Bottle-Necks and Push-Back – Problems in Production Goal Attainment

Knowledge Check!Let me begin with an affirmation when you believe that a problem is insurmountable, you are 100% correct, and nothing will ever change.  If you tell me a problem is insurmountable, I will say to you BULL!  Every time!  Why; because if people built it, people can disassemble it.  We might have to push at it, swear at it, sweat at it, and kick at it some, but people can disassemble it!  When we believe no problem is insurmountable, we are more than ½-way to solving the problem!

At work right now, a colleague has a problem; trainers do not want to come in early and train new hires.  Because new hires cannot be trained in off-hours, his team is slipping in production goal attainment.  When he drops far enough, his regional bosses will decide more resources need to be spent, and public shaming begins to occur because public notice accompanies greater resource allocation.  The bottle-neck is training; the push-back comes from trainers.

Fishbone DiagramThe trainers are pushing back because they are already double and triple tasked to training new hires in two other more “important” departments.  Except, because those other departments are considered “more important,” production goals for the entire facility will never be met.  A core philosophy is missed; when quality fails, nobody meets production goals.  The vicious cycles keep going around; training cannot spare people to train quality, quality fails to meet goals, and production goals are missed due to training.

Exclamation MarkThere are times I have wished this was an isolated example; however, this repeats so often I should have cards made.  Breaking the training bottle-neck requires thinking outside the standard paradigm, or in more basic vernacular, get out of the box and start thinking anew!  While the following solutions are explicitly geared to fixing the training bottle-neck, the pattern for thinking is helpful as a conversation starter.  Start the conversation rolling!

Here’s some ideas:

  1. Off-hours shift training. Look at your operational schedules.  Do you have times when equipment is not operating, when the production floor is down, and when people can be trained?  Use that time!
        • I worked at a manufacturing facility where after the first three days of new-hire orientation, all manufacturing and warehouse employees worked the third shift for their first four months. Why?  Training could operate the floors and equipment and work around maintenance without crimping operational schedules or hindering production.  Then, new hires went onto the day shift where two extra managers could offer management-by-walk around for additional OJT.
        • I have observed warehouses where new hires work a split shift; they come in for 4-hours of training when nobody else is around but trainers, and then 4-hours when the rest of the warehouse is around—giving new hire equipment operators experience in operating in both a quiet environment and a busy environment.
        • The idea is to find times when you can safely train without hindering operation tempo. Use the calendar, use a shift rotation, be honest with people and be upfront on expectations and the reality of business needs.  Guess what, when you are honest, people respond!
  2. Appreciative Inquiry – Believe it or not, when you have a problem, a pressing business need, or an urgent issue, your people will pleasantly surprise you with solutions if you listen and act. Too often, I have been stunned ever to forget this lesson; people have brains and ideas, use them, give them credit, and watch them blossom into your best problem solvers!
  3. It should go without saying, treat people as the professionals you hired.
        • My first boss in supply chain quality control did not teach me basic stuff, e.g., this is a part, how you count the pieces, a SKU, etc. The boss presumed I knew or would ask questions, which saved both of us time and resources.  More to the point, by treating me as a professional, I grew into being a supply quality control officer and loved the job.  I have witnessed the opposite too often to know my experience is not the norm in supply chains, which is detestable.
        • You hired a professional; treat them as a professional. Set standards, show them, explain, train them, and build them into greater professionals, primarily by getting out of their way!
        • Encourage people never to stop learning through example!
  4. Who is your customer? Who are your vendors?  Who are your stakeholders?  Why is this information important?
        • Customer service is dead; however, if you do not know your customer, vendors, and stakeholders are, so is your business model!
        • Customer helping is alive and well; however, your business model is dead if you do not know your customer, vendors, and stakeholders!
        • Managers, let me give you a hint, your customer is your employees. When was the last time you got to know your customers?  When was the last time you helped your customers?  Why did you last help your customers?

LookWhen it comes to bottle-necks and push-back, knowing your customer is the first step in solving the bottle-neck and charting a positive path through push-back.  Consider my colleague, his customer are his employees needing training, his vendor is the training department, and the stakeholders are the rest of the business, those setting production goals, those relying upon his team meeting production goals, and ultimately the paying external customer.  Yet, my colleague, cannot see who his customer is, does not think of training as a vendor, and the rest of the business as a stakeholder, for this is not how he was trained.  Worse, his business unit refuses to accept this method of thinking to improve production goal attainment.

