October 9, 2016 karynross

‘Leaning Out’ Processes? Or Creating Service Excellence?

This weekend I took my husband for a medical procedure. The procedure was conducted at the outpatient facility of a large, regional medical group that my husband’s doctor belongs to. And yes, as you can imagine (and as I’m often asked), as coauthor of The Toyota Way to Service Excellence, I do pay careful attention to service experiences of all sorts. Not having had to visit this kind of outpatient facility very often, I was particularly interested in what my husband, and I, as customers, would experience.

Here’s how it went:

  •  As soon as we entered the building, a narrow hallway led us directly to the reception area. My husband was checked-in immediately and given a clipboard with a short form to fill out.
  • A friendly admin then asked my name and my relationship to my husband, which she wrote on the top of my his admission paperwork.
  • Next, I was handed a pager (just like one you get when waiting for a restaurant table or take-out food) and told: “Keep this with you. When the procedure is done, it will buzz. Come right back here and we’ll let you know which recovery room to go to.”
  • My husband and I found seats in the waiting room, and moments later a prep nurse came over, collected both my husband and his paperwork and whisked him back for the procedure.
  • I nervously settled in to wait for my pager to buzz so I’d know when to head back to the recovery room.

The whole check-in couldn’t have taken more than 7 or 8 minutes. Quick. Efficient.

Although I don’t know for sure, I could imagine that the regional medical group used some kind of lean six sigma strategy to make the intake process more efficient by removing waste. After all, no one likes to wait, and with the large volume of patients coming through (the waiting room was jam-packed), finding ways to gain efficiency for the staff by using things like pagers could be quite helpful. Patients moved quickly through the check in process and ’things’ really seemed to flow.  On the surface, everything appeared to be great. But was it really?

I don’t think so. And the reason is that although the process may have been efficient, the whole experience made me feel like my husband and I were ‘things’. Especially when the pager went off (buzzed loud enough to make me and all the others waiting around me jump). As I leaped up to find out how to get the pager to stop buzzing, and, more importantly, where to go to be with my husband in recovery, (no one had updated me on his progress during the procedure), I thought to myself, “This is really terrible. Maybe the pagers are an easy and efficient way for the staff to let people know their loved ones are ‘ready’, but I’m not picking up a sandwich — a thing — my husband is a person, and I am too.”

Contrast this with an experience I had a couple of years ago with a different medical group.

  • Similar type of facility and intake process. No waiting time to be checked in.
  • My husband and I were then taken by a nurse to a prep room. My husband was able to stay with me while the nurse did my prep and while the doctor explained what would happen from start to end of our time at the facility.
  • Once I was wheeled into the operating room, the same nurse took my husband to a group waiting area. She then updated him regularly on my progress and when the procedure was over she brought him back to the recovery room so he would be there as soon as I was wheeled in.

At no time during the experience, which, even though pretty routine, was still quite stressful, did I — or my husband — have to be alone. We both heard all of the same instructions and were able to ask questions the other didn’t think of. The process itself was very efficient, but that wasn’t the most important part of the experience; more importantly, the personalized care made both my husband and I feel not like ‘things’, but valued and cared for as human beings. And isn’t that what a service experience — especially one in healthcare — should make us feel like?

As Jeff Liker, my coauthor, and I explain in The Toyota Way to Service Excellence, service excellence is not about simply ‘leaning out’ processes to remove waste, improve internal efficiency and drive short-term financial results. Service excellence starts with a deep understanding of what each of your specific customers want, need and value as a human being (see Principle 2 of The Toyota Way to Service Excellence. 17 Principles). Once you know that, you can continuously strive towards creating those peak service experiences that connect with each of your customers to improve their lives.

I often hear lean practitioners say, “Focus on the value stream first. Start by improving the value stream.” The problem with that is it is very easy to become focused only on driving internal efficiency. Service, by definition, involves focusing not on ourselves, but on others — our customers — first. I say, “Focus on the customer. Start by really understanding what you can do to improve things for your customer.” Once you understand what each of your customers — the people your business serves — need, you can then find unique ways to improve the way value flows to them to create the peak service experiences each of them wants.

That’s good for your customers and good for your business.

Your customers have many different choices of where to purchase their services and products. Unless you can provide the experiences that they truly want and value — that will improve their lives as human beings — you are in danger of losing them to competitors who figure out how to do just that. Years ago, I actually had the same doctor my husband did. As an independent practice, the experience was personal and human. Once they joined the regional medical group, however, I began to feel that I was just a ‘thing’. So I ‘shopped around’ until I found a practice that had the human, personal, caring experience that I wanted. Then I switched.

Service excellence isn’t about ‘leaning out’ processes. It’s about people. And about finding the specific ways for your service providers to deliver your services efficiently and effectively and connect with your customers in ways that makes them feel like valued human beings in each and every interaction.

This week’s challenge. Take a look at your company’s service processes. Are they simply ‘lean’ or are they delivering service excellence? Your customers really care. And you should too.

Looking forward to hearing your thoughts and experiences on this topic.

Karyn Ross


Does your company have a ‘lean’ program that’s focused only on driving internal efficiency and not on service excellence? Or, have a question about how your company can get started on service excellence? Contact me at karyn@karynrossconsulting.com. I’d love to help.


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