This is a pretty common question.
Today I was talking to a department director in a major regional hospital that is learning Toyota Kata. She picked it up very quickly, and wants to take the learning to the off-shifts.
She (rightly) doesn’t want the night shift to just be deploying what day shift develops, she wants night shift totally involved in making improvements as well. Awesome.
Her question was along the lines of “How do I maintain continuity of the effort across both shifts?” She was jumping into asking how to provide good coaching support, whether there were separate boards, or a single board etc. and playing out the problems with each scenario.
My reply was pretty simple. “I don’t know.”
“What do you want to see your learners doing if they are working the way you envision?”
In other words, “What is your target condition?”
But… how do we coach them, and so on?
I don’t know. But until we understand what we want the improvement process to look like, especially across the shift boundaries, we can’t say. Different target conditions will have different obstacles.
And what worked at Boeing, or Genie, or Kodak, or even another hospital I’ve worked with likely won’t work here in your hospital. The conditions are different. The conditions are different in different departments in the same hospital!
She admitted that she was having a hard time thinking about a target without dealing with all of the potential obstacles first. My suggestion was that this challenge is her improvement board, and the best way to work out a solution was to actually follow the Improvement Kata (that she has been doing such a great job at coaching for the last month).
Trust the process. Once there is a clear target condition for the people doing the work (in this case, the learners / improvers), then we’ll better understand the obstacles we actually have to deal with. That will likely be fewer than every possible problem we can think of right now.
Establish your target condition, then list your obstacles, then start working on them one by one.
The Improvement Kata is exactly the tool to apply when you know you want to do something, but can’t figure out exactly how to do it.
Step by step.
Keep it up, Susan. 
Good blog Mark. I like the path you were helping guide the Director down by bringing focus to the problem and from there drive learning to figure out how to address it. I try to model this when I’m coaching.
I see some organization struggle with this concept however. It seems to fly in the face of standard work. In the organizations that struggle there is often a mindset that once you address the problem, you create a standard that other groups can follow, thus leveraging the learning that has taken place to multiple areas. With this mindset it seems very time consuming and wasteful to have different groups all driving individual efforts to reach the same target condition.
Would it make sense in your example for the Director to focus on reaching the target condition of engaging the other shifts in the problem solving effort but then creating a standard for that approach and have other areas within the hospital follow it?
Have you seen this challenge? How have you helped groups walk the line between creating standards and allowing them to discover their own path towards a target condition?
Brian – we discussed the lateral-deployment model here: https://theleanthinker.com/2015/02/17/scientific-improvement-beyond-the-experiment/
Actually, in my “rounds” in the same hospital (visiting improvement boards), I see three separate teams working on essentially the same problem. I see another problem being addressed by two teams. What I am doing is making sure those improvers are talking to each other, and sharing what they are learning so the value of each experiment contributes to the whole.
While this may seem like wasted effort, the same argument is made about research in general. But the reality is that the more people there are working on something (and exchange ideas and learning) the higher quality the result. What is the alternative? A “controlled economy” where every effort is regulated? It seems appealing, but in actual practice has proved difficult.
Mark,
We run a 4 crew, 24/7 operation. If you could pass on my email to Susan(please don’t post it) I’d love to share learnings.
We are trying to get 2 of the four crews together during shift overlap at a time and then continue the kaizen during the next shift change that includes the remaining two crews. Yes, we don’t get all crews together at once, but this process allows us to see everyone and puts the burden of communication back on us as leaders.
Duke
Mark,
Please share my email with Susan. We are going through the same thing and I’d love to share what we learn and her what she learns.
We run a 4 crew, 24/7 operation so getting everyone on all four crews together is difficult. We are trying to over lap 2 of the crews at a time, doing the kaizen with them and then repeating the process with the next two crews when they over lap. It places the burden of communication on us as leaders, but we have found it to be cost effective from a machine utilization standpoint.
Duke