  1. Leadership must lead by first embracing new thinking and possibilities.

Previously in my career, it was a pleasure and adventure to be on a project where the leadership wanted a solution to their problem.  However, the leaders did not want to change, at all.  They wanted a solution, but refused to change in any shape, form, or method.  Worse, the leaders did not admit they did not want to change because they themselves had not considered that a solution would require change.  Thus, when the solution was delivered, it looked like a great idea, on paper.  But, the second it was implemented, reality bit, change was coming, and this scared the leadership team into panic mode.  Add in the coming economic downturn that had already started to hurt the company, and panic turned into a full-on disaster.

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1Leaders, it is imperative that you lead first by example personally, then by actions professionally, then only if necessary by words.  When you observe new thinking on an old idea, embrace that and see where it goes.  Even if the new idea fails, build people!  Production goals are about human efforts distilled into statistical symbols.  Never forget about the human element.  Build people, and you meet production goals.  Build quality into every single transaction, and you meet production goals.  Fail people, and you will never meet production goals!  Fail quality, and you will fail to meet production goals.

I cannot make this any simpler!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Bigotry or Racism – Low Expectations For Thee Produce Problems for We!

Angry Wet ChickenA headline on YouTube today discussing the bigotry of low expectations in public schools has me fuming.  Having written multiple times about how it is racist, immoral, unethical, and illegal to treat people differently based upon the poverty of their parents, and in doing so hinder the potential of a learner, is criminal child abuse of the worst kind!  Yet, what do we find in the news, all but daily; lower expectations based upon poverty, race, religion, handicap, and so much more because of the inferior minds of the teachers and school boards.

What is Bigotry?

Knowledge Check!Bigotry is being obstinate and intolerantly devoted to one’s own opinion and prejudices; of course, bigotry also classifies one as believing in the characteristics of a bigot, but that is another discussion entirely.  A teacher or school board member holding onto the myth that a student’s race or “economic classification” restrains that student’s potential is a bigoted method of thinking that should have been stomped out of public schools in the 1940s or earlier.  However, as this blog has recorded, the public schools in America have been purposefully designed to create dullards, anti-scholars, and functional illiterates since the early days of the 1900s, courtesy of John Dewey.

What is Racism?

Bobblehead DollRacism is the adherence to the fundamental belief that race is the single most important determinant of human traits and capacities, that racial differences produce inferior and superior races, and harmony among people can be achieved through racial ranking.  Essentially, racism takes bigotry and hones and focuses bigotry on racial differences as the sole determinant between people.  What is not said, not implied, and not discussed is that bigotry and racism are extensions of each other; thus, to call low expectations bigotry is to name those holding low-expectations racists nicely!

Why Does the Difference Matter?

From the article, “The Soft Bigotry of Low Expectations… Through Mathematics Education,” on the Racial Equity Institute, LLC website, we find the following:

The phrase “the soft bigotry of low expectations” was coined by President George W. Bush in 2000 in a speech to the NAACP that marked the launching of the No Child Left Behind (NCLB) Act. Bush asserted discrimination is still a reality, even when it takes different forms. Instead of Jim Crow, there’s racial redlining and profiling. Instead of separate but equal, there is separate and forgotten” (George W. Bush’s Speech to the NAACP, 2000). After promising that his administration would enforce civil rights, Bush announced that he would be confronting “another form of bias: the soft bigotry of low expectations…” (George W. Bush’s Speech to the NAACP, 2000). He acknowledged that educational achievement gaps fall along socioeconomic and racial lines but evaded discussing any systemic causes of these gaps.”

Plato 2What are these systemic causes for gaps?  The answer is relatively easy, simple, and straightforward, and no single piece of legislation will fix the problem until the 800#-Gorilla is addressed.  The Public School system was intentionally designed to mentally abuse children, classifying their potential by race, religion, color, sex, gender, handicap, socioeconomic status, and every other line of distinction.  All in an attempt to bring about the socialist utopia dreamed up by John Dewey in the late 1890s.

