GA 212 | How to Combine TWI, Kata, and a Kaizen Event with Brandon Brown

For those of you that maybe wanted to change your culture to more of an open mindset, more of a mindset that is focused on growth and focused on people being allowed to experience small failures and learn from them, I think the kata scientific thinking routine is at the center of how you start to move that culture.

If you've practiced lean for more than a few years, chances are you've been involved in what most refer to as a three to five day Kaizen event or Kaizen Blitz. Conversely, if you've practiced the Toyota Kata scientific thinking process, you may have noticed these three to five day rapid improvement events aren't always used as much as they used to be. But what if there was a way to leverage these two lean thinking approaches? Well, that's precisely what today's guest has done. His name is Brandon Brown. Now, Brandon's been on the show several times before and as you'll hear, he and his friends at the Baptist Memorial Hospital have found a way to combine apps, aspects of TWI Kata and the traditional Kaizen event into a powerful learning system. Now, show notes for this episode, which will include links to everything we discuss, can be found over@gembapodcast.com just look for episode 212. You can also check out Gemba Academy's Lean Learning system over@gembacademy.com with a fully functional trial. Now let's get to the show. All right, Brandon, welcome back to the show. How's it going, my friend?

It's going good, Ron. Thank you for having me back. Always like to discuss kata and lean topics and share ideas with the rest of the community.

Yeah, we were talking before we hit record that this is the fifth time that you've been on different podcasts over the years and we're going to. Rather than rattle all the episodes off, I'm going to point everybody to the show notes page for this episode which will be episode 21212 gemba podcast.com just go and look for episode 212 and we'll link to all the episodes that Brandon's been on. Definitely recommend folks go back and listen. And then, you know, obviously you were in episode 200 when we, we kind of did sort of a highlights of the first 200 episodes. So yeah, so thanks for all you've done, Brandon. And I always really love talking to you and your passion is contagious, my friend.

Well, thank you for having me. I appreciate it. And honor's mine, Ron, to be able to share and learn from others as well and share experiences and have exchanges, so I enjoy it as well.

All right. Well, so in case folks haven't listened to the previous episodes when you were on give everybody an update on who Brandon Brown is, how you first came to learn about all this continuous improvement stuff and then what you're up to these days.

Well, Brandon Brown, I'm an owner and president of Continuous Coaching Commitment. We do coaching in various service areas, from leadership to Toyota Kata to any of the lean tools that are used out in the Six Sigma environment. And so I've been doing that since about 2012, I think it was 2011. I attended a workshop that Mike Rother would put on at Carter Blood Care center in Dallas, Fort Worth area, and that's when I first learned about Kata. Previous to that, it was, I'm dating myself all the way back in the late 90s that we were doing Kaizen events. And you know, that typical three days, four days, five days or whatever at a couple of different manufacturers, primary backgrounds manufacturing. But most recently in late 2015, Skip Stewart with Baptist Memorial Healthcare in Memphis, Tennessee, asked me to come over and just observe one of their hospitals that they had been he had just trained in this initial awareness training in Cadda and was able to kind of help them start some storyboards, help them grasp their current condition, identify their challenges and set the storyboard structure up. And since then, Skip has expanded our role in some of the work we do at Baptist. We're very honored to be part of the Baptist team from a standpoint of we have a couple of coaches now that are placed throughout their system, coaching at various stages of learners. And so that's what we've been doing for the last third year now, as well as other manufactures, other workshops and things that we, we do throughout the year. So, yeah, that's kind of the background.

Beautiful. Now listen, we always make a lot of assumptions on this podcast that people listening here kind of know what's up with all this lean stuff that we talk about. But I don't want to make any assumptions. Can you give the listeners who may not be familiar with what this whole Toyota Kata movement is about, just give us a high level overview of what is Toyota Kata before we jump deep into some cool stuff that you guys are doing over at Baptist.

