Don’t Let Small Things Become Big Things

It seems most of us have a habit of focusing on the important things in our lives, both at home and at work, and letting the little things slide.

For instance, someone bangs their car door into your car, breaks through the paint but it’s only a pinpoint. “Shoot, why pay for that now – it’s so small. I don’t have the time or money to put it in the shop. And besides, it’s too small for any rust damage to really become a problem.” Roll forward through ice storms, rainstorms, hail storms, excessive heat and what happens? That little ding has morphed into a sizeable rust spot. The cost will be double.

Or what about things at work? There seems to be no end to all the little problems at work, mostly dealing with things like:

  1. The lack of supplies available when needed, like copy paper;
  2. Things not being where they are supposed to be like the stapler by the copier;
  3. Someone making a little accounting error like placing the decimal in the wrong place;
  4. An innocent spelling error like the customer’s first name;
  5. You get the picture.

We all deal with these problems, but let’s face it; they are quite trivial – right. We have much bigger problems to deal with. Or at least that seems to be the prevailing thought.

What happens when all these little problems add up? How much time is wasted every day, how much frustration do we put up with, how many work-arounds do we use to just get through the day and get the “real” work done?

What if we take a different tact? What if when we encountered a problem – no matter how small it is, we took the Toyota Production System (TPS) approach and “stopped the line?” At Toyota, no problem is too small to solve, once and for all. The expectation is that all problems are solvable when they surface, because people, when given the right direction and training, have the knowledge to solve all problems.

John Kenagy, MD, MPA, ScD, FACS picked up on this approach as a Visiting Scholar at Harvard studying the Toyota Production System across three years and subsequently developed Adaptive Design ®. Dr. Kenagy has applied Adaptive Design in hospitals and clinics across twelve years. His work consistently confirms what Toyota has long known. Problems should be solved by those doing the work where and when they occur. Every problem, no matter how trivial or how big, is an opportunity to move towards Ideal Patient Care.

Adaptive Design is a Registered Trademark of John Kenagy.

One perfect example of this point occurred with a hospital using Adaptive Design1. An RN knew her hospital relied on proper accounting in order to be reimbursed for their expenditures for patients who had no insurance and could not pay. Yet the device that she was using for a patient had no way to record it properly. This had been that way for a long time, but everyone assumed since the device was very low cost, that it did not matter. This RN, having been trained in Adaptive Design, knew this was a problem to be solved and got with the proper departments to solve it. The small team quickly (within days) put in place a remedy. As they investigated the problem further, in one month they saved $625,000 for the hospital just by ensuring that all supplies had proper coding and that everyone knew what to do. Small problem solved reducing a BIG EXPENSE for the hospital.

Adaptive Design helps organizations become continuous learning organizations, putting the power of problem solving in the hands of those encountering the problems. Continuous learning organizations work through problems, not around them, where and when they arise. Let the savings begin.

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