Tag Archives: lean

Talking about Depression: Otherness

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Talking about Otherness is an odd topic when it comes to depression. At least for people that don’t really suffer from chronic form of depression. However, this is something that I think a lot of people can relate to that suffer on a regular basis. Otherness in this context means that there are time where you feel like you’re watching someone go through the motions of your life for you. Where you look at things you’ve written in the past and don’t even recognize who that person was. That when you read that, you can’t even imagine that person could possibly have the depression that you have. That person is capable and competent. That they certainly couldn’t be the same person as you.

There are times where you feel like you’re watching someone put on your face and getting in front of a crowd of people doing something with such conviction and confidence that you’re floored. That person is supposed to be you, but you don’t feel like it. This has certainly happened to me. I look back at my blog posts from years ago or even within the same year and I hardly remember writing them. I’m impressed that I was able to put together that coherent of an argument. That I had that sort of passion for a topic, even if it was only while I was writing.

When I was a regular instructor for Lean Six Sigma in my various roles in my career I’ve often felt as someone riding and watching myself give those presentations. Where I would be able, without much or any preparation, to give a full week of training courses (granted there were some slide decks where this showed more than others). I would be asked questions and I’d feel like I was watching someone else answer. That I was just along for the ride while this other “Ryan” was giving the presentation. This person didn’t feel like me.

At the end of the day, I’d be completely exhausted and so worn out. In a lot of ways I was also energized, because I had a community. I was with a group of like minded people. I wasn’t alone, which felt great. But, I also often felt like a fraud and was depressed because I felt like I was selling something that my bosses didn’t really support. That enough though we offered to our students a great remedy for what was ailing these organizations, the leadership didn’t support it. This caused a great deal of internal turmoil because the values of the organization didn’t fully align with what I was teaching.

Recognizing this otherness is important to do though. We need to be able to sit and look at this otherness and try to identify the source of it. In the case of teaching Lean, the root of the otherness was a misalignment of values. This exasperated my existing depression, I had already felt alone. I then struggled to find new meaningful work, when I didn’t trust other companies to have a value that really aligned with what I wanted to teach.

It’s also important to recognize the otherness because we don’t like it in ourselves. This means we’re less tolerant of otherness in other people, because it reminds us of our own otherness. However, sitting with our otherness can allow us to see why we’re feeling that way. This otherness, hiding from ourselves, putting a mask on, or burying our true feelings, is a coping mechanism and is completely natural. Everyone does it. So, meditating after you feel like an Other will allow you, as you scan down your body, to experience a wholeness. It’ll make you aware of the anxiety or fear you’d been hiding from yourself. It removes the otherness and centers you back in your body. It makes you feel again.

I strongly recommend meditation when you feel like this. Your thoughts will drift, you’ll feel lighter, eventually, but you’ll feel. Which is important for your and my recovery.

On the Efficiencies of Business

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So, I’ve been going to therapy for a few months now to deal with depression. One of thing that has come up is how I don’t really release a lot of the emotions that I am feeling and one of them is anger. I typically swallow that to stay diplomatic and deal with whatever situation as well as I can. I think that I’ve been stewing about this for a while and mentioning it to my friends periodically. I don’t feel that business leaders respect my career path and don’t understand how to actually make their businesses more efficient.

Excluding the past two years, the majority of my career has been focused on Lean, Six Sigma, or Lean Six Sigma (yes all of them are different in terms of how you approach continuous improvement). I have run projects, developed courses, facilitated strategic planning events for companies like AMD, but the entire time, I never truly felt secure in my role. At Samsung, we had lay-offs and last some employees, at AMD, we definitely lost some and my Director actually decided to be let go to save a number of my coworkers. This is in spite of the fact that our group had saved the company measurably millions of dollars over the 1.5 years I worked at AMD. We were always on the chopping block. Then while working at Cambia (Regence Blue Cross Blue Shield) I was laid off, even though the result of my training program included winning a national Blues award and saved the company a lot of time and money. My team easily paid for itself more than once over while we were there (my team was me and my employee Phil).

As we all know Insurance companies are always raising premiums. The underlying assumption is that these businesses are actually working to continually drive down their financial overhead, but those damn regulations keep getting in the way to drive up cost. This is just flat out wrong. These businesses don’t actually know how to drive improvement in their organizations. The only way they can even imaging improving their business is to hire an organization like McKinsey or BCG which costs millions and gets little to no result. The results they do provide are typically brought about by recommendations internally to the organization that leadership is unwilling to implement unless told about them by an expensive consulting group.

