementable in other large, existing organisations, whether private or public.
That you may not benefit from applying all of Lean Startup; the corollary is true in that you can benefit from using some elements of Lean Startup. It depends on what you are trying to accomplish.
That the behaviour of staff (inherited from the culture of the organisation) will likely be your biggest obstacle.
Some of you may already know, I’m in the process of writing a book on improving your own service.
I’m aiming the book at the people who work the process themselves, e.g.:
and their managers
and change agents/analysts
As you can see, it’s not restricted to any industry, but will be most relevant to those working in service industries (whether from private, public and 3rd sector), so that should include:
More accurately, the information in the book could be useful for any industry, however there already exist books for improving manufacturing production processes, so I have not covered them.
What’s the book about?
The focus is on improving a service without recourse to large consultancy fees and should work well on small changes locally within a team and managed changes with partner teams and organisations (e.g. suppliers and B2B clients). It’s heavily based on Lean concepts, using simple tools, but also includes a framework in which to manage the changes. I’ve borrowed from a number of methodologies and concepts to meld together a method that is suitable for the average worker and implementable in any service team.
While I’m happy to write this book alone and for everyone to read, I really like the idea of the readers contributing their thoughts as I write it. This fits nicely with the Lean Startup model, so to accomplish this, I’ve listed the current table of contents below. Please have a read through the table of contents and let me know what you think. If you’re interested in this book, let me know what you want to learn from it.
Draft Table of Contents
Section I: Beginning
3 Where to Start? Section II: Redesign
4 How to Redesign the Service
5 Detailed steps for How to Redesign a Service Section III: Other Paths
6 Refocus service on customer
7 Only have today to make changes
8 Bottleneck Resolution
9 Reduce errors and improve service
10 Create a new service
11 Improve office layout Section IV: Case Studies
12 A Real World Example: Capacity and Value Stream Owner
13 A Real World Example: Duty Role in Social Care
14 A Real World Example: Urgent Cases in Social Care Section V: Extensions
15 Other sorting methods
16 Making it Happen
17 Managing the Change Section VI: Continuing
18 Sustaining Change Section VII: Reflections
19 Important Perspectives
20 Other Frameworks
21 A final piece of advice Section VIII: Appendices
22 Appendix A: The Rules
23 Appendix B – Pocket Guide for Service Redesign
24 Appendix C – Indicators of Blocked Flow and Waste
25 Appendix D: Tools
26 Appendix E: References
I really believe in getting customer input, especially before you build you product or service. Lean Six Sigma includes the concept as part of Voice of Customer, Lean Startup and similar methods include the concept within Customer Development. If you work for an existing organisation that currently delivers products/services rather than a start-up, sometimes it’s easier to actually be your customer than to gather their input.
Many companies try to get closer to customer needs by using mystery shoppers. Again, depending on your product this avenue may not be necessary.
I’ve been reminded of this many times when I see a process that just doesn’t make sense for the customer, but looks like it would have made sense for the person working in the office who created the process. I’ll discuss three examples below:
I was driving back from Llandudno on the A55 and a roadside sign flashed a message of “Incident after junction 32”. These IP-enabled roadsigns are a common sight on most of Britain’s motorways allowing staff to remotely update the message on the sign. But this sign was odd for two reasons. First, it was an A-road so to provide a junction number on the warning signs rather than a destination is not that common a sight. This made me wonder whether the message referred to the road I was driving on now or a road that we would intersect with, e.g. M56 or M6. This was compounded by the second oddity; there were no junction numbers on the static road signs nor on my car’s satnav/GPS. I was left confused by a message that may have a large bearing on my journey or none at all. To this day, I still don’t know where the incident was, I was fortunate enough to have an incident-free journey on my route home.
