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Leading Change

What’s Good for the Goose ISN’T Good for the Gander

I was watching Jon Stewart, where I get all my fake news from, and he had an interesting guest, Atul Gawande, the author of The Checklist Manifesto: How to Get Things Right.

Leading Change: Using a Checklist

Now, if you’ve spent time looking at my site, you’ll know that I am a fan of checklists. (I’ve even got a free 8-page downloadable PDF on the subject.) Of course, building a process so you don’t need a document to support it is the best option, (i.e. with poka yokes), but checklists are an effective tool.

Mr. Gawande’s book dives into the use of checklists in the medical field. It should come as no surprise to people familiar with the tool that it has proven effective at saving thousands of lives. Basically, the list makes sure that some of the common causes of problems are addressed prior to the start of a procedure.

Despite the success of the checklist, its adoption rate has been abysmal. And this is for a simple, 2-minute checklist that has been proven to save lives. What really surprised me, though, was an interesting statistic. The developers of the checklist did a study, and after 3-months, 80% of the doctors using the checklist liked it. The researchers asked a single follow-up question to the ones who didn’t.

If you were having an operation, would you want your doctor using the checklist? 93% said yes.

What that means is that the physicians who don’t like the list still see the value in it-they just don’t want to use it. So, imagine the challenge of leading change for a team where the stakes are not life and death. If nearly a fifth of well-trained physicians who see the value of doing an extra two minutes of work to save lives refuse to do it, what chance do you think you have of leading change on an assembly line or in a back office, or in a engineering group?

When leading change, Lean managers often fall into the trap of trying to prove the worth of the new method or philosophy, and forget that there are people involved-people with their own ideas of what makes them satisfied in their jobs. During the interview, the author speculated that part of the problem with doctors not wanting to follow the list was that they considered it below their skills. Many went through ten years of training, so they devalue their education and expertise by needing a simple tool like a checklist. Proving the value of the list does nothing to address their real reason for the resistance.

Remember, leading change is part sales. You are selling the new methods. You have to know your customer to close the deal. If you have any tips on how to sell Lean to a resistant team, I’d appreciate you sharing them with my readers. Please add them to the comments section.

By the way, I haven’t yet read this book, but I am adding it to my already lengthy reading list. I’ll let you know when I finish it.

UPDATE: 2/8/10 Mark Graban wrote about this same spot on his LeanBlog.org.


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  • Mark Graban says:

    I can’t emphasize how outstanding his book is for anybody doing work with “standardized work.” His checklists approach is not as simplistic as people might think, it’s pretty nuanced and arguably very lean.

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