Okay. It's, it's the work from Mike Rother who wrote with, along with John Shook, the Value Stream Mapping Learning Seed Book. Most people call it the Value Stream Mapping Book. It was published. Toyota Kata was published out of some research that he did with Toyota and five other Toyota suppliers and what are the unseen managerial practices around continuous improvement that has made Toyota successful throughout the years that we in the Western world or in our lean community have not been able to duplicate or not been able to sustain? And basically what he saw was two practice routines, or scientific thinking routines as we call them now, the improvement kata and the coaching kata that have some established roles of a learner, a first coach and a second coach. The learner being owning the storyboard and being the one that does the plan do, check, act or plan do, study, adjust cycles of learning around an area that needs to be improvement as we're striving toward a target condition, the way that we want to operate and improve the way we want to operate on our way to an overarching challenge. And then there's a coaching role that coaches, they're using the 5:2 or Kata questions as a starter kata to coach the learner through the thinking pattern and the scientific routine until it becomes a meta habit and the learner's skill develops. And as we do this each and every day, much like riding a bicycle, the first time you rode a bike, you fell over and skinned your knees. So the learner initially makes a few missteps and PDCAs, PDs don't go as well as planned. Or sometimes there are some surprises, sometimes the coach is surprised, and then the second coach is also involved in this improvement process where the second coach has been through the role of the learner, been through the role of the first coach, and is participating periodically in the coaching cycle to give the first coach some feedback on their coaching techniques and their coaching questions they ask and ensuring that both the learner and the coach are progressing in skill level from a very novice level up to more of an advanced beginner and competent to becoming proficient with the routine. So scientific thinking routine, that's basically Toyota kata method, thinking pattern, practice routine. Kata actually means form or way of doing or way of practice in the Japanese language. And that's what Mike described back to Toyota. As I see you doing an improvement routine or improvement practice routine called a kata, possibly, and a coaching routine that you're practicing to ensure the scientific thinking pattern happens, called the. He would say that would be a coaching kata, and that's what kind of coined those two phrases. And, and hence the movement since about 2009 toward daily scientific thinking practice routines for continuous improvement.

Beautiful. Beautiful. All right, well, thank you for that summary, Brandon. So I don't want to get into all the details of how powerful the Baptist kata movement is. We've covered that in previous episodes with Skip even came on you and I and Skip sat down at the Katakan Conference. I guess it was last year or two years ago. And so again, we'll point back to those previous episodes. Go to gemba podcast.com look for episode 212 and check out these previous episodes so you can kind of get caught back up to speed on all the good work that Skip and Brandon and the folks over that Baptist Memorial are doing. But what I want to talk about today, Brandon, and something that you and I were kind of exchanging some emails about, and I'm just really curious to learn more myself is, is I guess what Baptist is calling get better Jump Start. And the way I understand it is you guys are actually doing some really cool stuff with, with an aspect of twi, namely JM or Job methods and one of the one of the three J programs there's. And so I just wondered if you could just kind of walk us through that. Brandon. I don't have any set questions to navigate us through that. I'm just more curious myself as a learner here.

Okay, so this actually came out of a TWI summit or conference from probably around 2013 or maybe 14, I think Skip was at a TWI summit. I spoke there on KATA and a question came from the audience about where do I see the role of Kaizen events or Kaizen improvements and Kata? Are they different? What's the relationship? How do you see that? And I had been thinking about that for a couple of years and what I had posted, the answer to that question as well. What I see is maybe a hybrid or a crossover where you don't end a Kaizen event or an episodic event, a three day or two day, four day, however long the event is, with an action item list, which is what Mike outlines in the book. But what if you did some rapid improvements in the entire time you were ending it with a working KATA storyboard with a set learner, a coach and a second coach. And what would come out of that would be then an ongoing team of those people and they would continue on the improvement process. So it wouldn't just stop and be Project Champion or a Lean Champion or CI manager or CI engineer that would be responsible for those action items, which we all know, as if we don't continue to strive forward, we will fall back due to entropy to the original state or back to the old ways of doing things, old habits and behaviors. And I think Skip and I talked about that a couple of times and then he wanted to add to The Baptist management system, which includes, as you mentioned, training within industry, an idea generation program. Khatar really is the lubrication throughout the whole system. The thinking pattern is along with strategic A3s. And the question came up, I think during some leadership meetings is well, is there a role for Kaizen event to make rapid improvements? Beth Carrington and myself and some others drafted up some ideas about that and pareded off of the concept that I had answered that question on. What we coined it was a get better jumpstart. And so Skip likes to call it the Kaizen on steroids, so to speak, is what he says. What we do is, I could outline it for just a few moments is we take a challenge that's been issued by an advanced group or as we call it, Baptist, a shepherding group. It's a group that has gone first and deployed the improvement kata and coaching kata in the organization. They define the area that needs to be rapidly improved and helps define the challenge statement for that area. Once that is defined and the team is on board, we start to assemble the, what we call the event team, which would not be a traditional cross functional Kaizen team where you would have people from cross functional areas. They would start to do the first step of the improvement cadda, which is grasping the current condition. Many times that's the difficult part of getting started. Or we outline what we think the current condition is and as Mike has in his practice guide, and that the process is iterative, but yet it's recursive. So as we do experiments toward a target condition, we learn so much more about the current condition or we learn what we didn't know about the current condition. And it can take a month or a month and a half or two months before we're fully making steady strides toward that for that challenge. And so we took some time, depending on the complexity of the cycle of the process, how many departments are involved, we determined somewhere between three weeks and six weeks in advance of the event, we would begin to grasp that current condition, begin to collect data, go and see, go to the gimba, go and see and start to build really in the center part of the storyboard that current condition, you know, what is the working pattern that we're seeing, what are the characteristics that are defining that working pattern below that, then the process metrics that are measured day by day or in the moment, which that can be a challenge in itself, that are driving or producing the ultimate outcome metric which is related to the challenge. And so we gather that information in a series of meetings ahead of time. There's assignments each team member to gather area information. And we do this in advance of a three day event where we would spend the first couple of hours that first day really defining that current condition and finalizing it to really moving right into what's the first target condition. Our entire goal of the three day event is to end with a working storyboard. Well, with a report out to the leadership team, the advanced group team, and a working storyboard and a coaching kind of cycle. So we try and get on that first day, that first target condition, or say two weeks out into the future, and we begin just immediately doing PDSAs to remove the obstacles. Once we've analyzed and fully know the current condition and we know the gap between the current and target, we can list those obstacles, write them out, and immediately go to plan, do study, adjust or plan, do check act cycles. Trying really exploratory experiments, we, we feel that what we've been able to do in the first few events that we've had is really do an exploratory experiment, as Mike outlines in a lot of his slides and text, which is go and try to run it in the target condition and then where it fails or it breaks down, build an obstacle parking lot from there. Because if you're not able to run as you want to run in that first target condition, then you're finding real obstacles, they're not perceived obstacles. And you can get further into the pathway to the challenge in those three days by doing those rapid cycles of improvement. So much like the teams split up and in a Kaizen event and work on different pieces of lean improvements, we try and split the teams up and there could be multiple learners, maybe three learners going out doing PDSAs with a couple of coaches. And we come back to the board and each person goes through a coaching cycle. So there's multiple coaches, multiple learners helping to build different portions of that storyboard. But ultimately beforehand we have decided that one person's the learner, one person is the coach, and one person is the second coach. And most of the time this is a group that has already experienced a little bit of kata experience from the improvement kata coaching kata cycle. So we like to say that it catapults us into maybe the second month or the third month of a traditional startup of a deployment of a kata storyboard.

