Medical Taylorism, Lean, and Toyota | P.Hartzband and J. Groopman | New England Journal of Medicine

Seen today in the New England Journal of Medicine, under the signature of Harvard Medical School professors Pamela Hartzband and Jerome Groopman:

“The TPS is a set of principles designed for the manufacture of inanimate objects in a factory. We accurately depict two essential elements of this system that are directly derived from Taylorism: standardization and time efficiency. In his classic study of the application of Toyota principles to the manufacture of cars in the United States, Paul Adler describes how ‘Each job was analyzed down to its constituent gestures, and the sequence of movements was refined and optimized for maximum performance. Every task was planned in great detail, and each worker was expected to perform that task in the prescribed manner.’ Adler refers to ‘the intelligent interpretation and application of Taylor’s time and motion studies’ as key to its success. He states, ‘The reference to Taylor may be jarring, but it fits.’

[…] Other medical professionals who, like us, have experienced the toxic effects of obsessive standardization and time efficiency in the care of patients have expressed concerns similar to ours. In an era of accountability, we believe that those who advocate the application of Lean principles to medical care must take responsibility for the unintended consequences resulting from these elements shared by Taylorism and Toyota practices.”

Michel Baudin‘s comments:

The authors base their claim that the Toyota Production System (TPS) is “derived from Taylorism” from the writings of Paul Adler, a business school professor at USC who has written many papers over the past 40 years, a few of which touched on TPS and NUMMI, the first plant to apply this system in the US and now operated by Tesla. I met Paul Adler at Stanford in the late 1980s, and found his insights on NUMMI quite valuable. It was also clear to me that Paul Adler was not an engineer, that TPS, to him was one interest out of many, and that his knowledge of the subject was only at the business school level, as reflected, for example in an expression like “Taylor’s time and motion studies.” Taylor did time studies; Frank and Lilian Gilbreth, motion studies with, as stated in other posts, very different objectives.

This distinction, perhaps too subtle for business schools, is of paramount importance to anyone who wants to understand TPS, which owes much more to the Gilbreth’s work than to Taylor’s. Taylor wanted to prevent workers from slacking off; the Gilbreths, to observe the way work was being done and make it easier. And the medical profession has a good reason to remember Frank and Lilian Gilbreth: the way operating rooms function today is based on the analysis and recommendations they made 100 years ago.

How is Lean Different From Taylorism? | Michael Ballé | LEI

“They are completely different indeed. They differ in their purpose, their practice and their outcomes. Lean is about self-reflection and seeking smarter, less wasteful dynamic solutions together. Taylorism is about static optimization of work imposed by ‘those who know’ on ‘those who do.'”

Sourced through Scoop.it from: www.lean.org

 

Michel Baudin‘s comments:

Yes, “Scientific Management” was just a marketing label for theories that weren’t truly scientific but were instead based on a simplistic view of human nature. And Taylor’s stopwatch time studies were just aimed at increasing production at every operation with no consideration of flow. I would, however, ask for a more accurate and complete story

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Lean’s Midlife Crisis | Bob Emiliani

“It seems to be common knowledge that the Lean movement is now suffering from a midlife crisis. Lean movement leaders are perplexed at the widespread continuing emphasis on Lean tools, narrow focus on cost cutting, and the slow uptake of the “Respect for People” principle over the last 15 years. This is the outcome, despite determined efforts to inform people otherwise. I’m not surprised.”

Sourced through Scoop.it from: www.bobemiliani.com

 

Michel Baudin‘s comments:

While I agree with Bob’s overall diagnosis of a midlife crisis for Lean, I object to a few details, the main one being his assertion that Lean descends directly from “Scientific Management,” the brand under which Frederick Taylor sold his consulting services.

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Fairness to Frederick Taylor

Frederick Taylor is an easy target. In a tweet last November Michael Ballé, as “@Thegembacoach” attributed to “taylorism” practices that I have never seen advocated in Taylor’s writings. Enough of Taylor’s own work is questionable that we don’t need to pile on other people’s bad ideas. Along with the chaff , however, there is wheat, and we have more to learn from the enduring part of Taylor’s legacy than from what has been discredited.

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About Frederick Taylor and “taylorism”

“What is “Taylorism” ? Why is it called ‘Taylorism’?” asked Emmanuel Jallas in the TPS Principles and Practice discussion group on LinkedIn. To understand Taylor, I would recommend reading not only his own works, particularly Shop Management, but also Robert Kanigel’s biography of him, The One Best Way.

