Gemba Consciousness

I was very interested to read Stephen Crate’s recent post with Jim Womack’s “Historical Perspective of Lean,” which mentioned the idea of gemba consciousness, or awareness of what’s actually happening on the shop floor. “Management by walking around” is related to this concept; at one organization that I know of, meetings were forbidden before 10 am so the supervisors and managers could spend the time in their departments.

However, there’s a relationship here to span of control. At one of the organizations I have worked at, it was not uncommon for Nurse Managers to have over 50 direct reports on all shifts. One lab manager had over 100 direct reports, at over 30 locations. In the organization’s zeal to flatten the management structure, they had made it difficult – if not impossible – to manage by walking around.

I’m attending some meetings in the coming weeks that will focus on Nursing span of control, so we will try to bring together the concepts of a flat org structure and gemba consciousness. If any of you would like to share your thoughts on this issue, I would love to learn from you.

Comments 5

  1. Mike LaChapelle

    One could argue that the opposite is true, that a large span of control requires a manager to "walk around" in order to stay in touch with his/her people.

    It’s not uncommon to have a span of control of anywhere from 30 to over 100 in a 24 x 7 x 365 operation. Staying in touch with such a large group of people is exhausting and requires constant attention.

    You have to create mechanisms to get together with your people on a regular basis. You have to design your work day so that you can see multiple shifts. You have to come in at unusual hours, in the middle of the night, and on weekends to catch up with all of your folks.

    You have to have brief team meetings or shift change-over sessions where you can get your message out and make yourself available. You may need to set up regular "office hours" where your folks know you will be available if they need to talk with you.

    You need to set up multiple communication channels to make sure that you know what is going on and your message is getting out. Besides team meetings, and shift change-over meetings, and email, one method that is sometimes used is a paper log book or these days, a blog.

    The log book, or blog, allows shifts to communicate with each other and with you about issues that they are facing and things that need to be taken care of. Everyone (including the manager) is required to read it every day. My team used to get on my case if I hadn’t read it.

  2. Sue Kozlowski

    Thanks, Mike, for your perceptive comments and sharing your wisdom! I especially like the idea of a routine communication log or blog. That would be a good replacement for hit-or-miss verbal communication!

  3. Meikah

    In my organization, too, we use this communication log, where we put our daily outputs/ongoing concerns. You can create a wiki page for this, too, which is a more dynamic way of monitoring your people, because you encourage interaction. It’s very useful if your organization operates on different shifts. I have yet to check out this “gemba consciousness,” but as it is, it sure sounds very interesting.

  4. Ron

    Hi Sue,

    In your case ’walking the gemba’ as described in the article you referred to may not be realistic or practical.

    Might I suggest you look into how you can implement some “visual workplace” practices with the nurses.

    If you read Womack’s book, “Lean Thinking” you will see how Toyota did this in their warehouses. The problem was the warehouse workers (i.e. nurses in your case) may not be able to always sit around and chat with each other to see how things are going… likewise the “manager” surely cannot know what each worker (or nurse) is doing or how he or she is performing.

    But, by implementing visual workplace tools like scheduling boards (color coded, etc.) each worker, nurse, manager, etc. can simply go to that board or screen or whatever it is and instantly take note of who is doing what and how he or she is doing. The key here is that each worker or nurse must be diligent in updating the board regularly.

    The trick to Lean Manufacturing is how to make it work for your organization. Sometimes you need to think out of the box… have fun with it and good luck!


  5. Sue Kozlowski

    Thanks to Meikah and Ron for your comments. We are exploring ways to share information by taking advantage of our electronic tools. For example, in many of our hospitals there used to be a daily morning broadcast call to the leadership – you would get a voice message saying how many beds were occupied, the census in the different units, etc. Most leaders just deleted the message without listening to it, even though it could have been used to plan for the day – not too many people took notes while they listened to the whole message.

    We’ve held several Rapid Improvement Events (RIEs or Kaizen events) around the health system that focused on bed management. To replace the phone call, we’ve been implementing a color-coded spreadsheet that gets emailed to the leadership in the early morning. We’ve built in calculations with conditional formatting to indicate near-capacity and at-capacity states; and there’s a visual indicator at the top that gives a clue to the overall status of the hospital and the ED. As we do these RIEs at each site, we translate the learnings from the previous site including the new form.

    It’s not the same as walking around the gemba, but now the leaders can print or email the report if they want and share it easily with their staffs.

    You’ve given me more ideas on how to expand the gemba consciousness among our associates – thanks again for sharing your ideas.

Leave a Reply