Now, you mentioned that you might have multiple learners, multiple coaches running different PDCAs in that, in that first day or two or three of the event. Now, are they all focused on the same target condition?

Yes. We will have Maybe a focused process within a target condition or within a working pattern. There may be, maybe something crosses over between two departments or there's work flow in the hospital, maybe there's patient flow across the emergency department to the inpatient floors and then to the discharge process. So that would be three distinct parts that would have representatives from each of those areas. And so if there's an obstacle between the emergency department flowing patients to the inpatient and admitting them, then there may be a group that has a learner in ED and that coaches in inpatient and they're doing an experiment to improve flow. There may be at the same time someone in, say, transportation department that does discharges and maybe someone in the inpatient side that are working on the discharge process and they're working on that end of the working pattern that was an actual subject of a patient flow board that we did. And so where we see those crossover, many times we like to try and break down those silos by putting a coach and learner. And in the environment that we're trying to create, there's really no competition of, well, emergency is my department and I'm already doing a PDSA on this part of the process. And someone from inpatient side says, well, I'd like to attack this obstacle. And it's in your emergency department. Everybody's open and says, okay, well, you coach me on one pdsa, I'll coach you on the other. Even though it's not their area of responsibility and everybody knows ahead of time, the team, the work areas know ahead of time that we're going to be doing some rapid experiments during this time period. So there's going to be people coming to your area and doing some studies and asking you to try some things. And they may not be your immediate manager, but this is all under the learning cycle of experimenting within the Baptist management system. So we've had some successes, we've had some struggles with a few, but all in all I think they've gone well. Again, everybody's driving toward that final storyboard on the third day, reporting out what we've, what we've accomplished and what's currently ahead of us as far as obstacles and the go forward plan.

Now, are you able to share, and I don't want to, definitely don't want you to talk to anything confidential, but are you able to maybe share a, maybe a high level example of a challenge and an initial target condition and you know, some, some, some PD SAs that they, that the folks have worked on just to give some context to what you've just described.

