Many people are familiar with the seven types of waste originally identified by Taiichi Ohno.

• Defects or rework
• Waiting
• Overproduction
• Overprocessing
• Inventories
• Motion
• Transport

These types of waste are common not only in physical production but also in services and transactional environments.  With some experience, one cannot stop but see waste everywhere they work.  For example, mistakes happen and require rework (defects).  Documents go through multiple reviewers before approval (overprocessing).  Searching a number of locations before the information is found (motion). 

In my observation, this simple concept and basic awareness of waste is a very effective first step toward building a Lean organization.  Who wants to waste their time doing things not valued?

As an organization becomes more mature in Lean thinking, it will discover more types of waste that are less visible and potentially more detrimental.   For example, James P. Womack and Daniel T. Jones, in their book Lean Thinking, included “the design of goods and services which do not meet user’s needs” as an additional type of waste. 

Personally, I think the worst type of waste is underutilized human potential.  Many would agree.  It is also the most difficult type to reduce.  I see it manifest in three common forms.

1. Employees spend a large proportion of their time on non-value added activities.  These include attending unproductive meetings, writing lengthy reports that few people read, or preparing elaborate presentations for management when a summary suffices.  
2. Employees are not able to use their knowledge and skills they are hired for.  To quote a senior executive, “The company hires the best people and then ties their hands when they come to work.”  Often motivated employees eager to solve a problem only are told “that’s not your job.”
3. Employees are not growing to be more productive or effective.  They are stuck doing the same job using the same skills for years.  Many are not aware of the growth opportunities until late in their careers.  Some technical training, coaching, or exposure to leadership concepts, continuous improvement methodologies, or computer skills goes a long way to improve their performance.     

As more people move from traditionally manual work to knowledge work, the demand for new knowledge and skills only accelerates.  If we do not effectively address the waste of underutilized human potential, the loss will be immeasurable for both individuals and organizations.

Just to understand the problem is an enormous challenge.  But I believe there are steps that employees and managers can take to make a significant difference.

For example, for employees

• Take ownership of our career and professional development; no one else has the responsibility.
• Continue to develop ourselves professionally, in technical, business, and leadership skills. This can be achieved through education (e.g. taking classes) and experience (e.g. taking on a challenging project).
• Seek mentorship and feedback from others within our own organization and outside.

For managers,

• Encourage our employees to do the above and support them with our words and actions.
• Be aware of the impact of our actions and decisions on our employees.  Are we the root cause of their non-value added activities?
• Have a growth mindset in our employees.  Continue to provide them challenging opportunities.  Support, mentor, and coach them along the way. 

What is the worst type of waste you see?  How do you reduce it?

This lack of depth can be problematic to practitioners seeking practical solutions to their problems. Instead of knowledge that can be learned, practiced, and reproduced, they often get good stories (e.g. marketing) or worse, misleading information that can cost their future. It is a modern-day challenge that I don’t have a good answer for. But critical thinking — asking questions — always helps.

To illustrate my point, let’s look at an example. Harvard Business Review early this year had an article “Why Process is U.S. Health Care’s Biggest Problem.” The authors shared their experience in applying improvement methodologies, particularly the Toyota Production System (TPS), to the patient care process. Many people think of TPS as a method to improve manufacturing operations. Applying TPS to address the US health care problem sounds intriguing. What questions would you ask while reading the article?

Framing the problem
The authors introduced the problem of the care-delivery process in terms of “not standardized,” “lack of reproducibility,” and “every caregiver does it his or her own way.” This can give the reader the impression that standardization is the solution. Whenever I see “not” or “lack of” or similar words in a problem statement, I immediately treat them as implied solutions. What are the root causes of the observed variation? What kind of analysis has been done to understand them? Presenting solutions disguised as problems limits our ability to see the real problem.

More than semantics
The authors continued their introduction by offering the solution: “Stable systems that are reproducible” and “A process must first be stabilized and then standardized.” What is a “stable” system or process? How is stability measured in a patient care process? Is stability a problem in their system? What did they do first to stabilize the process? None of these was presented.

Many terms in business improvement methodologies carry specific or even profound meanings. They are not buzzwords to be used casually. As Walter Shewhart and Edwards Deming taught us, a stable process lacks special (or assignable) cause variation, which is different from common cause (or random) variation. This distinction is one of the most foundational concepts in business improvement because it directs us to very different courses of action. Without knowing how these terms are operationally defined in the patient care process and seeing the analysis on sources of variation, readers learn nothing if not confused.

Elements of a system
The authors claim that “There are two types of improvement systems needed to create a well-designed care process.” But little is discussed about why the two are needed and how they work together.

An improvement methodology, such as TPS, includes numerous elements (e.g. principles and tools). It is only effective if the elements are used together in a cohesive way. The result is not the sum of a few arbitrarily chosen parts; a missing element could lead to a complete failure of the methodology. In addition, the elements have to be used in a well thought-out sequence applicable to the particular situation. This is not different from strategy development. One cannot simply pull elements from various disconnected strategies and hope that they work together.

What were the strategic choices available to the leaders? How did they decide which methodologies or elements of the methodologies to implement, and which not? Under what conditions would a radical redesign be necessary? Were the decisions to standardize or radically redesign the process strategic, convenient, or ad hoc? How do other core TPS elements, such as value and flow, fit in the big picture? Answers to any of these questions would greatly improve a reader’s knowledge.

Managing change
What do we standardize, and what not? To what extent do we standardize? These are two important, practical questions leaders have to answer because of commonly known resistance to standardization. How did the leaders manage change? For example, did they evaluate how the existing culture or social structure in the organization might support or hinder the standardization effort? As described in The Toyota Way by Jeffery Liker, an enabling (as opposed to coercive) social structure is essential to TPS. It empowers employees, supports organizational learning, and provides rules and procedures as tools as opposed to controlling them. The statement “Every nurse and doctor does not get to do it his or her own way. Standards are established about how the work is performed, and those standards are followed by all until a better way is determined collectively by the team” indicates more control than empowerment. This and several other similar statements leave readers wondering if standardization would ever work for them.

The above are but a few sample questions we could ask to gain useful knowledge from others. What is your experience? What would you recommend?