The Basis of Lean: Making Dentistry (and Life!) Easier
On the surface, Lean looks simple! Lean principles focus on delivering value but never at the expense of the employee; on eliminating waste and improving the way we work and live. Leanness is about developing your people. If one can accomplish the same or better result with less effort, it’s a total win, right? But how do you get there? The basis of Lean is “do more with less,” and while the end result may look simple, getting there is anything but!
Before Macular Degeneration (AMD) became a part of her life, my grandma was an avid reader. She has the wet type of “macular” - her loss of vision is in the center of her eyes. Think of it as only being able to see out of your periphery. It is possible for her to see some words but they must be magnified. Growing up, grandma always had a book in one hand and my grandad’s hand in the other - alternating with a wine glass. When he suddenly passed away in December 2012, the challenges of blindness had manifested and basic Lean Principles would soon come into play.
The silver lining in 2012 was the fact that I was in a position to move to Florida and help my grandma. So after some thinking, I decided to take charge of putting basic life processes and decisions together for someone who has basically never lived un-assisted. But before I took on this role, I had to understand what was valuable to my grandmother and her happiness. For the most part, identifying this was easy because her heart relied on the intangibles life has to offer: watching TV, listening to a book, talking to friends and family, and going to church. The difficult part was convincing her that putting these everyday practices into action required minimal effort to accomplish. Thankfully, although legally blind and a bit slow to learn initially, my grandma, Golda Mae, was determined to stay happy and keep living. Thank the heavens she was very teachable!
First I got rid of the old clocks around the house and replaced them with bright, talking, loud alarm clocks. I put larger felt-covered markers on her microwave numbers. I threw out the remote controls that would get lost in her couch.
I bought more plastic and less glass. I switched out small numbers with huge numbers and blew up spreadsheets with channel numbers in bold, black ink and placed them under lamps at each place she sat to watch her TV shows. Regular light bulbs were replaced with much brighter LEDs and a brand new cell phone with voice activation and a large touch-tone screen lit up when it rang. I rounded off any bumps in her floors, put down rugs over the rough spots and bought her fur-baby “Little Bit” a comfortable dog bed with a lifetime warranty. All of these were moving pieces to make my grandmother succeed at life. I put my head down and concentrated on the task at hand - it’s what I do best. The steps we took were foreign to her, and grandma did not like being vulnerable. But like me, she kept her head down and trusted my process.
After numerous trips to her house to push some buttons or change a channel, and with a few on-site lessons, she became a master at all her new gadgets. She became more independent; and developed a knack for more modern technology. She smiled when she told stories and watched TV with her pup by her side. She was happy - our whole family was happy - because she trusted the process, as well as herself. This small, but important period of my life, parallels what I have learned over the past twenty-eight years in clinical dentistry.
Like my grandmother...results do not happen overnight. I’ve never said, “do more with less and expect to reap the benefits tomorrow.” I can’t tell you how many times I had to drive forty minutes each way over to explain processes. The coaching is the same:
For Every New Skill or Task
TELL -explain what we were doing and why we were doing it;
SHOW - show her how to do it several times;
DO - she needed to show me that she could do it;
APPLY - The skill is mastered and does not require me to drive over there every day.
This reminds me of coaching Lean Principles to dental practices - Reboot Training. It starts with people. Adopting processes that create clarity, eliminate any risk of error, and improve the quality of work - in less time - means more opportunities for your dental teams to grow. When they grow, your dental practice grows. That’s how it works.
We have made several improvements to the Lean and Mean processes we installed back in 2012. I have a copy of the processes at my house so we can troubleshoot together without the need to jump in the car for small emergencies. My grandma is 88 years old. Instead of a book, she carries a Walkman strapped around her waist. Every Christmas, I replenish her stock of AA batteries and throw them in the freezer - you know, the place that keeps your batteries like new for a whole year. (See, she teaches me stuff all the time, too!) She can keep up with the nuances of modern day, she just needs a process by which she can do it - easily. And I always make sure she is stocked up on Carlo Rossi - by the gallon.
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