“Medical Taylorism:” An Article that Does a Huge Disservice to Needed Healthcare Transformation

By Dr. Patricia Gabow and Ken Snyder

The article, “Medical Taylorism,”[1] by Pamela Hartzband, M.D. and Jerome Groopman, M.D., in the New England Journal of Medicine, reflects a major misunderstanding of the principles and practice of the Toyota Production System, or Lean as it is often called. Specifically, the article appears to conflate poor implementation with the underlying principles. Several commentators, including many from the Lean community, have weighed in on this debate, but more needs to be said given healthcare’s need for transformation and the powerful solution that Lean offers in this transformation. Continue reading ““Medical Taylorism:” An Article that Does a Huge Disservice to Needed Healthcare Transformation”

KPIs are Dead, Long Live the KBIs!

Project succeeded?

About a year ago, the head of logistics and purchasing asked me to carry out some observations on the floor. Their new ERP system had been implemented about two years ago, and he wanted to know where knowledge was still lacking so he could use the information as input for a training plan. So off I went to talk to some of the employees. I asked an employee to tell me exactly what she did while she was working on something, a bit like TV-chef Jeroen Meus. “And now I change this printer to the correct printer … This has been wrong in the system for a long time.” She felt no regrets to report the issue and get it solved once and for all, instead she solved the problem herself on a daily basis. And she was certainly not the only one I noticed doing this during my observations. The employees certainly knew what the final output should be, but they were less concerned about how it should be achieved, or even how efficiently it should be achieved. Is this the behavior and the consequent results you want to achieve as an organization?

Continue reading “KPIs are Dead, Long Live the KBIs!”