Why Static Standards are the Enemy of Quality
One of our mentors, Les Sutherland, suggested Mike Rother's latest book, Toyota Kata: Managing People for Improvement, Adaptiveness and Superior Results. Its an enlightening read that I can highly recommend.
Much of our success in the Henry Ford Production System is due to the adoption of the principles of management described by Steven Spear as the DNA of the Toyota Production System. We have strived to create standardization of activities, connections and pathways, the Toyota rules of work, for many years now and this has resulted in many improvement successes in these Henry Ford laboratories in conjunction with our clinical specimen 'suppliers'.
Here's another spin on standards that I would like to share as you continue your efforts to reduce process variation, otherwise recognized as the enemy of quality. I suspect you will think differently about our path forward now as we focus on the management principles that codify standardization and make defects visible for correction at the worker level in real-time.
The following is taken directly from Rother's book. See through the factory production and employee terms like operator to the complex healthcare roles and 'production' related processes that you own. This captures the reason for creating a culture of worker empowered, PDCA based continuous improvement founded in Spear's rules of work that promote identification and repair of poor outcomes from non-standard activities, connections and pathways of work.
"We cannot leave a process alone and expect high quality, low cost, and stability. A popular concept is that we can utilize standards to maintain a process condition.
However, it is generally not possible simply to maintain a level of process performance. A process will tend to erode no matter what, even if a standard is defined, explained to everyone, and posted. This is not because of poor discipline by workers (as many of us may believe), but due to interaction effects and entropy, which says that any organized process naturally tends to decline to a chaotic state if we leave it alone (I am indebted to Mr. Ralph Winkler for pointing out to me the second law of thermodynamics). here is what happens.
In every factory, small problems naturally occur every day in each production process-- the test machine requires a retest, there is some machine downtime. bad parts, a sticky fixture, and so on--and the operators must find ways to deal with these problems and still make the required production quantity. The operators only have time to quickly fix or work around the problems, not dig into, understand, and eliminate causes. Soon extra inventory buffers, workarounds, and even extra people naturally creep into the process, which, although introduced with good intention, generates even more variables, fluctuation, and problems. In many factories management has grown accustomed to this situation, and it has become the accepted mode of operating. Yet we accuse the operators of a lack of discipline. In fact, the operators are doing their best and the problem lies in the system--for which management is responsible.
The point is that a process is either slipping back or being improved, and the best and perhaps only way to prevent slipping back is to keep trying to move forward, even if only in small steps. Furthermore, in competitive markets treading water would mean falling behind if competitors are improving. Just sustaining, if it were possible, would in that case still equal slipping."
"Quality of a product does not necessarily mean high quality. It means continual improvement of the process, so that the consumer may depend on the uniformity of a product and purchase it at a low cost."