I worked for a good ICT company almost two decades ago and another one a few years later. In between, I worked for a large consultancy. Both of the ICT companies were moving into the consultancy arena with more mobile staff taking on more business change and less pure ICT activities. As an employee, I found the treatment of mobile staff to be very different between the ICT companies and the consultancy. The policies – such as how much could be spent on hotels, time before you could claim for certain types of expenses, what time the head-office closed in case you were in another country needing assistance to get home – were all written by HR staff from headquarters in both the ICT companies. That made for some interesting events where there were no hotels available (not just a question of standards) for some meetings or no-one to help out when the hire car’s broken down and it’s better for everyone (especially your corporate client) if you change plans. In contrast, the policies at the consultancy were written by consultants who travelled and operated by HR. That made for a much more reliable service, one that gave the mobile staff much better support while travelling.
Local authorities in England inherit the duty to maintain local roads. That involves the scheduling of roadworks and should involve working with national agencies so that motorway roadworks don’t cascade into the local road network. I can think of at least two towns that have had concurrent roadworks on every route out of town, adding 1 or 2 hours to journeys each way. No doubt some of the council officials were involved but probably hadn’t thought of themselves as customers of their own service.
Be The Customer
Both companies could do with thinking about their customers and trying to use the service as a customer would. I think of two actions when I think of being the customer:
Actively take time out of your product development to go and experience what it’s like as a customer. So go and drive on the road a few times a year and watch what messages, signs are being given, what the spacing of roadworks are.
Engage your staff to think like customers as they go about their days and then to inform the teams responsible of what they find.
In the case of the the road sign, the HR policies and possibly the roadworks, the events were initiated by people in the office. All of these could have been improved by being the customer. I saw the difference with the HR policies, it was a much more comfortable experience recognising that as a mobile employee, you were often away from home and family. The issue with roadworks is probably more one of common sense, rather than being a customer. Why block every main artery and some of the minor ones? The act of being a customer creates a better mindset, by forcing you to think in more basic terms. It’s not about the difficulties in the office, takt time or production control, it’s about what you experience as a customer. I’m pretty sure that Traffic Wales would have had the equivalent of England’s Highways Agency Officers driving up and down the A55. Unfortunately, having them think what it’s like being a customer may not have helped too much since they would have to unlearn what they know as part of the job, e.g. abbreviations, road junction numbers, etc. In their case, they’d still have staff who are less integrated to the operation, e.g. new starters, who could be asked to act as the customer on their way to work and back.
In short, this is a variation on the typical lean battle cry of Gemba, “go to where the work is”. In addition, Be The Customer.
Starting this week, I’ll be answering your questions on Lean and Lean Startup and how they can be applied to the public sector. I’ll also answer questions on wider subjects of business transformation and change management, although I expect most will relate to Lean in public sector and/or Lean Startup in existing organisations.
I’m assuming that any questions you ask me are public and can be posted on this site and publicly responded to. If you need a private response, let me know in the question and I’ll treat it so.
The idea behind this is to share some of my experiences, e.g. how I’ve overcome some of the typical obstacles to change or what to expect when transforming a public sector operation.
You can keep up-to-date with the questions and my answers by subscribing to the newsletter in the simple form below. Take the opportunity to ask a question in the form.
Last week, I was provided with the short opportunity to improve a service within an NHS Acute Trust. I had 5 minutes to understand the problem and then I suggested a quick improvement. I’d like to take you through how we arrived at a solution and the resulting lean cost benefit analysis of that solution.
I don’t get that involved in the individual solutions anymore, instead I’m usually engaged for more strategic issues and end up mentoring others to make the changes across the whole organisation or enterprise. So it was fun to roll up my sleeves and suggest a solution that could work in a hospital. I fully expect the team to modify it to suit their specific needs and I’ll be on hand to help them improve it.
So let’s get to the calculations:
Lean cost benefit analysis
5 minutes x 1 health professional explaining the problem
5 minutes x 1 consultant listening to the problem
5 minutes x 1 consultant developing a solution
10 minutes x 1 consultant describing how the solution could work and what could be changed to make it more suitable
15 minutes x 1 health professional understanding the solution
1 x flipchart paper
1 x pen
3.5 hours per day x 4 health professionals across a 5 day week = roughly 2,800 hours a year
The 3.5 hours is based on a reduction from 4 hours to 30 minutes for handover and prioritisation.
