Maintaing progress and sustaining improvement (continuous or otherwise) can be difficult. Here’s a tale of how the reality dawned upon me while I was sitting in a hospital bed (a few years ago).

A while back I was involved in training about continuous improvement methods. One of the main methods we looked at was visual management. We were provided with a lovely blend of theory and practical case studies, one of which was from an organisation right on my doorstep.

Visual Management Theory:  Visual management/control is a commonly used continuous improvement technique, explained here. In essence it is about communicating information clearly and efficiently. You use signs, pictures and symbols instead of text or other written instructions. There is a big emphasis on the design of the visual material used so that information being communicated can be quickly recognised.

The term visual management is interpreted broadly and can include things like ‘Team Status Boards’, which provide an ‘at glance position statement’ for complicated activities or production areas. The visual management on the ‘Team Board’, is often achieved using things like ‘Red, Amber Green’ (RAG) Status.

Another area of visual management involves the use of single graphics or pictures – for example the danger of electrocution signs commonly seen.

The visual management area is improving continually, and a wide range of materials are being developed, many with significant amount of design input and clever thinking behind them.

Visual Management Case Studies:  Back to my training….. The case study we considered was a perfect example of kaizen; small improvement steps, led by the workers in their own Gemba (workplace). An example of employee engagement if you like. The situation was as follows:

• A hospital was trying to reduce the levels of hospital acquired infections,
• One method was to place hand sanitiser dispenser pumps at specific locations,
• Staff moving between patients in different locations, could sanitise their hands with gel from these pumps,
• This meant that germs would not be transferred between different locations,
• Brightly coloured notices told people what to do, ‘Sanitise Your Hands Here!’,
• A great visual management solution to the problem,
• Then someone noticed that the gel in the pump was transparent, and so was the container. Working out when it was empty and needed refilling wasn’t obvious,
• The result was occasions when the pump sat empty for some time,
• Then, someone from the staff proposed a solution of placing a sheet of coloured card behind the pump so that the level of gel was easily seen,
• Bingo! A ‘continuously improved’ visual management technique that worked perfectly,
• No more empty gel pumps, staff sanitised their hands regularly as they moved around the ward and hospital acquired infection rates lowered,
• I understand that the approach was transferred across all other wards in the Hospital,
• An excellent example of the horizontal deployment of some visual management good practice.

Theory, case studies and the real world.

Imagine my excitement about 12 months later when I contracted pneumonia and ended up on one of the hospital wards using these visual management techniques. This was a chance to see what I’d been taught being used in everyday practice.

Unfortunately my excitement was premature. I did get to see the hand sanitiser dispenser, but it was redundant. The brightly coloured card was stuck to the wall, a ‘sanitise your hands’ poster above, but no container of germ killing gel underneath. What had gone wrong?

I was there for a week and did ask a few questions about the hand sanitiser. Eventually I found someone who knew what had happened. The hand sanitiser had been used, the visual management of the sign and the brightly coloured card behind the gel container had worked; then the suppliers were changed. A new brand of hand sanitiser had been procured, which came with its own proprietary dispensing system (different holder). These were mounted on the walls, close to the original hand sanitisers. The thinking behind visual management and what it was trying to achieve had become a bit of a vague concept to the person I spoke to. It had been a good idea, but just got lost in the business of doing the job, day-to-day.

I did keep an eye on who was using the hand sanitiser during the early part of my stay. This wasn’t a scientific evaluation (I did sleep and read on occasions), but it certainly wasn’t a 100% compliance situation. From what I observed, not everyone used the hand sanitiser, and for those that did, they certainly didn’t use it all of the time.

Things I learnt from the Hand Sanitiser experience.

The theory and case study example I had learnt about had sounded perfect. A problem arose and the staff involved came up with a solution to fix it. Great text-book material that I couldn’t wait to observe in practice. Unfortunately an unforeseen event occurred, the new dispenser arrived and upset the system. The learning and thinking behind the old system seemed to disappear.

I do wonder if this happens quite frequently? There is an initiative to improve something, everyone gets exited, does what is required for a while, and then the initiative dies out as things return back to situation normal?

So, what’s the PONT?

1. Visual Management techniques have been successfully used in many situations, in many organisations.
2. Theory and case studies are a great way of learning, but you can go further.
3. Nothing beats going to the Gemba. In my case this was spending a week in a hospital bed, but I did learn plenty about the reality of sustaining improvement.

Picture source. Buy your Hand Sanitiser stickers here: http://evaq8.co.uk/USE-HAND-SANITISER-SIGN-Self-Adhesive-Vinyl-20cm-x-30cm.html