100,000-300,000 is a wide range. So, let’s be conservative and call it 100,000.  Now, contrast that with the number of deaths that occur in all of U.S. industry per year—4,340 last year.

There’s nothing different about reducing employee injuries and deaths and patient injuries and deaths. The approach is identical. If you want different results, you need to change the system that’s causing the current results.

In the case of patient or employee deaths, two things need to change—the way work is done and the culture that establishes the underlying values of the organization. 

Thanks to Johns Hopkins physician Dr. Peter Pronovost and others, the simple surgical checklist during major operations has been found to lower the incidence of deaths and complications by more than one third. The checklist is usually a single page that requires only a few minutes to complete at three critical junctures of operative care: before anesthesia is administered, before skin incision, and before the patient is removed from the operating room.

Checklists aren’t new. Airline pilots have been using them for years. Checklists have been part of what’s often referred to as standard work in many industries for a long time. They work and they’re easy to make work because all you have to do is follow the list. What’s not easy is shifting the culture of an organization from one where the surgeon is the master of the operating room universe to one where all OR occupants work as a fluid team.  

This culture shift doesn’t start in the OR. It starts in the office of the CEO and it needs to include every leader in the hospital, whether it’s the chief of the medical staff, chief of surgery, chief resident or the “chief” of human resources.

Shifting the culture requires a re-clarification of roles and expectations of each person in the hospital. It means measurement, communication, learning and development, work processes, technology  and rewards and recognition all need to be focused laser-like on becoming and remaining a zero accident  institution and nothing less.  Checklists are part of the hard, technical aspect of change. Shifting the underlying values within a hospital or any other organization is the soft side of change.

But checklists are easy. Culture is hard.

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But other businesses have simply gone through the motions and have little to show for their efforts other than a bunch of disgruntled employees. In most cases they fail because they  adopt tools, techniques, measures and mechanics associated with lean, but  don’t recognize that lean is a mindset  that must be built into the culture. These organizations view lean as no more than moving machines around or changing workflow arrangements without much input from employees.

A lean culture values–and is obsessed by–customers, employees and continuous improvement.

In the lean world, there’s a workplace organizational methodology called 5S (pronounced five ess). The name comes from five Japanese words that loosely translate to Sorting, Straightening, Shining, Standardizing and Sustaining. If you 5S’ed your garage this morning, it would be immaculate. There’s a place for everything and everything should be in it’s place, as the ditty goes.

But like most things in business, it’s easy to go anal nuts with lean. So nuts that some companies have used gobs of white tape to outline where, for instance, standard desk items should go on a desk–your desk. I was visiting a company recently and desks had taped outlines reserved for the stapler, the desk owners’ laptops, yet another for the paperclips, calculators and drink coasters. Neatly typed at the base of each rectangle were the words, STAPLER, LAPTOP, PAPERCLIPS, CALCULATOR AND COASTER, BLACKBERRY.

Now some lean acolytes would respond by saying, “Of course, that’s the way it’s supposed to be to make sure everything has its place and is in its place.”

To these acolytes I’d suggest they take their trolls of tape where they will do some good and not offend my sensitivities to pure, unadulterated tackiness and most employees’ sensitivities to intrusions into their personal expression.

Forcing this kind of rigid structure takes away the passion and fun out of a team’s quest for greatness. I visit a lot of offices and employee cubicles and I get a real kick out of seeing family pictures, little kid’s school drawings and personalized disorder that communicates about the owner of the cubicle or the office.  There’s a line between a quest for professional order and an act that snuffs out the very personality that was a key ingredient to your decision to hire Mary, the accountant.

What should really matter is our ability to meet customer requirements. For example, hospital patients (customers) might benefit if the hospital didn’t permit nurses to put medications wherever they want –each nurse having a different spot or putting the medicines in a different spot each time. The lack of standardization might lead to errors. In this case, the need for standardization probably outweighs the need for individual expression.

But in cases like determining how to decorate an office or deciding where you will place your stapler, there’s probably no customer benefit to having standardized decorations or taped off areas for your stapler, lamp or whatever. If anything, it dehumanizes the workplace. It takes away the color and passion and personal expression. The following video satirizes the use of lean as a mindless way to control.

The project was focused on integrating the so-called hard and soft sides of lean to improve operating and financial performance. During the effort, sales increased 30 percent, productivity went up 10 percent, quality went up 40 percent and on time delivery increased from 70-95 percent .