This is problematic because it doesn’t actually change the culture of the organization to drive continual improvement and innovation. As I’ve written in the past Innovation and Improvement are positively correlated. Furthermore, these training classes help expand people’s networks, which also significantly improve innovation as well.

So, first of all, I’m pissed off at corporate leaderships for not understanding the value of continuous improvement. Second, I’m pissed off that it’s just accepted that businesses always figure out ways to be more efficient. This isn’t true. If it was true there wouldn’t be a large number of people in their mid-50’s looking for work after a very successful career in continuous improvement. If these businesses didn’t think that the best way to improve efficiencies was to cut costs and then have someone else do two people’s work, this wouldn’t be a problem.

You can reduce headcount and drive up efficiencies, but only if you provide your people with the right tools and the requires true investment in the business. Although, all continuous improvement efforts pay for themselves if you aren’t just looking at how much a few people cost that are part of the team. You need to weight that against the positive gains they are making for the organization.

I’m pissed off about this because I feel like Michael Bolton from Office Space “I shouldn’t have to change, he’s the one who sucks.” I have had to completely change my career, which I was really passionate about because I don’t trust corporate leaders to try invest and buy in to continuous improvement. Maybe this is short sighted and I just need to find the right company. But I’ve looked I’ve been at a number of them and I’ve heard stories from other people that have been laid off (while i was interviewing for the position Phil filled) for exactly what I’m talking about here. So as a response I’ve tried to protect myself from that by avoiding applying for those jobs.

I loved doing that work because I knew at the end of each day and each project, I made someone’s work life better. Which is awesome. You listen to their problems, which helps them, but then you provide them with the tools to make change and to fix their current situation. When they look at how that aspect of their job is going to work after you finish the project, you can just see how much happier they are. You can see that it allows them to focus on the thing they were hired to do, not deal with some bullshit that was there because it’s always been there.

Businesses need more of this. The culture needs to change from top to bottom. It’s the role of the Lean Manager to change the culture so that people want to do continuous improvement. It’s the role of the business leader to provide the right incentives to do this as well.

Starting with Lean

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I had a great conversation with a new friend yesterday. He’s a dentist and is looking to drive continuous improvement within his small organization. He’s feeling overwhelmed, since he’s busy with being a dentist, running an office, and managing a small team adding any extra responsibility seems like it’d put him over the top. He wants to do process improvement because he things that there’s a lot of waste in his small organization but he is terrified of starting because it seems like more work that he doesn’t have time for.

This isn’t the first time I’ve heard of a Dentist wanting to improve processes or go Lean. While working at Samsung I watched a Webinar about the Lean Dentist, Sami Bahri, who several years ago began to implement Lean at his dental practice. He’s since gone on to write two book, one of specific importance to both Healthcare and Dentistry: Single Patient Flow. This really turns the concept of provider centric care on its head. The goal of Single Patient Flow is to maximize the “utilization” of the patient. No, this doesn’t mean treat patients with unneeded tests to keep them “busy.”

No it means that we need to measure the value added component of their time in the clinic and set a goal of that as close to 100% as possible. This means warm hand-offs between any assistants and the doctor, it means no waiting in the waiting room. No waiting in the office for people to come. None of this is something that we’re willing to pay for, yet we must pay for it. Actually in most cases our employers are paying for it through lost productivity at our jobs.

Moving towards patient centric offices also changes the how the patient expects to interact with you. They will know more because they did some research coming in, this information could be wrong so it will take more time to explain to them the correct diagnosis. People using WebMD is a result of dissatisfaction with existing doctor offices.

Becoming more patient centric is a big deal and takes a lot of work. Where do you start? With anything. Yes that’s a bit of a cop out statement, but it’s also true. Pick anything that is causing pain for either your staff or your patients and map it out. Figure out what the process currently and where the wastes are. Work to eliminate them. Start with something small like how you answer the phone or greet the patient when they walk in the door. Figure out who should be doing this and how to ensure it’s the right person doing this work.

Start somewhere. Start where you can have a quick win. Start where you think it will help the patient quickest first.

Enabling Innovation Through Lean Improvement

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This is part of my ongoing Lean Disruption series where I write about how to combine Innovation Theory, Lean, Lean Startup, Agile, and Lean product development.

Since values and metrics drive processes how can you enable innovation in an organization that isn’t completely willing to support innovation? As I mentioned before Skunkworks are a key component in this process. Using emergent strategies with Lean Startup tools such as the Lean Canvas are another key method to enable innovation with the skunkworks approach. However, not every organization can or will truly allow this approach.

In organization that cannot or will not support a skunk works approach to innovation what options are available? In the case where you are a manager of more than yourself you have the ability to implement Lean within your small organization. Owning the processes within your organization and becoming a coach to your employees, can begin enabling metrics that drive customer centric focus.

