Tom Brady (TB12) – Lean thinker
by Tom Gormley, Manager, Process Improvement, Franciscan Childrens
“I kind of know what I see out there”. Tom Brady
(from an interview with Tom Brady on October 21, 2016. See the link below to read the full article)
We often say, lean principles and thinking apply and are used in every industry, right? Even football apparently, if you go by what Brady said in this interview.
In the WEEI article linked above, TB12, our (Patriots) four-time Super Bowl winning quarterback, answers a reporter’s questions about the use of tablet PCs in in-game strategy (probably in response to Belichick’s negative comments earlier in the week on this topic). Both Belichick and Brady are widely viewed as experts at seeing defensive schemes and adapting to them during games with proven results. It turns out there is a lot of lean thinking in TB12’s responses and in his game-winning strategy. Read on…
Consider the lean definition of “value”, so central to lean thinking – value is defined by the customer; what they’re willing to pay for; transforms the product or service in the process to bring it closer to the customer’s desire. Steps in a process that don’t meet any of these criteria are non-value. Here’s Brady’s take on value in the football context:
“There’s nothing good that happens when the ball is my hands. I’ve got to get the ball to somebody that can actually do something with it, so that’s part of it for me is identifying who should get it, how quickly they should get it, and then getting the ball out of my hands and into the hands of the receivers or the running backs so they can actually make some yards.”
What is value in Brady’s football eyes? Yards gained. Moving the product closer to the desired end result – points via touchdown or a field goal. There’s no value in his mind until he gets the ball to someone who can gain yards for the team. How do we define value in healthcare? Is waiting value, whether it’s in the waiting room or the exam room or the OR? Of course not, you say. How about gathering supplies, forms, or surgical instruments for an exam or procedure? By the lean definition – no, although they are needed. Registration – no. One more — a physician or other provider writing an illegible order, or not providing a clear explanation of prescribed medications? Once again, and I think TB12 would agree – No. But many systems still view these parts of our work as valuable, and they constitute a large portion of our national healthcare bill.
In healthcare, patients and family members desire accessible, efficient, reliable, comfortable, high quality care and information that fixes their health issue and explains treatments, when and where they need it. In his book, On the Mend, Dr. John Toussaint, former CEO of Thedacare in Wisconsin, now CEO of the Thedacare Center for Healthcare Value, offers an even more challenging view of value in his description of Thedacare’s definition of value for an emergency patient with a STEMI heart attack. For them, value is when a balloon is inserted into the patient’s blocked artery, removing the blockage and allowing blood to flow again. How about the ambulance ride, or the waiting, triage, EKG, ER doctor, cardiologist, the movements from one room to another, or the travel time of the Cath Lab staff to get to the bedside. Non-value.
Brady and Patriots coaches apparently also understand the importance of “going to the gemba”, or “going to see”. Gemba – where the work happens, or where value is created. Strategies and plans based only on reports and data, without going to see at the gemba, fail in many, important ways. That’s not the Patriot way.
“I’ve never been too much of a picture/tablet guy – I kind of know what I see,” Brady said. “I see out there and as soon as I come off the field, Josh [McDaniels] will say, ‘What was it?’ and I’ll say, ‘Oh, they did this and this guy dropped.’ …It’s great for the coaches because they have a different angle. It’s hard to see when you’re seeing from the sideline. When you’re out there playing, a lot of times I can come over and tell Josh, ‘This is what happened and here’s why we did that.'”
Being on the field, Brady is in the gemba and knows what he sees, i.e. he doesn’t need the tablet PC to see, and his input from the gemba is crucial to the coaches and assistants on the sideline who develop game strategies and call most or all of the plays. They respect each other’s expertise. Coaches might use tablets but without seeing through Tom’s eyes, their strategy development and play calling would clearly be very average at best.
Are your healthcare leaders leading or trying to see or call plays from the sideline? Go to the gemba, and ask the players there what’s happening, why, and what they think should be done to improve the next case, the scheduling of the next patient, the next post-acute follow-up to prevent avoidable re-admissions. Respect that input and the people who provide it.
Standardized Work…and more
Brady’s just getting started with his lean thoughts. He moves on to continuous improvement; the need for standardized work; the value of practice, like pilot testing a new process change; as well as coaching and celebrating.
“The week of practice is very helpful. This week has to be a big week for us because every week it changes. You win the game, you go home and celebrate, and then at some point you shift focus to the next week and you’ve just got to put the same process in in order to try to get the same results.”
The same process, to get the same results. Sound familiar? Does patient care change every day? Does your healthcare system, clinic, or inpatient unit have a standard process that all staff have studied, practiced, and understand? This is different from what’s taught in medical, nursing or other clinical academic settings. Standard, reliable, repeatable processes are designed and developed in the gemba by the staff who do the work every day, and should be guided by local data and knowledge of best practices. Do you have coaches who respectfully watch how closely staff follow standard processes and point out those variations or improvement opportunities?
It’s instructive to hear the members of pro football’s leading franchise in recent histor, using these principles to achieve outstanding results. If you have any football fans among your staff, especially those who are new or a little resistant to lean, I hope you’ll share this with them. Good luck!