Don't Be Strangled By Process-Improvement Black Belts

In ITIL, we healthcare CIOs are acting in predictable fashion by following the “Most Popular Practice” as opposed to the “Best Practice.” Before we pull the trigger on yet another silver bullet savior of process, I urge all of us to look closely at the contribution of burdensome process in the woes of Toyota…and GE…and Motorola. Try though we might to fix the problems of healthcare IT with rigorous process-- most recently ITIL-- we’re only putting lipstick on a pig.

Fat processes like ITIL will only make matters worse for us until we fix the core issues: (1) Stop buying poorly designed software systems and insist on something better from vendors; and (2) Hire and mentor engineers, computer scientists, mathematicians, and musicians into healthcare IT and stop microwaving nurses, doctors, registrars, and technicians into overnight software developers and IT professionals.

Background
Those of you who know me, know that I’ve admired Toyota for many years, particularly their philosophies of leadership, employee relations with management, Lean manufacturing and the Toyota Production System. My faith in Toyota is taking a beating as I watch it struggle with one recall after another, even though, I’m betting, the problems with runaway acceleration will more likely be associated with driver error than faulty design. We’ll see what the Failure Modes and Effects Analysis (FMEA) team at NASA has to say when they release their report in the next few weeks.

Even so, there’s no getting around the fact that Toyota is losing its edge in quality and innovation—they’ve been out-Toyota’d by Hyundai and Kia. In fact, at the rate they’re going, Toyota is going to be out-Toyota’d by Ford. The root cause of Toyota’s problems is, of course, a tangled web of roots, but I see a common thread that crosses the fabric of other companies across 30 years—and the common thread is Process Overkill.

In the Air Force, I was one of Motorola’s biggest customers for their new products, notably spread spectrum and CDMA networking (but many other radio-based systems as well). I was around when Six Sigma was a Motorola baby — that was in the early 1980s when quality and reliability were more important to the military than product agility and innovation. I thought Six Sigma was the coolest thing around. Everyone thought Six Sigma was awesome … including Motorola … they burned Six Sigma into their hiring, organizational structure, and the DNA of the company.

Then they started believing their own press or, as my granddad would say, started drinking their own bathwater. Fast forward to the mid-1990s, when it wasn’t enough to produce reliable products anymore … you had to produce reliable and innovative products, faster than ever before. Mean Time Between Failure (MTBF) was replaced by Mean Time to Improvement (MTTI) (that’s a Sanders Theory and phrase…so don’t bother to Google it). Six Sigma bogged Motorola down like a Mississippi mud walk, and they still can’t get it off their feet. Motorola might be able to produce a fairly reliable product, but you couldn’t possibly describe Motorola as innovative. They’ve been strangled by the Black Belts of Six Sigma.

Jump to the late 1990s and early 2000s … cut and paste the exact same story at Motorola, then do a global replace with “GE” and “DMAIC”. Jack Welch was to GE what Steve Jobs is to Apple, and without either leader the company identity is completely different. Nevertheless, the weight of DMAIC on GE has them stuck in the mud walk of innovation, too — Jack Welch or not. Drive the time machine ahead to 2009 and do the same cut and paste, but this time insert “Toyota” and “Lean” into the story. Lean’s gone Fat at Toyota and their arteries are ready for a CABG.

In love with their own success and thirst for their own bathwater, Toyota over-applied Lean concepts, creating a bureaucratic environment that squeezed innovation to death (only the Chevy Citation was uglier than the current Toyota Camry), and cultured apathy in their design teams and production lines. Toyota might be salvageable, however, because their leadership still exudes humility and accountability. It’s going to be interesting to watch.

Do you believe for one second that Google’s search engine was the product of a DMAIC session? Or Apple uses Six Sigma or Lean Gone Fat in their product development? You could argue that a dose of better process would have prevented the worm in Apple’s recent 4G antenna problems, but the 4G, iPad, and iPod are the most innovative, best quality products to be produced in the US since the Apollo space program. It’s amazing to me that the 4G antenna problem is the only problem they’ve had in a string of pioneering, revolutionary products. Take away Apple and Google, and the only claim to major, society-wide impact and innovation we can claim in the U.S. since the late 1960s are hedge funds and credit debt derivatives.

The best processes are worthless in the hands of the wrong people. Does a good change-control process in the hands of a bonehead make a genius of that bone? No. Even worse, Processes Gone Wild — such as ITIL, Lean, Six Sigma, and DMAIC — are a disaster in the hands of great people. Good people trump everything. EVERYTHING. But the best people … the most innovative people … will not stick around if constantly force-fed ITIL, Lean, Six Sigma, or DMAIC. They’ll go to work for Apple and Google. The force-fed people and organizations left behind will end up as so much foie grais.

Sip from the cup of ITIL Kool-Aid, don’t gulp it.