This work now is serving as a company model for other facilities undergoing a lean transformation.

To learn more, watch the video on the our home page.

Let’s assume you and I are looking at the resume I was reviewing last week. It was a model background, great college, lots of impressive activities and internships during school and between semesters. Call it the model background for a college kid.

Content was strong but the packaging was deficient. Call it an iPod in a crummy box, which Steve Jobs would never permit.  The primary packaging deficiency? Lack of differentiation. His model background did not sell him over all the other model backgrounds out there.

Here’s what I told a young neighbor who was seeking my “business advice” about her resume and job search just recently.

“You and others with model backgrounds are competing for a finite number of jobs. Think of yourself and your competition (i.e., those with other model backgrounds) as boxes of cereal on a supermarket shelf. You’re all sitting there with very model backgrounds that are waiting to be purchased. If I’m a recruiter or a hiring manager at Name Your Company and I have a pile of model backgrounds from people coming out of school (I’ve thrown away the ones from people with average backgrounds), why should I hire you? What is it about your resume that makes you more special than those other boxes of cereal on the shelves?

“Think of your resume as packaging, not a list of activities. There’s a reason Apple is obsessed with design and packaging. Sure, people buy the results that an iPod or Mac Pro delivers. But the cool packaging helps make Apple products further stand out—and sell.

One way to differentiate is to turn activities into results where you can.  I realize that a 21 year old has a smaller list of accomplishments than someone older.  But, try your best to explain not just what you did but why it mattered. If your competitors have lists of activities and you have even a small list of results, you may have a point of differentiation that will represent a tipping point for your customer.

A good hiring manager has choices (lots of them these days).  She will decide on the candidate that stands out above the crowd.

What will make you stand out and, in turn, make the hiring manager look good to her boss?

Yes, there are times when jobs must truly be eliminated. It happens in belt tightening efforts. It’s often why mergers and acquisitions occur in the first place–to take advantage of synergies. I’m not suggesting it’s right or wrong. But, it is a business reality.

However,  firing people for this reason happens frequently without any consolidation activity in a company. I think it’s a crappy way to terminate people and here’s why…

What’s also a business reality are the managers who do not address performance problems straight on. They fail to give someone who’s struggling the honest feedback they need to succeed. They don’t help the person shore up his or her weaknesses. Then, when “the decision” needs to be made about the poor performer’s future, the cop-out “your position has been eliminated,” is offered as the reason the person must leave the company.

Leaders use this excuse for several reasons. Some by nature are conflict-avoiders. Some have done a pathetic job of documenting performance conversations with the  under performer, so HR counsels the leader to eliminate the position rather than expose the company to legal action. Other leaders have never been adequately trained or held accountable for delivering constructive feedback.  And there are some who know what to do, but consider leading others a major intrusion into their already busy work-a-day lives.

The worst thing about using the “position has been eliminated” rationale is that it’s an out-and-out lie. It’s the equivalent of the internal email and external news release that announces the under-performing CEO’s sudden departure for “personal reasons.”  Certainly getting fired for poor performance is very personal. But we all know the guy was fired because he didn’t deliver. So we wink knowingly. But it’s still communicating to anyone who knows better that we are not telling the truth.

It’s the same with using the rationale that the position has been eliminated, when that really wasn’t the reason.

So rather than fix these root causes of a performance problem, we establish lying as a value to be perpetuated.  It becomes a cultural norm–alongside customer-centricity,  one company mentality, innovation, valuing people, integrity….

In the high performance world, something that needs to be fixed after you’ve made it is called a defect. Defects represent a form of waste. They represent waste because defects have to be either scrapped or re-worked. Scrapping something represents money down the drain. Re-working it adds unnecessary costs. 

In the high performance world, when you produce defects you understand that as long as the systems remain the same you’ll reliably keep building defects. So in order to stop building defects, high performance organizations change their systems and processes so they won’t produce more defects.  They try to get the right results the first time. 

But in the political world, when you produce defects you first try to find someone to blame for creating the defects. It’s especially convenient to blame the other party.  That’s in part because politicians are often less concerned with the results as they are with the process–especially the process of getting re-elected. (That’s why Kennedy and Deal in their book Corporate Cultures referred to bureaucracy as a process culture out of control.)  “Just work the process; we’ll fix the problems we created later,” they say. 

That’s foreign thinking to high performance organizations who understand that customers won’t pay for those fixes and that everyone needs to accept personal accountability for continuous improvement.  