Frederick Taylor was first an engineer and co-inventor of the Taylor-White High Speed Steel machining process. It is not what he is best known for today, but that he did this kind of work is revealing about the kind of man he was. While self-taught, he had enough depth as a young man to challenge established beliefs about metal cutting and conduct experiments that proved it could be done twice as fast. This work led to the development of a feed-and-speed calculation slide rule for lathes at Bethlehem Steel.

Another detail that struck me in the discussion of stopwatch time studies in Shop Management was the method he recommended to calculate times for production steps that are too short to be accurately measured individually. He proposes to measure them in groups, for example, from the 1st to the 5th, the 2nd to the 6th,  the 3rd to the 7th, etc. and  solve a system of linear equations to infer times for each step. Then he explained that this worked if and only if the number of steps in each group was relatively prime to the total number of steps. While true, it is beyond the level of arithmetic usually found in industrial engineering texts, particularly of that era.

Frederick Taylor quote

Frederick Taylor quote

Taylor’s technical depth, however, was coupled with such a crude and dismal view of human nature that is could be called “contempt for people.” His explicit goal in Shop Management is to prevent workers from colluding to curtail output, which he calls “soldiering.” See Perpectives on Standard Work for a discussion of the differences between his approach and that of Frank and Lillian Gilbreth.

He is best known for his use of stopwatch time studies for this purpose, but the confrontational and adversarial way he did it set the stage for decades of conflict with labor and ultimate defeat. While stopwatch time studies are the skill most associated in the public mind with industrial engineers (IEs), most university IE programs don’t even teach it anymore. Such studies are rarely conducted in manufacturing plants and, when they are, the results are so laden with allowances and fudge factors as to be meaningless.

The most commonly used alternative is predetermined time standards, mostly Maynard’s MTM or MOST, and the most effective way to analyze operations is not to time them directly with a stopwatch but to make video recordings and analyze them off line together with the operators involved. See Using Videos to Improve Operations, Parts 1 to 7. When doing this kind of work today, Taylor’s legacy is one of fear that must be overcome before starting.

A more enduring and positive Taylor legacy is his work on functional foremanship. While I have never seen a manufacturing organization follow his recommendations exactly, he defined a number of support functions for production that closely map the ones you do find today. What Taylor called a “Gang Boss” is now a Production Supervisor or an Area Coordinator; his “Speed Boss,” a process or manufacturing engineer; his “Routing Clerk,” the technical data manager; his “Shop Disciplinarian,” the Human Resource manager, etc. Taylor saw each production worker as having eight such functional foremen, which was obviously impractical and no one implemented. What remains is that, through the existing support departments, we can still see the categories he specified.

Taylor’s name is also often mistakenly associated with the invention of the assembly line. It was done at Ford, shortly before Taylor’s death in 1915, and he had nothing to do with it. His work is about individual operations, not end-to-end flow.

Taylor was also the first consultant. As a corporate executive, he was not successful, and found that he could make a living as an independent, selling advice instead. The profession he thus created has been a haven for corporate misfits ever since.

It is usually opponents of an approach who reduce it to an “-ism.” Taylor and his supporters talked about “Scientific Management,” which is an overstatement; labor unions that fought it called it “taylorism,” which makes it sound like an opinion or a movement and denies it has any objective basis. You don’t ever hear of “newtonism” or “einsteinism,” but evolution deniers talk about “darwinism.” Likewise, today, people who oppose the implementation of Lean or TPS call it “toyotism,” which, to them, has the added advantage of sounding ominously like “taylorism.”

 

 

Using videos to improve operations | Part 1 – Overview and Motivation

This is the first in a series of posts about  the use of video technology to improve operations. This technology is now so pervasive that it is nearly impossible to buy a phone that does not include a camera capable or recording footage that is good enough for broadcast news. Journalists use amateur videos to show storm damage or expose human brutality. We use it to identify improvement opportunities in operations.

For long-time followers of this blog, this is closely based on comments I posted 18 months ago about a news article on the application of a sports video analysis package to manufacturing. The forthcoming installments, on the other hand, are completely new. 

