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Archive for the ‘Human Acpects’ Category

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Producing Business Intelligence has always been thought of as a linear process where, you have at the beginning of a the BI process, all the data, then it gets cleaned; then you populate your data warehouse and then you do your reports. The reports are then of immense use to you!

Hardly works in real life! In fact, truly useful Business Intelligence lies in Excel Spreadsheets and skunkworks projects within companies in many departments. Yes. There may be a central Business Intelligence effort, but frustration with getting precisely the information they needed at any time in the forms they need, has always been the achilles’ heel of many BI efforts within companies, especially larger ones.

I ran across a novel way of thinking about this whole process. What if you just had all the data sources available to you somewhere and you assemble in the form of a flowchart, your own unique Business Intelligence mashup including Geographic, Demographic data as needed? What if you could just drag and drop these components on the screen and you get the new kind of mashups you need?

SRC is a company that makes a product called Alteryx that enables this kind of Business Intelligence.

What is interesting about this product is that it first of all, it serves customers better! Consumers of Business Intelligence for the most part do not know ahead of time all the different kinds of Business Intelligence they need and what data needs to be collected and stored in the first place.

Add to it, the waste of human effort, and time spent on monolithic Business Datawarehousing, and Business Intelligence efforts. This is not to talking about waiting for IT resources to free up to work on  the precise kind of reports you need for your work!

By making it easy for consumers of Business Intelligence to do a lot of the assembling and analysis themselves, it makes for a Lean form of Business Intelligence effort within the company.

With the amount of Geocoding, Demographic and other location-related data available for many countries in the world in great detail, tools like these enable a Lean form of Business Intelligence, cutting a lot  of wasted efforts within large companies. For small and medium sized companies that do not have large IT departments, of course, something like this is a natural!

You can observe a lot by just watching – Yogi Berra

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Many a well-intentioned organizational change effort has been derailed by human beings!

Ask any of the large corporations that have spent millions and millions of dollars in ERP software the last two decades, only to find that the implementations were struggling to stabilize and work properly. All that money may just have been flushed down the toilet!

Checkout this story that documents well known ERP disasters at even companies like Hershey, Nike and HP that are supposed to be good places to work! – 10 Famous ERP Disasters, Dustups and Disappointments .

Many of them failed for many disparate reasons,  but one common thread among many of them would be failure to get buy-in from end users, and their inputs in trying to adopt the new way of doing things!

Therein, lies a very important lesson for many a Lean Improvement effort – Failure to get buy ins from end users!

When you change the way something has been done in the past, you are disturbing the steady state of many human beings involved in that process.

In ERP systems, the warehouse clerk may be used to doing things a certain way, and may be that’s all the skills they have to do, and care to do. Unless that person’s buy-in is obtained in the beginning or somebodyelse who will provide you that buy-in is brought in, the whole effort has a lot of potential pitfalls!

The warehouse clerk likes doing his work by filling out a paper form and is quite comfortable with it. Now you introduce a totally different way of doing things like fill out an online screen on a computer, they may not like the way it is done for whatever reason. It could simply be a case of “they didn’t ask me what I thought about this change”. They may be trying to sabotage the whole effort when no one is looking!

This is the Achilles Heel in not considering the Change Management, Human impact aspects of Lean Improvement upfront, before the analysis and redesign of the mechanical aspects of a process. If a certain person is likely to lose their job because of the improvement, it will be very difficult for that person to accept with happiness, how it is helping the company improve its bottom line. There is nothing in it for him, except bad consequences. On the other hand, if that person is convinced that they will be moving on to bigger and better things after the improvement is in place, they may be persuaded to enthusiastically engage in managing the change.

Lean Improvement is not just about cutting waste and doing things in a better way. It is also paying attention to ALL the factors BEFORE the effort is taken up so that the effort itself is successful.  What’s the point in undertaking an effort in cutting waste if that entire effort turns out to be a bigger waste of time, money and resources?

Failed ERP implementations are great instances for learning valuable lessons for planning and executing Lean Improvement efforts!

People are very open-minded about new things – as long as they’re exactly like the old ones – Charles F. Kettering

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My daughter had an outpatient surgery for half a day on her knee. A ligament had torn off and had to be tacked back on.

Her total billing to the Insurance company was a whopping $44,000. The insurance company paid $33,000.

She was one of 10 or so people scheduled for surgery that day and by no stretch of imagination can we see this costing $33,000 mush less $44,000! These were just what they called “Incidental Expenses”.

If you think that there is nothing wrong with this picture and healthcare in the U.S is alive and well, you should be delusional! We all blame the insurance companies but someone billing these atrocious amounts, just because “Insurance pays” is not doing any one great service.

Seems like the whole thing is a racket that can use a lot leaning. The first initial Leaning seems to be bringing a sense of honesty and fairness to the whole thing! Then we can think about other ways to reduce waste. If the whole thing is a made up number out of thin air, then lean methods may fail miserably!

For our own’s sake, the best Lean Healthcare is Prevention and not to fall sick, ever!

Honesty is the first chapter in the book of wisdom – Thomas Jefferson

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Airlines have sunk so much money into their aircraft, and aircraft reliability is built in so much, that they can use an aircraft in operations continuously for so much time, before they need a maintenance cycle.

This, however, means that whenever a plane lands, people are waiting to do their work in parallel as much as possible so that they can turnaround the plane as quickly as possible.

