I recently attended the 26th Annual IHI (Institute for Healthcare Improvement) National Forum (www.ihi.org). Besides learning about blogs during the social media lunch and learn, the topics also included lean processes, healthcare quality, and social determinants of health. After this experience I wanted to share my analogy of what healthcare can learn from mowing lawns…
Most of us have mowed the lawn at some point in our lives. Even if you never had this opportunity, you will be able to relate. Whether you consider this a tedious or relaxing task, there are always ways to improve.
Working longer: This is basic arithmetic. You can mow more lawn if you are mowing for 2 hours compared to just 1 (working at the same rate).
Working harder: If you want to mow more lawn, or be done faster, then simply moving faster will get you there. This may involve walking faster or even running behind the push mower.
Working smarter: This is where a “lean” process comes in. If you are in the lawn mowing business, arranging locations to reduce travel time between them will improve efficiency. This is removing the “waste” from the process. If you are mowing your own lawn, then reducing the number of times you transit areas that are already mowed will decrease waste.
Capital investment proposal: Maybe a new machine or wider mower deck is necessary. A wider mower can mow more than a narrow mower (at the same speed). This proposal involves a benefit, risk, effect size, return on investment, etc. to determine if it is a good idea.
Interestingly the first 4 types of improvement are focused on doing the exact same job (mowing the lawn). For the following scenarios consider that you a have lawn mowing business.
Improve the quality: Adding an edger, weed whipper, and a leaf blower will improve the service/quality. Here is where a paradigm shift is starting. No longer is it simply “mowing the lawn,” but providing “lawn care.”
Adding complementary service: Aeration and fertilizer will help the grass grow faster. Adding an irrigation system will also facilitate grass growth. Furthermore this will increase the quality of your “lawn care.” If lawn mowing is your business, then this is a good path to take. Your customers will need your service more frequently. Other services may be landscaping, fountains or retaining walls. Now “mowing the lawn” has transitioned to “landscaping.”
Adding different service: If you live in a region that snows (as we do) the lawn care company can also provide snow removal. Most of the time <haha> we don’t need both lawn care and snow removal at the same time, so the lawn care business can diversify and change from a seasonal business to a year-round business.
The first 4 focus on the task of mowing the lawn. The next 3 work on business development and quality. The last step is not frequently considered in innovation, but is possibly the most important question. This is where the magic happens.
Ask why: Why are we mowing the lawn??? Do the customers really want their lawn mowed? Maybe they really want a natural habitat with long grass for wild birds, a wetland pond for waterfowl, an organic garden, decorative stones, a display of yard art, or an outdoor toy train diorama.
What is the “why” for the healthcare that we provide? Are we providing something that patients value, or have we just been finding an efficient way to “mow the lawn” when the patient really wants something completely different? The next time you are faced with an improvement decision, ask yourself and your team which category it falls into, challenge them to consider other strategies, and remember to take time to answer “why.”
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