The trip senseis and organizers (Shingijutsu Global Consulting and John Black, LLC) have cleverly arranged our visit so that each successive company is leaner than the last, and the experience has literally been inspiring. These companies have achieved so much that it sometimes feels beyond our reach to emulate them, but we see practical applications for Children's everywhere we look.

Our sensei have helped us understand and see lean principles at work in the factories (and one office operation) we visited, but it is up to us to apply them in our world.

Here are some thoughts from team members about how they think lean can be applied in their areas:

Lynn Stapp, Microbiology team

"I would like to apply the teachings of the sensei to enhance the flow in microbiology. Some things to try are visual controls for quality (e.g., visuals for specimen collection); removing flow bottlenecks (e.g., provider notification difficulties); and enhancing our mixed model line (e.g., mixed versus pure cultures)."

Sarah Thomas, Clinic
Referral and Scheduling team

"Our sensei stressed the elimination of "muda," or waste, to support flow. Elimination of the "muda" of rework in scheduling will improve our ability to manage our growing volume of calls."

Darren Migita,
General Medicine Team

"We have learned a lot about lean priniciples like "outside flow" and "inside flow." What these principles come down to is enabling people to do the best job possible by bringing supplies and equipment to them--right item, right time, right place--to support the care of patients. The "outside flow" of equipment and supplies is critical to the "inside flow" of patient care."

Glen Tamura,
General Medicine Team

"When the workload goes up, we tell our doctors to just run faster and our patients to wait longer. We have seen how companies have effectively matched workforce to workload through the principle of heijunka. Our patient activity is both predictable and predictably unpredictable, and by using the load leveling principle of heijunka we can do a better job of responding to changes in workload."

Barb Bouche, Microbiology Team

"I have been able to see, with each successive factory visit, that "kaizen"--continuous improvement--is not an add-on to the work; it IS the work. The improvements can be seen and felt. It is truly amazing, and has inspired all of us."

On a personal note, all of us have thoroughly enjoyed and learned a lot from the three sensei from Shigijutsu Consulting and John Black. They have brought a rigor and discipline to our studies that would have been impossible to achieve without them.

More in a day or two...