It probably won’t surprise you to learn that every job is performed to a written standard that describes each step and the way it is to be taken. The written standard is essential for uniformity of product and quality. Without it, plant manager Rick Wynveen says, four different people will perform the job in four different ways, and produce four different versions of the product.
When a new employee comes on board, he or she is trained following an instructional sequence of practice and feedback that Wynveen calls “tell— show—do—review.” The new worker is paired with an experienced worker, practice is on- the- job, and feedback brings learning and per for mance in line with the written standard.
How do the workers train the managers? When a worker has an idea for improving productivity and management endorses it, for instance revamping the way parts arrive at a work station to make life easier for the worker and assembly faster, the worker who offered it takes leave from production to help implement the new standard. “Everyone’s idea is valuable,” Wynveen told us, “whether you’re an engineer, a maintenance technician, or a production worker.”13 Likewise, when one of the production line teams comes up short in meeting its targets, it’s the workers who are asked to identify the problem and redesign the production pro cess to solve it.
The instructional role of employees is most dramatically illustrated in what Wynveen calls a Kaizen event. Kaizen is a
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Japa nese term for improvement. It has been central to Toyota Motor Company’s success and has been adopted by many other companies to help create a culture of continuous improvement.
When Wynveen wanted to effect a major increase in the productivity of the plant’s double- hung window line, he recruited a design team to engage in a Kaizen event. The team consisted of an engineer, a maintenance technician, a crew leader from the production line, and fi ve production workers. They were given the stretch goals of reducing the line’s space requirement by 40 percent and doubling production.
(Stretch goals are ones that cannot be reached through incremental improvement but require signifi cant restructuring of methods.) The team met in a conference room eight hours a day for a week, in effect teaching each other the elements, capacities, and constraints of the production pro cess and asking themselves how to make it smaller and better. The following week they came back to Wynveen saying “Here’s what we think we can do.”
Wynveen took their plan to each of the twelve work stations on the line with a simple question: What changes are needed to make this plan work? Production workers and their crew leaders put their heads together and redesigned the components to fi t the new plan. The line was disassembled and rebuilt in two halves, over two weekends, restarted, and fi ne- tuned over subsequent months, a pro cess that generated yet an additional two hundred improvements suggested by production workers: a learning pro cess of testing, feedback, and correction.
The result? After fi ve months, the plant had met Wynveen’s stretch goals and cut costs in half. During the conversion and shakedown, the production teams never missed a shipment and never had a quality issue. The principle of engagement—
actively seeking the ideas of employees from all levels of the
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plant—is central to the company’s culture of continuous improvement. “Engagement is a management style of trust and a willingness to talk,” Wynveen says. The production employees learned how to refi ne the design as they worked, and the company provided a way for suggestions to be heard and for employees to participate in their implementation.
A learning culture places the responsibility for learning with the employees and empowers them to change the system.
Problems become information rather than failures. And learning by solving the problems (generation) and by teaching others (elaboration) becomes an engine for continuous improvement of per for mance by individuals and by the production line that they compose.
Inner Gate Acu punc ture
There are times when getting learning and teaching right can shape the trajectory of an entire life. Consider Erik Isaacman, a thirty- something husband, father of two, and passionate practitioner of traditional Chinese medicine: acu punc ture, massage, and herbal therapy. We close this chapter with the story of a turning point in Erik’s fl edgling practice, Inner Gate Acu punc ture in Portland, Oregon. It’s the story of a clinic that was succeeding in its therapeutic mission but struggling as a business.
Erik and his business partner, Oliver Leonetti, opened Inner Gate in 2005, after earning graduate degrees in traditional Chinese medicine. Through networking and creative marketing, they began to build a stream of clients. Portland is fertile territory for alternative therapies. The business grew, and so did expenses: They leased larger space, hired an assistant to schedule appointments and manage the offi ce, brought in a third clinician, and hired a back- offi ce employee. “We were
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growing 35 to 50 percent every year,” Erik recalled when we spoke. “The growth covered up a lot that was missing: We didn’t have the systems in place to manage costs. We didn’t have clear goals or a management hierarchy. It was fast becoming clear that we had no idea how to run a business.”14
One of Erik’s patients is the Oregon business coach Kathy Maixner. Maixner offered to help. “Unmanaged growth is scary,” she told us. “You jump ahead, then you fl ounder.” She asked a lot of questions that quickly focused Erik’s and Oliver’s thinking on critical gaps in their systems. The three then set out a schedule of frequent coaching sessions, between which Erik and Oliver generated elements of the missing infrastruc-ture: operating manual, job descriptions, fi nancial goals, metrics for mea sur ing the per for mance of their clinicians.
Every business serves two masters, its customer and its bottom line. “Our clinicians need to understand more than how to practice traditional Chinese medicine,” Erik said, as he re-fl ected on his and Oliver’s learning curve. “They need to understand how to turn a patient visit into a relationship, and how to help the patient understand his insurance coverage.
Satisfying our customers is our highest priority. But we have to pay the bills, too.”
Maixner used generation, refl ection, elaboration, and rehearsal in her coaching sessions, asking questions that exposed gaps in thinking or that invited the partners to strengthen their understanding of the behavior and tools they needed to adopt in order to be effective managers who delegate and empower their employees.
They developed a system to track clinic metrics, like the number of patient visits, patient disappearance rates, and referral sources. They learned how to ensure they were paid appropriately by insurance companies, raising reimbursements from as little as 30 cents on the dollar. They drafted a uniform
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protocol, or template, for clinicians to follow in seeing a new patient. They role- played conversations between themselves and their employees.
Central to putting the clinic on sound footing has been Erik’s becoming an effective coach and teacher of his coworkers.
“We’re not just letting it be intuitive,” he said. For example, the new protocol for clinicians to follow in a patient’s initial session helps to clarify what brought the patient in, the therapies that might be useful, how to describe these therapies in terms the patient would be likely to understand, how to discuss fees and insurance reimbursement options, and how to recommend a treatment plan.
“If you’re the clinician, we’ll role- play: You are now the patient, and I’m the clinician. We raise questions, objections, and we practice how to respond and end up at the right place for the patient and for the clinic. Then we’ll switch roles. We record the role playing, and we listen to the differences: how you have responded to the patient, and how I have responded.”
In other words, learning through simulation, generation, testing, feedback, and practice.
As we write this, Inner Gate is in its eighth year, supporting four clinicians and two and a half administrative staff. A fi fth clinician is coming up to speed, and the partners are looking to open a second location. By dedicating themselves to being learners as well as teachers, Erik and Oliver have turned their passion into a solid enterprise, and a top- rated acu punc ture clinic in Portland.
We have talked throughout this book about learning, not about education. The responsibility for learning rests with every individual, whereas the responsibility for education (and training, too) rests with the institutions of society. Education embraces
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a world of diffi cult questions. Are we teaching the right things?
Do we reach children young enough? How should we mea sure outcomes? Are our young people mortgaging their futures to pay for a college degree?
These are urgent issues, and we need to wrestle through them. But while we’re doing that, the techniques for highly effective learning that are outlined in this book can be put to use right now everywhere learners, teachers, and trainers are at work. They come at no cost, they require no structural reform, and the benefi ts they promise are both real and long- lasting.
N O T E S
S U G G E S T E D R E A D I N G
A C K N O W L E D G M E N T S