President Bush’s speech argued that school achievement gaps produce discrimination as if how a school works in one part of town creates the gaps and failures in another part of town.  Thus stealing resources from one school to deliver to another school would fix the discrimination gaps.  This is a glorified wealth redistribution scheme, and it has failed miserably!  It refused to discuss the reality in schools that the teachers and the school boards have attained power based upon discriminating upon race, gender, sex, socioeconomic status, and the intentional child abuse of the students.Plato 3

President Bush failed to understand that raising the bar will require destroying more than a century of ingrained thinking and training of teachers to abuse students.  Eradicating the discrimination will demand the rejection and destruction of the school board models, the Federal Hold on education, and placing states back in charge of the education in their states even if it means that each state has its own model of education.Angry Grizzly Bear

Regardless, the main problem in America’s schools is not the gender, sex, socioeconomic status, religion, etc., of the students, but the bigoted and racist minds of the teachers and school boards who would hinder students’ potential by setting low expectations for academic achievement.  I have worked with students across America; they are worth more than their teachers claim, can do more than their teachers think, and possess innate abilities, skills, talents, and raw potential.  But, without high expectations to aim at, the students fail themselves and live lives more diminutive than their worth and value, thinking they are stupid, dyslexic, unable to learn, and more.  All because the teachers and school board members set low expectations, refused to challenge the students’ own beliefs, and failed to do their jobs!

cropped-bird-of-prey.jpgWhen a school board, principal, and teacher fails to do their job, they commit child abuse in the most heinous and deceitful manner, and this abuse must cease forthwith!  As a new school year opens, let us challenge these low expectations, these abhorrent standards for performance, and these Neolithic ideas that should have died with John Dewey!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Let’s Talk About Root Cause Analysis

Flying BuffaloSome of you are thinking, “I will skip this article because the title does not sound interesting.”  I beg your forbearance, just please keep reading.  I laughed today, long and loud, over the incompetence of the current elected leaders in America, fully supporting public mocking, public shaming, and public humiliation over the following piece of news.

You cannot make headlines like this up:

Kamala Harris Emphasizes “Root Causes’” of Border Surge, Says the Problem is “Complex” while blaming climate change for the border crisis.

Let that sink in for a minute; the person who cannot hold a press conference, cannot even get VP added to her title, and cannot do root cause analysis!  I have been working since I was twelve; I was taught root cause analysis as a shade-tree mechanic; you have to be able to diagnose the correct problem to fix the engine.  This article looks like VP Harris is fixing the tires on a car without an engine, claiming this will get the vehicle running real good.  Here is VP Harris’ actual quote:

We are looking at extensive storm damage because of extreme climate, we’re looking at drought in an area in a region where agriculture is one of the most traditionally important basis for their economy, we’re looking at what’s happening in terms of food scarcity as a result of that and in fact, incredible food insecurity, which we used to call hunger food insecurity.”

Detective 4Let me see if I understand this statement correctly.  Political instability, Venezuela’s continuing meltdown politically, and the invitation from many politicians with (D) after their names have nothing to do with the “border surge.”  Just like a stricter stance on illegal immigration by President Trump (R) didn’t slow down illegal immigration on the southern border; do I have that correct?  Let’s talk about incentives, mainly welfare, housing, education, and a political base that refuses to enforce immigration law, do these not influence a southern border crisis, and buffalo wings come from flying buffalo.

What is Root Cause Analysis?Root Cause Analysis

Root Cause Analysis (RCA) is a process of logically working through a problem as a solution is developed.  I know some of you have other definitions for RCA, and that’s okay.  I am just trying to be real simple here, for if VP Harris sees this article, I do not want her confused with big words.  There are three goals to simple RCA, discover the root of the problem, understand how to fix the problem, apply what is learned to prevent future issues.  VP Harris’s comment above has already failed the goals of RCA; hence we can conclude that RCA was not accomplished!Fishbone Diagram

Effective RCA processes possess core principles that are apolitical and easily understood:

      • Focus on fixing the problems, not band-aid solutions
      • Symptoms relief is a short-term answer to buy time for long-term solutions.
      • Multiple root causes are possible; however, each root cause requires factual justification and logical discussion.
      • Who is never part of RCA, just HOW and WHY.
      • Methodical cause and effect evidence is required for each root cause.
      • Future prevention requires increasing learning and understanding.
      • Corrective action requires information and ACTION.

I am not here to hurt VP Harris’s feelings, but her comment about the southern border crisis being climate-related still does not pass the smell test on the core principles of RCA.  Let alone any logical test for veracity.  Thus, again, we can conclude that RCA was never followed to justify her commentary!

The easiest and simplest RCA is the 5-Whys Approach.  Here is the 5-Whys Approach in a simple analogy:

      1. Why? – The car battery is dead. (First why)
      2. Why? – The alternator is not functioning. (Second why)
      3. Why? – The alternator belt has broken. (Third why)
      4. Why? – The alternator belt was well beyond its useful service life and not replaced in a timely manner to save the battery. (Fourth why)
      5. Why? – The vehicle was not maintained according to the recommended service schedule. (Fifth why, a root cause)

Using the 5-Whys Approach, one can also work backward from a completed RCA to double-check integrity in the process.

