Tuesday, March 8, 2016

Beneficiaries and the Blue Yarn

This last weekend, I painted my bathroom and binge listened to the design podcast 99% Invisible, which is a great listen. ​This older podcast is about 10 minutes long, but it talks about a great process that I think would really have some interesting implications in development, if we tried to use them in some of our activities. They talk about how a hospital shifted how they think about their process by applying the Toyota Production System (TPS) approach to their work. This started with using a blue ball of yarn to chart the process a patient uses to go through the hospital to get tests done.
This process led them to realize that the patients were expected to move all over the hospital and wait, a lot. As a result of this, they redesigned the layout of the hopsital, where doctors kept their offices, and how the patients were treated, leadning to substaintial cost savings at the hospital, and better treatment of patients.

There are a few great learnings from this as well:

1. You can learn from anywhere: TPS is well regarded in most business circles, but it is considered a manufacturing approach. At first, doctors joked about building cars in the hospital, but then they saw that they still could learn from the success of a separate industry. In development, we often like to think we know best, or that our work is too unique to draw from elsewhere. But successes in one industry can often show the way to potential in another space.

2. In TPS, waiting is waste. In global development, waiting is expected. However, in TPS, you constantly tweak the system so that you can imporve how things are done moving forward. How often do we think about continous improvement in our program delivery? What would that look like? In some ways, adaptive management has trickled down from TPS or agile, but we still often seem to try to come up with the ways to do this on our own. Why not look to other sectors where that has lead to large gains?

3. Putting the patients at the center of the discussion can lead to major redesign. In this process, the patient was seen as the product running through the production system. For global development practitioners, this might be beneficiairies, climate adaptation change, or some other core metric. But the learning is the same--shifting your focus (from doctor stations to patients, for example) can lead to major shifts, and improvements in delivery. In participatory systems thinking, this might be the point that we bring in beneficairy feedback, but why  wait for project deployment? What if we respond to an RFI with info saying we have thought about or consulted with beneficiaries, and "this" is what they said?
Anyway, it is a good listen. Take 10 minutes while eating that sandwich, and see if you get something out of it. If you do, feel free to comment. 

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