Kanban with Compassion

Quite possibly the most emotionally moving talk at LKNA16, the presentation by Marcus Hammarberg titled “@Salvation Army Health: How Kanban Helped Save a Hospital in Indonesia” brought me and everyone else in the room into the context of a disaster. The disaster was a hospital that was failing to meet its mission. Marcus went through the story of how over two years he aided the hospital by getting staff motivated to change and improve their way of managing work. Like many people involved with managing a system, Marcus attempted to open up the need for change by discussing the larger challenges facing the organization as one of a “cash flow” problem and how much cash they would need to earn daily in order to break even over the course of 30 days.

The staff that worked at the hospital were not motivated by this information. Disappointed and a little perplexed, Marcus then went on to break down the number of services that the hospital would need to sell or provide in order to break even each day. Still no major impact. In fact, this time, when he had the lead physician present the data, the staff laughed and some even switched to checking their Facebook pages. Having received that round of laughter feedback, Marcus continued searching for information or data that would motivate the staff to change; to evolve the hospital’s current condition.

After his second attempt at talking about money, Marcus decided to switch to talking about people. He and the accountant calculated the number of people that would need to show up for help in order for the hospital to break even each day. When he provided that number, it was a moment of reflection for the staff. They recognized that if a certain number of people didn’t show up, then the hospital would start losing money and most likely need to shut its doors quickly.

Using this data, Marcus began visualizing the targets for each week and making changes once a week. The changes included number of patients seen, revenue, etc. He also supported the organization to limit its work in progress for an ongoing renovation using the physical limits of the hospital beds and rooms.

There is much more to Marcus’s story, which can be found in an upcoming book he’s publishing on his two year experience with the hospital. I’m looking forward to reading the sample chapter soon!