Contents:

Frank and Lillian Gilbreth did it 100 years ago

Motion pictures have a long history in manufacturing. In 1895, the first film ever publicly projected onto a screen showed women leaving the Lumière Brothers factory in Lyon. In 1904, the American Mutoscope and Biograph Company shot several scenes in Westinghouse factories. In 1913, Frank and Lillian Gilbreth were probably the first to use this new technology to analyze operations, and a compilation of their films is available on line, which shows that, from the very beginning, the camera was much more than a substitute for the stopwatches used by Taylor. As is obvious from watching the Gilbreth films, where Taylor measured in order to control, the Gilbreths observed in order to improve. Taylor’s greater fame or notoriety, however, obscured this fundamental difference in the public mind, and made workers as wary of cameras as of stopwatches.

According to psychologist Arlie Belliveau:

The Gilbreths used workers’ interest in film to their advantage, and encouraged employees to participate in the production and study of work through film. Participants could learn to use the equipment, star in a film, and evaluate any resulting changes to work practices by viewing the projected films in the labs or at foremen’s meetings. Time measurements were made public, and decisions regarding best methods were negotiated. By engaging the workers as participants, the Gilbreths overcame some of the doubt that followed Taylor’s time studies.”

In other words, these pioneers already understood that, unlike the stopwatch, this technology enabled the operators to participate in the analysis and improvement of their own operations.

Until recently, however, the process of recording motion was too cumbersome and expensive, and required too much skill, to be massively practiced either in manufacturing or in other types of business operations. In addition, most managements failed to use it in as enlightened a way as the Gilbreths, and manufacturing workers had a frequently well-founded fear that recordings would be used against them. As a consequence, they were less than enthusiastic in their support of such efforts.

Use in Setup Time Reduction

Setup time reduction is probably the first type of project in which it was systematically used, first because the high stakes justified the cost, even in the 1950s and second because its objective was clearly to make drastic changes in activities that were not production and not to nibble a few seconds out of a repetitive task by pressuring a worker to move faster.

The Vanishing Cost of Shooting Videos

Technically, the cost of shooting videos has not been an issue since the advent of the VCR in the 1980s. Analyzing a video by moving forward and backwards on a cassette tape, while it appears cumbersome today, was far easier than dealing with film. The collection of data on electronic spreadsheets also eliminated the need to use counterintuitive time units like “decimal minutes.” Adding columns of times in hours, minutes and seconds was impractical manually but not a problem for the electronic spreadsheet.

With videos now recorded on and played back from flash memory, and free media-players as software, not only is moving back and forth in a video recording is easier, but the software maps video frames to the time elapsed since the beginning. We could manually transfer timestamps read from the bottom of the video player software window into electronic spreadsheets and have the spreadsheet software automatically calculate task times as the differences between consecutive timestamps.

Analyzing Data in Video Form

While this approach has been a common practice for the past 15 years, video annotation software is available today, which helps break down the video into segments for steps, label them, categorize them, and analyze them.

You can also use it to structure the data and generate a variety of analytics to drive improvements or document the improved process through, for example, work instructions. Over the previous approach, video annotation has the following advantages:It automates the collection of timestamps. Reading times on the video screen and typing hem into an Excel spreadsheet is tedious and error-prone. Plowing through the details of a 30-minute is tedious enough already.

  1. Within the annotation software, each video segment remains attached to the text, numeric or categorical data you attach to it. One click on the data brings up the matching video segment.
  2. Using parallel tracks, you can simultaneously record what several people and machines do. Of course, you can do that without annotation software too, but it is more difficult.
  3. You can still export the data you collect and analyze it in Excel, but you can also take advantage of the software’s built-in analytics.

“Video time studies” is too restrictive a name for what we do with videos. It implies that they are just a replacement for a stopwatch in setting time standards. But what we really do with videos is analyze processes for the purpose of improving them, and this involves more than just capturing times. The primary pupose of the measurements is to quantify the improvement potential to justify changes, and to validate that they have actually occurred.

Remaining Challenges

Putting this technology to use is not without challenges. Video files are larger than just about any other type we may use, be they rich text, databases, or photographs. And they come in a variety of formats and compression methods that make the old VHS versus Betamax dilemma of the VCR age look simple. More standardization would help, and will eventually come but, in the meantime, we have to learn more than we want to know about these issues. Functionally, the next technical challenge is the organization of libraries or databases for storage and retrieval of data captured in the form of videos. The human issues of video recording and analysis of business operations, on the other hand, remain as thorny as ever.