It’s hard to think like this unless you have a high level of emotional intelligence and maturity. Given the spectacle we’ve seen in Washington lately, this may be the primary reason politicians can’t seem to learn from high performers.

• Strong operational hydraulics
• Rewards for performance, not mediocrity
• Core values with teeth
• The right conversations
• Adventurous leaders in key positions
• Constant pressure versus heroic efforts

It uses a straightforward and useful checklist of questions you can ask yourself.

It started with a call from Jose, a business leader in Southern California  who’d learned of our work integrating the cultural and technical aspects of lean transformations. He wanted help launching lean six sigma with his leadership team and employees. Last week was my only available four day window–day out, day back, two days at the client site.

Jose loaded me up with emails covering every conceivable aspect of his company. Everything I needed to get up the learning curve on the long ride out.  

I used day one to get to know the leaders, conduct a few focus groups with employees and tour the operation. That plus the advance reading gave me what I needed to understand the climate and culture, performance opportunities and likely barriers to achieving them.    

For the next two days we plowed through change management fundamentals and then the advanced course: defining the future condition; identifying the requisite leadership roles and expectations; creating a plan to eliminate root causes of performance problems related to on-time delivery, quality and operating income; building the framework of a continuous improvement process; and prioritizing what work needs to stay on the plate and what must go. 

All in two days!

It worked because the leadership team was business-savvy, enthusiastic, used to doing hard work fast and, of course, (here comes the self-serving part) the content was exceptional.

The team has plenty to work on. We’ll check in at regular intervals for what Jose referred to as “sanity checks.” 

Good work, happy client, nice ride home. 

But the softie side of me also loves the ads that poke a little or jerk at the emotions. Because I spent a number of years in the advertising/marketing community  I believe I can view spots from the ad guy’s perspective and  from the perspective of the guy watching the game while eating a bowl of chili.

From both perspectives, I thought the Super Bowl ads last night were mediocre compared to previous years.  The Doritos adds were clever and reminded me that they were selling Doritos.  And I’m a sucker for the Clydesdales, especially when a dog brings a horse and steer together for a lifetime of friendship.  Ahhh! Get me another Bud, please.

Otherwise I didn’t see a lot of creativity and wonder if that’s not part of the conservative, risk-averse advertising we’ve been seeing in recent years, especially in the economic downturn. Most of the spots lacked clear selling propositions and failed to make the product or service the hero of the ad, as David Ogilvy importuned young copywriters years ago. The Intel ad for a processor got my vote for the most juvenile and most difficult to figure out.  There was so much noise around the message that it took two airings before I figured out that they were selling processors not robotic toys.

Memory Lane. I miss the great ad days I was part of.  The days of Ogilvy, Leo Burnett and Doyle Dane and Bernbach “Think Small” spots for the Beetle. Here from YouTube is the German version of the famous snow plow ad. For those who missed this great ad era, the tag line at the end is loosely translated as “Ever wonder what the snow plow driver drives to work?”  The spot almost needs no commentary.   http://www.youtube.com/user/beetlejuice150#p/search/1/cUnEbNgHFco

Let me know what you think.

Jim

For those who were watching more serious fare, like I Love Lucy re-runs, Undercover Bossis is about corporate CEO’s who masquerade as someone else so they can snoop on their employees. Some snooping may be perceived as good and some bad by the producers.  But snooping is always disingenuous in my book.

It may be cute TV but a leader resorting to dishonesty to get in touch with his organization and its people is perverse, uproots the concept of authentic leadership and eliminates the leader as a candidate for teaching the corporate ethics class.  Its potential for abuse is horrendous.

In today’s climate, it’s important for leaders to tell the truth. Authenticity has its virtues. CEO’s have immense political and personal influence. They have opportunity to inflict both good and bad. But when you tell people you’re a dockworker when you’re not, you aren’t telling the truth and you compromise yourself and your position. And your real motives come into question.

Some may say that walking incognito “among the troops” is a good thing.  But, I believe there isn’t something fundamentally wrong about the relationship between a leader and his people if he has to fake it to stay in touch?

Some  news media are desperately trying to hang on to the separation between the editorial and business sides of their business, although it’s getting awfully murky out there when advertising appears on news pages and is camouflaged in magazines as news stories) but I wonder about any dilemma CBS might face as its news people seek transparency from leaders while its programmers celebrate CEO’s who lie and hide.

Your thoughts?