5 – I am holding the maintenance records showing timely maintenance was conducted.
4 – The alternator belt is broken, but so are the other belts in the engine. Are we sure the root cause is the alternator?
3 – The alternator is missing.
2 – The battery is missing.
1 – The car is not working; why?

Using VP Harris’s comment above, we can back check the climate-change excuse to the erroneous assumption using the same technique.

5 – How many illegals at the southern border are only from the three countries being blamed for illegal immigration?
4 – Guatemala, El Salvador, and Honduras, suffered from El Niño and El Niña in 2017 and 2018, but there was no increased immigration during those tumultuous years of extreme weather.
3 – Since 2015, food security has been an ongoing problem in Guatemala, El Salvador, and Honduras. Again, we do not find a surge in citizens from these countries immigrating illegally to the US Southern Border.
2 – According to the World Bank, regardless of the weather issues and the global financial crisis, Guatemala, El Salvador, and Honduras are still being favorably looked upon as places to invest in for good returns on investment.
1 – What is causing a southern border crisis immediately after a presidential election year?

Please note, I only researched to 2015 for the weather, economy, and food security issues, as obviously President Trump (R) never had a positive influence on the Southern Border Crisis.  President Biden just inherited President Obama’s mess.  Does the RCA backward and forwards process make sense?  I ask solely because we have had migration issues on the southern border before today.  The politicians in America never seem to find the root causes and act to protect America’s defensible borders!  Blaming the weather, which has been changing in cycles since recorded history, for recent events, is akin to blaming the position of the planet Mars for burning one’s hand on a hot stove.

ApathyYet, let’s give VP Harris the benefit of the doubt; maybe her staff did complete an RCA process to reach this conclusion, while she has been sequestered and unavailable since the election.  If so, it would be easier than stepping off a curb to produce the RCA in detail and allow us, the electorate, to see how and why she is blaming the weather for a migration crisis.  This is a reasonable request, produce the proof an RCA was completed, where climate change is the only root cause in a “complex problem.”  Want to raise the stakes a little; if you cannot produce the RCA and accompanying evidence, along with the plans of action, you leave American politics forever.  If you produce the evidence and RCA, I will issue a sizeable public apology and never write about politics again.  I am waiting!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

 

Department of Veterans Affairs – Xray Follies – Shifting the Paradigms

I-CareDuring the COVID-19 pandemic, I have been trying to give the benefit of the doubt to the VA; I was wrong to extend this kindness.  The Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin, was investigated by the Department of Veterans Affairs-Office of the Inspector General (VA-OIG) due to reports of leadership failure and manipulation of radiology reports.  The VA-OIG found gross errors in treatment delays, misleading reporting in records, and the leadership both knew and were tolerating this behavior.  From the report, we find that the VA-OIG, “… found evidence of manipulation and vulnerability of the electronic health record and mismanagement of the Medical Imaging Service. Facility leaders failed to successfully manage or address the impact of interpersonal conflicts within the Medical Imaging Service that included intimidation of staff radiologists.

Sadly, I am not surprised at the findings in this investigation; for a considerable time now, the VA has suffered from leadership irregularities, poor leadership, mismanagement, and over management in the majority of the local hospitals.  This situation remains highly frustrating to the veterans cursed with needing the VA’s services, and this madness must cease!  If it were not for another VA-OIG report declaring follies and leadership failure specifically in the radiological department, the dire situation would not have been so egregious.

The VA-OIG began their report of the VA Illiana Health Care System in Danville, Illinois, stating the following:

This report is compelling because it discusses significant patient safety issues including a radiologist’s error rate, the facility’s radiology quality assurance program, and a recommendation to the Under Secretary for Health regarding adopting national radiology guidelines.”

The VA-OIG inspection began due to radiological concerns and a high error rate.  The VA-OIG discovered such a poor error rate, a second investigation was required to expand upon the issues found in the first investigation.  A radiologist had an incredibly high error rate, and the facility leaders did nothing.  Does this not initiate a leadership cleaning of the house to remove the rot and begin to build community trust; if not, why?

To be clear, both the local hospital leaders and the Veterans Integrated Service Network (VISN) leaders are at fault for poor leadership decisions.  From the VA-OIG report, we find, “Veterans Integrated Service Network and facility leaders failed to conduct a thorough and impartial review related to the OIG request to evaluate the original allegations.”  Leading to another question, actually repeated now for multiple years, why are the local leaders, who created the problems, “conducting a review” during the VA-OIG investigation?  Isn’t this akin to placing a bank robber in charge of the criminal investigation into the bank robbery?

