11-04-2009 - Buenos Aires - Healthcare
Argentina has the reputation of having a good medical system. Hospitals and clinics (especially the private ones) are well equipped and the staff is well educated. Luckily I haven’t had the need to test it thoroughly. And I would like to keep it that way.
Although the country has one of the highest doctor-patient ratios in the world, there is waste in the 3 tier system of Public, Obras Sociales and Private healthcare. The public system is the biggest (50%) and “exhibits serious structural deterioration and managerial inefficiency” according to Wikipedia. The system Obras Sociales (45%) consists of more then 300 highly decentralized organizations with very irregular effectiveness.
In the rest of the world, and especially in the United States, Lean in Healthcare is hip, hot and happening… Books are published, conferences and workshops are held on a regular basis and the American Hospital Association has started a campaign in the pursuit of excellence. http://www.ahaqualitycenter.org/ahaqualitycenter/hpoe/index.html
Buenos Aires alone has hundreds of hospitals, clinics and laboratories. Especially in this period of financial turmoil more people will depend on the care in the public service. So improving operational efficiency in this sector is certainly a good idea. And if Lean is a proven method to accomplish this, why not learn from all the experiences and start today?
Some useful links:
Lean in a blood bank in Mar del Plata:
17-03-2009 - Buenos Aires - What's in a name?
The name Lean is nowadays widely known to almost every industry in the world. The name Lean is very clever, because it gives you an instant feel of what your goal is. You can almost feel the analogies. You are in better shape, more flexible, faster, fitter and healthier.
But in Argentina the name Lean is not as widely spread. To begin with, it doesn´t help that Lean also means Read! in the imperative tense. Of course it is pronounced differently, but in written communication that distinction is lost. So if we send an email about Lean, the Argentinean reader might be a bit offended because of the tone.
Argentinean people are used to adapt words from a foreign language by using a direct translation. We found out that some people don’t know about Lean, but know the methodology as “Manufactura Delgada”. Also a translation might lead to a different abbreviation. The frequently used JIT (Just in Time) might not be familiar at all, but JAT (Justo a Tiempo) might ring a bell.
There are Universities that teach the principles as Toyotismo. Toyotismo as an alternative to Taylorism and Fordism. This is not unique for Argentina. Wikipedia and lots of articles from many countries use this analogy. But if people say that they have never heard about Lean and after a few minutes talking about the subject they say “Oh you mean Toyotismo”, it feels that you had a bit of waste in your communication.
Building a network, finding other believers, communicating about the subject… It all starts with using the same words. I guess any one of them is fine, as long as we are consistent. But if the name Lean is already so widespread, so well known and so well chosen, it seems logical to stick to it. This poses a new challenge. How can we make the word Lean commonly used and widely spread in Argentina? ...........Any suggestions?
Things are different between Argentina and the Netherlands. Of course the reason to move here was to experience these differences. There are differences in language, culture and the way that business is being done. This is a story about a company that is implementing Lean Manufacturing. Although the implementation itself is interesting enough to write about, the reason why they started with Lean is even more interesting.
Recently we met with our friend Daniel Sabino (www.cig21.com). Daniel made us feel very welcome in Argentina and showed us some of the projects he was working on. He showed us one specific situation that made a lot of impact on me.
In Argentina there is a financial crisis about every ten years. In these times many businesses shut down, so many companies are not older then one generation of managers. Most of the companies are family businesses and the owner, el Dueño, is also the manager. When the owner moves away from daily business, the company will often be managed by a family member, often a son or nephew of the owner.
This specific company is quite successful. It is a relatively large factory that employs around 40 employees in 2 shifts. They are growing and are managing to adjust to the changing laws. But there is hardly any organization, no HR, no costing structure and no formal policies. That was all done intuitively done by the Dueño.
Then the family experiences a tragedy that disables the Dueño to work in the factory on a daily basis. The management is transferred to his sons. They are in their twenties, have no business education, very little experience and are now managing a factory. This leads to many problems. Machines are not properly maintained, raw materials and are piling to the roof, they lay-out of the factory is far from optimal, and disorganized. And the two young managers do not really know how to improve this anymore.
You can imagine that this is tough for everybody there. It is tough for the employees, but equally difficult for the two brothers. It is an understatement to say that not everybody is lucky enough to have to proper education, or even competences for this task. You can imagine that many companies will struggle heavily from time to time. We were told us that this is a very common situation in Argentina.
Daniel was working with this company for several months now. Slowly but surely they made progression. They were optimizing the lay-out of the factory, organizing the workspace and creating maintenance plans. By doing so the reliability of the process was improving and this was now actually visible. And the young managers were learning by doing. They were not studying Lean, or a management theory. They were doing their practical homework to organize the factory. They were learning to see the possibilities and the pitfalls. At the same time they were also learning a great deal about managing their company and their staff.
This example strengthened me in my beliefs that it was a good idea to come to Argentina. If there are indeed many situations like this, implementing the very basics of Lean will already do a lot of good. Not only for the performance of a factory, but also, most important, for the human side of production.
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