Yes, there, you know, hospitals are always trying to improve the patient experience. Trying to improve what we call HCAHP scores or press Ganey scores within healthcare. And that's how the hospital is compared across the nation. There are certain areas that when patients answer surveys that if you don't answer always to the question, which is kind of like getting a 5 out of 5 rating, whatever the rating system is, then you almost get no. Well, you don't get any credit on that. On that particular question. Well, that hurts your score in that particular area of where the patient's evaluating. So there were some few areas that we talked about within how the pharmacy and the nursing and the respiratory are all communicating with the patient on the side effects and the indication of medications that are administered in the hospital or could be discharged with prescriptions for that particular medication. And so we were trying to improve that area of the Prescani scores was what we had identified as a challenge. So it became obvious that we needed to do some education, we needed to do some visual aids, we needed to do some auditing and teach back with the nurses, communicating those particular parts of the discharge process with the patient and then going back and kind of auditing. Was a patient able to retain certain information? And how well was that being communicated? How well were we preparing the nurses to do that? How well are we preparing? We've involved the respiratory side because there could be breathing treatments or things that go on during. During the patient's stay that are required to get them back into health. Even dietary. We involve dietary and moving their diet back from what type of diet they have to be on while they're inpatient and then as they progress toward discharge status. So all of that was different areas that were looking at trying to make sure that we were communicating to the patient and providing them with the best possible patient experience, fully communicated with. And so the experiments were around changing the way that we currently communicate that. So.

Got it, Got it. Talk about maybe let's start with a challenge as it relates to get better, jump start what's been difficult or what have been some learnings through, you know, through some struggles.

Okay. So we have a way of writing challenges, continuous coaching, commitment. And we do it at Baptist. We do it at many of the organizations we work with is, you know, write a challenge statement. It would be marvelous if by a certain date, a year out, we have an environment, a robust environment. We use some words that kind of describes in a year, what does the environment look like, what does the working pattern kind of look like without writing a solution place so that we achieve. And then we'll list key performance indicators or the outcome metrics that we're trying to move by creating this new working pattern. And in doing that many times we'll grasp the current condition. We'll spend a lot of time in the beginning trying to gather data, trying to gather information. And sometimes it can be a challenge to link what we call the process metrics. What's happening hour by hour, in the moment, day by day that is impacting that outcome metric. Because we can't really do a PDSA to remove an obstacle to achieving an outcome metric. That's not what we're intending to do. The scientific thinking pattern is that we're intending to do a PDCA or PDSA to remove an obstacle from that next target condition we're trying to reach. And in doing so, the quickest way and the fastest way is if we're doing rapid PDCA for PDSA cycles is we need to see movement in the process metrics that are measured hour by hour, day by day, as soon as possible. So we know whether our experiment was a success. Did we remove the obstacle or did we have a failure? The obstacle is still there. And possibly we uncovered a deeper obstacle that requires a different type of experiment or maybe some different thinking. And so right off the bat, trying to nail down that process metric sometimes has been a little bit of a challenge. We may or may not be measuring a particular occurrence in the current way that the hospital is evaluating different departments performance. And so it requires maybe some manual record keeping, maybe some report writing out of the computer system and gathering information off of patient flow or off of different time periods out of the system. So linking that all the way up, challenge operating, working pattern to what kind of ultimate outcome metric that tells us whether we've won the game or won the championship, so to speak. And linking up with the day by day activities can sometimes be somewhat challenging. And we may change back and forth between studying something in the current condition for a week or two and then realizing that we need to be studying a different process metric to prepare ourselves for the get better jump start event.

Yeah, yeah.

Continuous coaching command. We also, we call them Kata jump starts. It's really the same type of thing whether it's in manufacturing or other service areas.

Yeah, got it, got it. Hey, I want a slight change of topics still related to kata, but I know you're a big believer in the Katakan conference and you attend and speak at them. I want to give a. Not trying to Do a plug for Jim and Dwayne and Lean Frontiers guys. But I do want to plug it a little bit. I want you to talk about how important it is for you or if it. I'm assuming that it's important for you to attend those. Those meetups once a year. What do you take from those Katakon conferences and the twi, you know, if the TWI is linked up with it, which sometimes it is, what do you take from those events, Brandon?

Well, I like to look at it as a learning experience. I kind of consider myself more an eternal learner, as Skip kind of likes to call it, the top level of proficiency within Kata. I'm always learning and seeing how other people have faced struggles or faced challenges and the different methods that they've used and how they've integrated training within industry as job instructions or job methods into countermeasures or into ways of helping to continue to sustain standardization once an experiment is successful. So that's the number one thing I take away from it and the different ways that people evolve the kata. Mike has been calling it for a couple of years, the five questions on the blue card that are on his website, the starter Kata. And when he first referred it to that, it was kind of a new term for me and many of us in the kata community. And then when he started explaining it and we started seeing people present on how they are practicing kata, began to understood that this is a broader thinking pattern than just the structured routine of the questions. And if the questions just get you started down the path of practicing each and every day, but then you evolve the questions or you evolve the way that you use the storyboard and use the thinking pattern to fit your specific company and your specific culture again, to drive that culture in the direction that you want. Getting to see the different cultures and how they're using kata, how they're using twi, is always enjoyable and a good learning experience for me as I walk away from that particular conference.