This is possible by taking a single step and picking a metric that will move the metrics that your bosses care about. Focus on improving one process at a time. Start with something that is completely in your control, such as how you hand off material within your group that goes to other groups. Measure the number of errors your group introduces, however do not blame people. If things are wrong investigate the root cause of the problem rather than accusing your people of causing the problems. Problems can come from the group that handed off the work. In those cases, create a process to review the work looking for errors and then work with the team supplying that work to eliminate those errors where you can.

In the case where there are errors within your team, you work together to uncover each source of the problem. As a manager you own the processes as much as the result of the work your team does. The final output of your work is 100% dependant on the processes that lead to those output. Another important step is to work on converting your daily meeting, assuming you have one, into a daily standup rather than a typical beat and greet. These meetings instead must cover the goals for the day, issues from the day before, and follow up to address those issues. In the case where the team has projects they are working on, this can become an opportunity to being pulling in some agile stand up practices, such as “What did you work on yesterday, what do you plan on working today, and do you have any impediments?” These questions can help change the way projects are run within your group.

To improve processes within your group, the best way to do this is to go to where work is being done. You must actually watch as work is being done, while keeping in mind that the way work is being done will change as you watch people work. Make sure they are aware that you are not going to be critical or even record who is doing the work at the time. Record the information and move on. You should not use this information in their next 1 on 1 or review. The goal is to learn how people are doing work especially across work types and workers. After you map the process review the results in your daily stand up to discuss potential issues. Partner with your team to find the root cause of the problem and empower them to make changes to their processes.

Before you change the process it is important to measure current state and measure the impact of those changes on the metrics that matter to you. Keeping in mind that you must make all changes from a customer’s perspective. These are the easier things to implement. However, making changes and getting support in this change from your leadership isn’t going to be easy, so you must show that you’re making wins and improving the result of your work. That’s all leaders care about.

Successful process improvement opens the way to broader innovations. Start small and then move into larger projects as you have a better understanding of what you are trying to do.

Values in an Agile/Lean/Innovative company

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This is part of my Lean Disruption Series where I’m looking at Lean, Agile, Innovation, and Lean Startup.

None of these methodologies can be adopted for free. They require a great deal of firm introspection. Understanding how processes interaction with people and values is vital to adopting any of these approaches let alone a combination of these approaches.

Metrics are one of the best examples of how there can be conflicts between stated values, values in making decisions, how resources are handled and how processes are structured. The famous saying “You manage what you measure” is right in a lot of ways. Many companies claim that they value customer satisfaction, however many of these companies do not actually do anything with the satisfaction surveys they do get. Comcast is the most obvious example of this. Comcast doesn’t really value customer satisfaction because they measure their customer support on how much they can upsell to the customer anytime they are on the phone. This changes the processes their customer support must use, rather than designing processes to enable single call resolution, their processes are designed to enable selling more products. Their employees, the resources, are rated based on this and if they don’t meet those goals they are unlikely to do well. Considering the Verge’s Comcast Confessions series most of the resources at Comcast do not feel valued. This all points to the true values for Comcast being retention at all costs and more revenue per user measured in Churn and ARPU (Average Revenue per User) respectfully.

Agile Manifesto from ITIL’s blog

For a company to adopt an Agile approach to developing software, the paradigm of what the organization values must radically change to align to the Agile Manifesto. In most software development the concepts on the right are what are valued through a Project Management Office. The concepts on the left are typically considered only at the beginning or the end of the project or not at all. Working product is the goal of a project, while customer collaboration inclusive only in the beginning getting requirements.

Switching from the right to the left creates massive cultural upheaval at an organization, where power is shifted down and out. It is shifted down to the team level, where managers in the past made all the important decisions Product Owners, Scrum Masters, and developers make the decision now with the customers. Power is shifted out through increased collaboration with the customer. Customer centricity forces the company to understand what the customer really wants and more quickly respond to changes in their understanding of their needs. This does mean that the “requirements” change, however, in many cases due to the uncertainty in a technology, interface, or some other aspect it was impossible to properly articulate the actual need until there was an example in front of the customer.

With these value changes there must be process changes to that properly reflect the change in the way the values require work to be completed. In the case where Single Call resolution is the most important metric reflecting the value of true customer satisfaction, processes must be built to enable that – such as training, information repositories, and authority to truly address customer needs at a single point of contact. In software development rapid iteration with continual feedback is a process that must be built to enable that.

This changes are not free and require true commitment from leaders across the organization. Without their commitment any adoption of these frameworks is doomed to failure.