At roughly 1,400 working hours per year (based on 200 days per year and 7.5 hours per day), that equates to 2 FTE (full-time equivalent) posts saved per year.
So that could mean the service treating a lot more patients, a potential cashable saving of roughly £70,000-£90,000 per year or – as is often more likely – a mix of the two
Not bad for a 15 minute session.
The solution would need installing, but that’s the easy part. It would require some pens and a whiteboard or similar. That’s probably £200-£400 for a board and magnetic strip and counters plus £20-£50 per year for pens.
The implementation would usually rely on a critical core of the staff wanting to implement the change. In this case, by applying Lean Startup concepts, just one staff member could do it and then the others will learn about how it could affect their working lives and the impact on their patients.
What was the solution?
My suggestion was based on Lean, using a Kanban board. It relies on the principle of visual management. In this case, it’s easy to see at-a-glance where the work lies. It seemed a perfect fit for the problem. Due to the small amount of time spent with the service, there is a significant risk that the solution may not work for all the health professionals involved. I’d have liked more time with more of the team to mitigate this risk.
My aim was to improve flow. There was a blockage in the handover stage of the day and that’s what I wanted to eliminate. With more time, I’d have taken a more relaxed view of the entire process, involving other stakeholders, referring teams and teams that are being referred to. As it was, engaging with only one health professional, I focussed on what could be achieved quickest to remove the blockage.
The kanban board isn’t the end of the solution; it’s the start. I expect the therapists to find that the bulk of their work is being stuck in one or two stages or that they are not able to provide services to low priority cases. I don’t actually know what they’ll find, but that’s what I would be looking for. After the therapy team have been running the board for a week or two, they should be able to see patterns. Then they can act on those patterns.
So which appeals more; the lean solution itself or the numbers in the lean cost benefit analysis?
From my perspective, they’re two sides of the same improvement and I teach analysts to remember both sides (and some others) when engaging with teams and their stakeholders.
There’s a lot of hype around Lean Startup for at least the last year. The positive thing is that much of this hype is well-deserved; the concepts have changed the thinking of a lot of its readers. Having a foot in both camps as a lean practitioner improving services and organisations and as an entrepreneur roughly adhering to the Lean Startup method, I think it’s important that we are all clear on the difference between the concept of the lean startup method and lean organisation.
I like a lot of the concepts in The Lean Startup written by Eric Ries. However, from viewing social media conversations and articles, it appears that a lot of readers are confused as to what the focus is. It’s not about about creating a lean organisation (i.e. an organisation that operates in a lean manner). Instead it concerns creating an organisation in a lean manner, using a methodology analogous to Lean, itself largely based on TPS (Toyota Production System). The book doesn’t reflect how the organisation will operate. Fortunately, you would expect an organisation that was built using lean methods to have a better change of being lean itself. Unfortunately, it doesn’t necessarily follow.
Now, enter The Lean Entrepreneur by Brant Cooper and Patrick Vlaskovits which is just going through pre-release. From the table of contents, this book does appear to discuss creating an organisation that will operate in a lean manner. While this is something that I would tend to do naturally, I look forward to reading the book and understanding how other people would approach the same challenge.
Are you designing a service or transforming an existing service?
For redesign, we help organisations to reform teams more logically and change the way that they work resulting in more efficient processes. This is more structured and more logical than older BPR (Business Process Redesign) concepts as we’re heavily influenced by Lean but in a service environment.
At the smaller end of the scale, there are service improvement engagements and delivering strategies and methods for continual improvement. We can’t implement the continual improvement for you; that has to come from within your own organisation, but we can be there with you on your journey.
For new services, we assist organisations in developing their new operating models. At this level, it’s not the strategic target operating model, it’s a more tactical design that has to be workable in a live situation with real customers. It should link to the target operating model and indeed should move your organisation closer to achieving that target.