“We Already Have Procedures For This”

Posted on August 29, 2012 by

Over the last several weeks, JHS has undertaken a number of efforts aimed at building a foundation for stability of core work. One of these areas is in Release Planning, a core function of the Jail Health aimed at helping targeted patient inmates, suffering from chemical dependency, HIV, mental health, and other ailments, access programs “on the outside” to help them get back on their feet (and hopefully stay out of jail). This is an extremely value added function for many inmates, many of whom are looking for a way to improve their lives. Some background to the release planning team: it is a relatively new function with a very small staff given an impossible task to target as many patients as possible, knowing full well they can’t adequately service all of their demand. Over the next few weeks, there will be a great opportunity for this team to define their standard work for the triage and intake processes they selected, with two new positions opening up in the near future, and the work processes not really well-defined. It takes a manager able to acknowledge that existing methods and procedures have not adequately created standard, stable processes to undertake this, and boy is she eager!

Many managers and staff alike often wonder why standard work is needed when they already have procedures, targets, SOPs to follow. The answer to that question often arrives while they walk a process, seeing waste / variation with their own eyes, and wondering why some staff have deviated from procedures with heroics or workarounds. So what is wrong with procedures? Nothing inherently, and standard work is not collectively intended to replace SOPs, but rather compliment them. The cold hard reality is that lengthy, detailed procedures alone are difficult to remember, complex, and not always tied to what a customer or stakeholder really wants. In addition, they can be dictated “from above” and often contain waste and unnecessary steps. When faced with applying the detailed procedures to practical work environments, many staff are left scratching their heads. As this variation “bubbles up” and creates unintended results, managers often find themselves fighting fires trying to correct problems.

So standard work helps a team of subject matter experts step back, apply lean principles, and define the explicitly established content (what steps) and the methods (how) tied to reliably and consistently producing outputs. It sets meaningful targets and expectations for staff on a daily basis, and captures the performance of that work process against the needed requirements by measuring it and making it visible. It reduces variation in work from one operator to another, and allows the team to problem-solve, and improve the process until a new standard is established. In some cases, it can be interpreted by managers as a loss of control since they are used to defining how the work should be done. The shift however takes place when these managers realize that front line staff are in the best position to create reliable methods, and that their job is to help set targets, coach and facilitate the team towards standardizing their work, and solving their own problems.