Yeah, yeah. So I looked up on the website here while we were talking. So the next one is February 18th and 19th in 2019. Looks like it's going to be in Savannah, Georgia. So that'll be a cool little place to go crash there for a couple days. Um, so if you go to katasummit.com, you can put your email in there, and I think you'll get some updates from. From Jim and Duane and the guys over there. So, yeah, definitely recommend hanging out with Brandon and Skip and Michael Lombard and all the regular kata thinkers out there. That are always out there. So good stuff, Brandon.

And in that week, I think we're changing it this year we're going to do kata summit at the beginning of the week, which I'll be doing some of the kata improvement katana workshops and possibly a breakout session. And then the end of the week is a training within industry.

Okay.

On a Thursday and the Friday, I think they're going to reverse it this year. And we're actually presenting, I think, on some job methods and how we're integrating that with kata as a topic that we're going to be presenting on.

Beautiful. Beautiful. All right, good stuff. Well, hey, we've been going for about 30 minutes, and I know you're on your lunch break, Brandon, in between all of your activities and coaching. So thanks for carving some time out with us. Let's go ahead and wrap things up. Brandon, with you, maybe just sharing a few final words of hope and wisdom. I know you're full of hope and faith and go ahead and talk about that and then tell people how they can connect with you, Brandon.

So what I would say is that there's a mindset that gets developed in us throughout our lives. And I mentioned riding a bike early on. I use this a lot of times when talking about not being afraid to fail, not being afraid to experiment. When we're children, riding a bike or whatever it is, work is like play to us, or riding a bike sometimes can seem like work. So as we start to take the training wheels off, we're going to fall down, we're going to skin the knee. But there's always somebody there to encourage us, give us positive reinforcement, get back on the bike, pedal a little faster. You fall down, scrape your knee again. That person picks you back up and says, okay, keep the steering a little more straight. Don't get off to the side. They're giving you tips and coaching along the way and positive reinforcement. And we move away from that childlike way of learning to more of a more negative reinforcement, really, within our later years in high school and in college or whatever, trade school, technical college, to where if we don't make a good grade or we're not getting an answer correct, it's almost a negative reinforcement. And then throughout your career, you're paid to know the answers. Most people think they're afraid to say, I don't know, because that shows them I don't have the competency for this position. When in fact, the environment we're trying to create with Kadiat is one where we remove the fear of Failure, we remove the negative feedback. So for those of you that maybe wanted to change your culture to more of an open mindset, more of a mindset that is focused on growth, focused on people being allowed to experience small failures and learn from them, I think the kata scientific thinking routine is at the center of how you start to move that culture. And you almost have to go back to that childlike attitude toward learning. And that's what the coach is supposed to do in the coaching kata. We don't want to. I coach people. Don't say, why? Why did you do that? Why did you choose that obstacle? Why did you run that experiment? Why did it fail? You know, I coach people and coaches to say, let's remove that word. Why? Use the five why's on the process. Let's remove that and let's say, help me understand your thinking behind. And then what it is that you're trying to understand, because it's really what you're saying, but it's being received as you had a failure, you had something didn't go right, you made a negative choice. That's what the word why many times when we use it on the person means. So that's what I would say within companies that want to try and move their culture toward a daily, continuous practice routine with scientific thinking, with positive coaching reinforcement.

Yeah. Beautiful. And what's the best way to connect with you, Brandon?

Connect with me on our website, continuouscoachingcommitment.com. reach me at brandonatamastercoach.com as well. Our email is on that website. There's a contact page and a phone number as well as we have a LinkedIn page. You can connect with us there. You can Message us through LinkedIn or just pick up the phone and call and let's. Let's chat a little bit.

Yeah, and we're gonna link to all your. All your stuff on the show notes page. Again, I'll say it is GembaPodcast.com. just look for episode two. No, this is 212. 212. Yeah, 212. And we're gonna link to everything that. All the previous episodes that Brandon's been on and all his social media and all that good stuff. So, Brandon, my man, thank you again for coming back on. This is not gonna be the last time. I mean, one day we'll be joking. This is the 28th time you've been on, Brandon. But, you know, but I love having you on. It always fills me with hope and energy and I feel good after spending some time with you. My friend.

Well, thanks for having me on, Ron. I really appreciate it. I enjoy it.

All right. You take care.

Thanks. You too.

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