This article by Anita Tucker and Amy Edmondson at Harvard highlights a problem that is as common on the manufacturing floor as it is in the hospitals they studied:
When people encounter a problem that stops their work, they work the system, get what they need, and continue their work.
A lot of people call this initiative, and most organizations reward this behavior. Many of those organizations have actual or implied negative consequences for bringing up an issue that “you could have solved yourself.” Unfortunately this behavior only accomplishes one thing: It guarantees that the problem will occur again.
What is the big deal? Simple. Small problems accumulate. They do not go away, and more come into play every day. Eventually the Team Members are overwhelmed by “too much to do.” Supervisors press for “more people,” the organization grows in size, and the cycle continues. In health care all you have to do is spend an hour talking to harried nurse to know all of the things that keep them from providing patient care.
Go stand in the chalk circle on your own shop floor. What things keep your Team Members from doing their jobs?