Blog Archives

Guest Post: Libby Zion

Today’s guest post is by James Lawther.  James gets upset by operations that don’t work and apoplectic about poor customer service.  Visit his web site “The Squawk Point” to find out more about service improvement.

On 4th March 1984 Libby Zion (an 18 year old known to be using anti-depressants) was admitted into a hospital in New York with a high fever.

That night, Luise Weinstein, a medical intern 8 months out of medical school, was on call. He discussed her case over the phone with a senior doctor, and then prescribed two drugs, a pain killer and a sedative.

The next morning Libby was dead.

The subsequent inquest found that a reaction between the two medicines and her anti-depressants was the cause of Libby’s death.

Why was she prescribed those drugs by the medic? Didn’t he know what would happen?

It transpires that like all medical interns he had been working a long shift. He was over worked and sleep deprived and made the wrong decision.

How long do you work?

How long can you expect somebody to work? In the UK and US there are laws that prevent lorry drivers from working more than 11 hours without a 10 hour break.

11 hours is also the time it takes to fly from London to Los Angeles. Would you get on a plane flying the return leg if you knew that the pilot had just flown the outbound trip?

That shift, Luise Weinstein had worked 36 hours.

A change in the law

Libby Zion’s father happened to be a journalist and he did what all good Journalists do. He created a story, a mass of publicity. In response the governor of New York set up a committee to look into the case and in 1989 the law changed in New York State forbidding Medical residents to work:

  • More than 24 consecutive hours
  • More than an 80 hour working week

Remember that plane trip?

Ten years later the New York State Department of Health conducted surprise inspections at a number of hospitals. They found that over half of surgical residents work in excess of 95 hours a week .

Why do the hospitals flout the law? Simply because it would cost them a lot of money to obey it.

The problem with focusing on cost

Lean thinkers talk about purpose, they say you should always focus on purpose first and foremost. If you do that efficiencies and cost savings will come as a by-product.

Hippocrates is often quoted as saying “first do no harm”.

Perhaps that would be a good purpose for the hospitals to focus on.

James writes about process improvement at


Blog Carnival Annual Roundup 2011 – Squawk Point

I have the honor of participating in this year’s Blog Carnival Annual Blog Roundup.  The roundup is hosted by John Hunter at the Curious Cat Management Improvement blog.

Today’s blog, Squawk Point, is the first of three blogs I will review.  The blog is hosted by James Lawther.  James is a middle manager that has held many roles within operations.

James approached me earlier this year about his blog.  I am glad he did because I hadn’t seen it before.  James does a very nice job of making his points clearly and with some humor and great analogies.

The blog is split into three categories: Operations Analysis, Process Improvement and Employee Engagement.

Operations Analysis touches on subjects such as Statistical Process Control.  One example is knowing when things have changed.

In Process Improvement, James takes on topics like Man vs. Machine.  When is it alright to ask a machine to do something in place of a man or to ask a man to co something instead of a machine.

James tackles Employee Engagement issues.  A great post was about how to measure employee performance.

If you haven’t read Squawk Point, I encourage you to give it a try.

30 Rock Definition of Six Sigma

A couple of weeks ago, I posted something from a guest blogger James Lawther (“Do They Get It?”).  During our emails, James showed me the 30 Rock Six Sigma approach.  I found it to be very funny so I thought I would pass it along.  It is a good way to go into the weekend.

The Six Sigmas are (link to the 30 Six Sigma page):

  • Teamwork
  • Insight
  • Brutality
  • Male Enhancement
  • Handshakefulness
  • Play Hard

Not sure where they came up with the six attributes instead of the variance, but it adds humor to it.

I also enjoyed the acronym for C.L.A.S.S.  Consuming Lunch and Simple Socializing.

That sounds just like the reason most people go to all day classes, doesn’t it?  Get a free lunch and because either friends or people you want to know are going.

Here is one last very short clip of Frank’s definition of Six Sigma is

Have a great weekend!

Guest Post: Do They “Get It”?

Today’s guest post is by James Lawther.  James gets upset by operations that don’t work and apoplectic about poor customer service.  Visit his web site “The Squawk Point” to find out more about service improvement.

As you get used to improving processes, the one thing that becomes obvious, over and over again is that the more complicated we make things the more difficult it is to get them right.  Half of the time the biggest process improvement we can make is to make things nice and clear and simple.  It doesn’t really matter if you are working in high volume manufacturing, healthcare or for a bank, the principle holds true:

  • Sort out roles and responsibilities
  • Make things visible and obvious
  • Ensure that customer requirements are written down clearly (in words of not more than 4 letters)…

Why does this work?  Well that is fairly easy to answer, because if things aren’t clear and simple they are difficult, and then, lo and behold, people get them wrong.

At this point your eyes are probably rolling to the back of your head; this is not exactly new news is it?

No it’s not, but here is the rub, as process improvement people we have:

  • Theory of Constraints
  • Total Preventative Maintenance
  • ISO 2000 (and some)
  • 6 sigma
  • Total Quality Management
  • Lean
  • … and the list goes on

Not content with all of that we then proliferate like crazy, within the topic of Lean I have read about:

  • Lean Manufacturing
  • Lean Thinking
  • Lean for Service
  • Lean Management
  • Lean Sigma (my personal favourite, an excuse to sell books if ever there was one)

Then we have the audacity to complain that those we work with don’t “get it”, whatever “it” is.

Can you blame them?

Albert Einstein is quoted as saying “If you can’t explain it simply, you don’t understand it well enough.”

Could you explain things simply for those around you?

Is it time we took some of our own medicine?