In the movie Hoosiers there is a great quote from one of the local team supporters who says to the new coach, “Look, mister, there's... two kinds of dumb, uh... guy that gets naked and runs out in the snow and barks at the moon, and, uh, guy who does the same thing in my living room. First one don't matter, the second one you're kinda forced to deal with.”
It is because of the undeniable logic in that adage that someone has to deal with the blathering stupidity – and outright dishonesty – represented by a guy by the name of Mark Lemstra, a writer for the Star Phoenix in Saskatoon, Saskatchewan who has taken it upon himself to come into the lean living room and bark at the moon. Granted, journalists are rarely noted for their subject knowledge or integrity – the ability to consistently avoid ending sentences with prepositions is the chief talent most display and it seems the term ‘yellow journalism’ has become something like ‘round circle’ – so blatantly redundant as to be unnecessary; by definition all journalism is yellow these days. But in launching what appears to be a one-man lean bashing crusade, Mr. Lemstra has gone beyond the pale.
The central theme of his last anti-lean rant is that health care does no drive health – such factors as lifestyle and genetics do. (Give the man a Kewpie doll for figuring out the obvious!) Therefore, in his curious logic, support for the lean health care effort in the province should be slashed and the province should focus its money and resources on lifestyle and genetics … exactly how they should do that he fails to identify, but his criticism of lean is very, very specific – and is built on that combination of ignorance and dishonesty to which I alluded. (Note the deft avoidance of ending that sentence with a preposition.)
Lemstra bases his criticism on the details of a 5S effort at the Kipling Memorial Health Centre; in particular he belittles employee driven changes to rearranging a work area to bring some times down from a high shelf and to arrange wheelchair storage. The less you know about lean and 5S, of course, as well as how decisions are made and management processes work, the more trivial 5S type improvements seem. I have to wonder whether he is empowered to rearrange something as trivial as the coffee machine area at the newspaper without at least asking a few other folks if it is OK; or if has full authority to sort out all of the office supplies based on his needs and his version of common sense regardless of anyone else’s needs and views.
His sole source of support and understanding of 5S? A comment agreeing with him – in fact, the only comment to the 5S article. So his journalistic effort: ‘Here is my wholly uniformed opinion, and here is some unknown guy with unknown knowledge or experience in the subject who agrees with me.’
The dishonesty arises from his statement, “Let's forget about health outcomes and remind ourselves what Lean management really is. In their article, Brossart and Vachon ask readers to visit the website www.betterhealthcare.ca. At the time of writing this column, the top two Lean success stories listed on the website were Wash Basin Blues and No Parking Zone.” Wash Basin Blues and No Parking Zone are the 5S project details.
Actually, at the time of his writing there was a story on the website describing how one hospital went from five days to six hours to get a patient into a bed. There was also an article describing how kanban had cut the time nurses spent reordering supplies from two and half hours a day to zero. Or he could have read that the Victoria Hospital Emergency Room reduced lead time from triage to being seen by physician/ reassessment by 80%. For that matter, there is quite a bit of meat in the archive of lean articles in the Saskatchewan health care system web site.
Why he would not only fail to cite radical reductions in patient care cycle time and real cost reductions is obvious. They don’t support his absurd and ill-informed anti-lean crusade.
Most important, he misses the big picture entirely. Of course a person’s health is driven by the things that take place before that person goes into the hospital. The aim of lean in health care, however, is not to alter life styles or genetics. Rather, it is to improve the quality and reduce the cost of health care no matter what causes someone to need it. For that matter, there is quite a bit of health care that goes directly at the preventive side of the issue – colonoscopies and mammograms are a couple of unpleasant but very helpful predictive/preventive processes in the health care realm. How on earth can the goofball writer for the Saskatoon rag argue that people are not better served by health care providers who can execute these procedures quicker, cheaper and more accurately? He can’t of course.
In the end this guy is just another small thinker who seems to think that tearing something down is the same thing as making an improvement. Perhaps there would be some redeeming value in his writing if he offered a single creative, practical alternative to lean healthcare. He doesn’t because he can’t. So we are left with a man who assails lean in the public square to no one’s benefit and on the basis of grand ignorance. The good people of Canada, in general, and Saskatoon, in particular, deserve much better.