X-RayThe primary care doctor, emergency room doctors, and more all depend upon the radiologist report as the VA doctors no longer read x-rays, MRI’s, CT Scans, due to the complexity of the imaging.  Thus, any error in the radiological report causes significant patient care delays, harm, or death.  Yet, at two geographically separate VISN’s and Hospitals, the VA-OIG is reporting poor QA and high error rates in radiological reporting.  Compounded by leadership failure at both the local hospital and the VISN level.  The VA-OIG reports do not relate that anyone was fired, forced to change jobs, or other remedial actions taken beyond making “suggestions” for improvement at the federal, VISN, and local hospital levels.  What significantly increases the problem, these same radiological records form the backbone of the compensation and pension decisions.  Downstream issues were not in the scope of either radiological investigation. Still, every error in the VA bureaucracy has a significant downstream impact that always seems to be forgotten or overlooked.

Secretary Wilkie, lacking a downstream review from the VA-OIG investigations, places patients at significant risk and incredible harm.  Consider the following; the VA-OIG reported last year (2019) that radiological reports on spinal problems were not adjudicated correctly in compensation and pension claims from 2002-2006 roughly.  No downstream review occurred, and thousands of veterans’ claims are locked in the appeals process for decisions that should have triggered an automatic analysis and new radiological reports ordered immediately upon the conclusion of the VA-OIG’s investigation.  Where is the culpability and responsibility to the veterans harmed and suffering all because the VA did not do their collective job?

Problems

Now, at least two VA facilities are hindered by radiological errors and poor leadership at the hospital and VISN level.  Thus, the veterans need to know, can any radiological reporting be trusted with this blemish on the VA record?  Quality assurance (QA) is the backbone of the radiological imaging and reporting processes to assure the patient that proper diagnosing is happening.  Yet, QA is the problem in two different VA-OIG investigations of the radiological departments, and how many other VA Medical Centers have the same problem but have not been caught?  Where is the accountability for preventing these issues in other VA Medical Centers?

Here are five suggestions for rebuilding the reputation in the community, and in the VA Health Care System (VHA):

  1. Downstream investigations are critical and need initiation upon discovery by the VA-OIG of wrongdoing. Downstream investigating includes compensation and pension decisions, patient medical record discovery, and fixing the problems in the healthcare record.  Build an internal team of various professionals who can investigate and initiate these reviews.  Doing so will build trust, save millions of dollars in wrongly adjudicated compensation and pension claims, and saves lives in the VHA.
  2. Since the leadership failures are so common, so prevalent, and creating such an incredible talent drain, all while risking patient health, it is time for the VA to begin growing leaders through a VA University program. Do not allow leadership currently working for the VA to apply without good reasons; allow open applications where students can learn, can graduate with a degree, and can work in VA leadership roles as they gain a formal education.
  3. Begin weeding the leadership for the most disingenuous, detestable, and despicable leaders, replacing them with people who have never worked for the VA but are capable and willing from other industries. The VA needs new ideas, new leaders, and new methods if they are to fix the current problems.
  4. Put teeth into the VA-OIG investigations. These problems as so egregious and widespread that the VA-OIG needs tools to demand compliance and insist upon remediation.  In three VA Medical Centers in Albuquerque, NM., Salt Lake City, UT., and a VA Clinic in Ashtabula, OH., I have heard the following, or something similar, from employees regarding VA-OIG investigations, “Don’t worry.”  Never again should any VA Employee not worry about being investigated by the VA-OIG.
  5. ISO9001Start using an ISO 9001 for healthcare as a QA program where processes and procedures are written down and followed. QA should be a program that fits holistically and improves people.  Quality assurance should be a constant learning evaluation that never ends.  Yet, somehow the VA, including the VBA, the VHA, and the National Cemeteries, always seem to not have a quality program.  Implement the ISO 9001 one VA Medical Center at a time until a whole VISN is working under the ISO program.  This allows the VA to learn and use these learning moments to build anew that which has fallen into disrepute.

Leadership CartoonSecretary Wilkie, some will suggest these ideas are expensive, but how expensive has the revolving door in human resources been for talent drain?  How costly has failed training programs been?  How expensive is the appeals process to compensation and pension decisions both in green and blue money?  The short answer, too bloody expensive.  Thus, it is time to begin looking for innovative ideas, using new ideas, employing new talent, and demanding higher returns for the taxpayer investment in the Department of Veterans Affairs.

©Copyright 2020 – M. Dave Salisbury

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