Replacement crews are already waiting as soon as a plane lands, passengers disembark, and the cleaning crew moves in. The new crew gets in, settles down, and at the same time the plane is refueled, new food carts are hauled in after hauling out the used ones, maintenance crews perform their checks, all in parallel!  Baggage from the incoming flight is unloaded, and the new baggage loaded. Passengers are boarded and then the plane is ready to leave.

Southwest Airlines routinely does this in 20 to 30 minutes, so far unmatched by any airlines. This is captured very well in this story – Southwest Airlines Success Story.

There are many new technologies like RFID that can be and already are being leveraged to improve these turnaround times.  Here is an interesting paper that analyzed Aircraft Turnaround times of various airlines and found that Passenger Boarding is the Critical Path for most Airlines!

If boarding passes come with an RFID chip, there is no reason for anyone to scan your boarding pass. You can just walk inside the ramp and the system will know who boarded just now!

RFIDs can be just as useful in baggage handling and knowing which baggage is on board, which is not, which needs to be taken out since a passenger is missing, etc.

All of these can shave seconds and minutes here and there and pretty soon, they add up to a lot!

Of course, there are always the weather related delays that no one has any control over and that can throw a wrench in the turnaround times!

Very exciting possibilities for Lean Improvement of Aircraft Turnarounds!

It is not by muscle, speed, or physical dexterity that great things are achieved, but by reflection, force of character, and judgment – Marcus Tullius Cicero

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Here’s an example of how to use RFID chips to totally automate return of Library Books:

Return of library books, processing them, sorting them into different piles for the different shelves has always been a manual chore, prone to repetitive motion injuries and monotonous manual work. Here’s an example of how RFID chips have automated the whole thing and eliminated a lot of wasted effort, time and risk for injuries to human beings!

It also gives patrons a receipt that can prove that they returned something! Very good use of RFID chips to accomplish something tedious!

We live in a time when automation is ushering in a second industrial revolution – Adlai Stevenson

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Administrative Processes in Healthcare are awe-inspiring in their Waste of Human Effort, Unnnecessary movement of Paper and costly processes. They don’t need to be that wasteful!

Technology may be the Lean Improvement solution to many of these opportunities!

Typically in the U.S, there are about 30 Major Healthcare Insurance providers and one major single Payer,  Medicare that covers health insurance claims from those over 65 years of age and getting Medicare benefits.

Typically, providers have to deal with 30+ payers for healthcare claims, potentially many many different designs of forms, Coding methods, a lot of paper moving backward and forward!

If there was ever a gold mine for Lean Improvements, Healthcare is a classsic one! In fact, bits and pieces of this big puzzle as being automated and big gains realized as in the ePrescribing software that many of the providers have already embraced. The Physician sends a prescription electronically to the Pharmacy, the data is updated on their system, if any potential drug interactions are suspected, it automatically queues it up for the physician in an inbox to reply back and approve or change the Rx.

This process used to be done over the phone and the fax machine before. They faxed or phoned in the prescription. If the Pharmacy had any questions they called back. The Nurse then had to bring it to the attention of the Physician. The Physician approves, the nurse then calls or faxes back the pharmacy, etc. You get the idea of how many person hours are wasted in unnecessary waits and delays, not to talk about the need for human beings to keep track of all of these manually!

Technology standards for interchange of information like the HL7 standards are enabling all these different computer systems   to talk to each other automatically and cut out a lot of the unnecessary wasted effort and delays in between!

We have not even scratched the surface as to realizing the potential of Lean efforts in Healthcare Administrative Processes! It’s an area where Technology can institute order of magnitude improvements and cost savings!

How wonderful it is that nobody need wait a single moment before starting to improve the world. – Anne Frank

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Healthcare is just ripe with possibilities for Lean Improvement of processes. Administrative and Clinical processes are both good candidates for improvement. In the U.S Healthcare Market, with each healthcare provider potentially dealing with the U.S Govt in the form of Medicare, and 30 or so major Insurance Payers, claims for payment to these disparate providers take their own toll on billing and collection. Just this area alone, can use a lot of lean improvements.

Of course, on the Clinical Side, many hospitals and healthcare providers are always focused on improving processes not only from the point of view of reducing costs and making these processes faster and easier to complete but also from the point of view of reducing medical errors. Reduction of medical errors goes a long way in reducing risks for the provider, insurance costs and increases Patient Safety leading to better service and Customer Satisfaction.

Predominance of Paper based records is a huge problem in U.S healthcare. The Obama Stimulus Package of 2009 provides a lot of incentives for adoption of Electronic Health Records by providers. This would go a long way in improving many of these business processes organically, since electronic data is easier to deal with, store, exchange and eliminates redundant data entry in multiple applications. Just making information electronic eliminates a lot of the manual work, movement of paper and wastage in time, people and other resources like paper storage space.

The best kind of Lean Improvement comes from moving processes to self-service and the web. This is where a lot of the current emphasis on Patient Health Records are moving to and we can expect a lot more involvement of the patient in their Electronic Health Records and hopefully, emphasis on their wellness rather than illness.

This is an exciting area for lean proponents, just given the lack of electronic information in many aspects of healthcare, especially in the U.S!

 Why not make the work easier and more interesting so that people do not have to sweat? – Anonymous

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