Some Laboratory Managers Getting Carried Away by Lean/Six Sigma Projects

Don't get me wrong. I am just as enthused as the next person about correcting lab errors and work product defects. The bone that I have to pick with some of the Lean/Six Sigma experts is that this approach to lab management seems to becoming the answer to all lab problems. Some aspects of Lean/Six Sigma have always seemed to me to be vaguely ominous -- turning lab professionals into automatons who paste tape outlines on benches so that the scotch tape dispenser does not wander around the lab. All of my concerns came to the surface when I read a recent article in the Wall Street Journal (see: How Labor Is Liberated). Here is the excerpt from the article that caught my eye:

"Jean-François Zobrist ...captured his leadership philosophy with a distinction. There are, he said, two kinds of companies: 'Comment' in French, or 'how' companies, and 'pourquoi,' or 'why' companies. 'How' companies spend their time telling workers how to do their jobs—where to place the machinery, when to come to work and when to leave, and so on.The second is that it becomes difficult, if not impossible, to change any of the myriad rules about how to get things done. You want to move that cart to a different spot on the shop floor? You need clearance from your manager, who may have to ask his manager, and so on, creating a never-ending 'chain of comment.' The result, as Zobrist put it, is that it becomes impossible to get the work done without disobeying somebody in the chain of command. A pourquoi company is different. It replaces all the myriad 'hows' with a single question: Why are you doing what you're doing? The answer is always the same: to keep the customers happy. As long as what you do satisfies that commandment, Zobrist doesn't worry about how you do it. Freedom at FAVI meant replacing the chain of comment with a single pourquoi." This has two consequences. The first is that you end up judging employees by everything except what counts, which is whether the job gets done and the customer is happy.

So, for me, lab personnel who spend most of their time worrying about "how" or "comment" questions may be too involved with improving daily work processes and perhaps avoiding some of the more challenging "why" or "pourquoi" questions. I am sure that lab executives who specialize in Lean/Six Sigma can readily point to customer feedback to buttress their claims that they are pursuing goals that please their customers. For a change of pace, however, how about responding to this question: Is your laboratory sufficiently innovative in addressing the questions of tomorrow that many clients may not even be asking about? In order to begin to explore some of these strategic "why" questions, it might help to begin with consideration of the four rapidly developing fields that I think will pose the greatest challenges for labs in the upcoming years: (1) molecular diagnostics; (2) information technology; (3) digital pathology; and (4) ultra-fast histology processing. Here's another "why" question. Is your lab a regional or national leader in these four areas?

Comments

[Larry Mead]

Bruce,

I agree that we don’t want employees to become robots without the opportunity to create and improve. Harnessing the intellectual capital of those who do the work is critical and part of Lean’s Jidoka principles. The innovation may be around day-to-day delivery and “how” to continuously improve service and quality.

Part of establishing a high performing culture is for an organization to be simultaneously strategic AND able to operate the day-to-day with excellence. The “how” questions of tomorrow that relate to new market developments and technology are strategically critical but the innovation process looks different and engages a multi-discipline approach, that includes the lab manager as part of the team.

[Barry Portugal]

Bruce,
I agree entirely with your comments. As someone who has been helping hospital labs with operational and organizational issues for almost thirty years, I echo your concerns that sometimes laboratory directors and hospital administrators allow benchmarking and survey data to overcome the need
to view laboratory operations from a strategic point of view. Thanks for a great article.