It would sound glib if the proof weren’t so compelling. “Aim for perfection by taking one small step each day…” Sounds like a life hack to scroll past. Yet that credo underpins the stellar performances of Great Britain’s Olympians; a hospital in Seattle that has slashed its number of complaints and car maker Toyota, which put the philosophy into best practice decades ago.
In the early 2000s, British Cycling’s marginal gains think tank set out to identify every granular contributor to success. Thorough handwashing reduces infections. Bike saddle pain was resolved by a change to saddle tilt and a ban on bikini waxes. Wind-tunnel experiments and integrated performance measurement boxes (fixed under saddles) allow forensic analysis of everything from bike design to rider skin suits with raised rubber strips. The approach was replicated across Team GB, with Rio’s gold-medal-winning women’s hockey team training to cope with mental stress and handle specific competitive situations (holding on to a lead, going behind to a favorite, seizing momentum when a game was evenly balanced).
Sports teams, like businesses, should never assume they have wrung out every last advantage. “The low-hanging fruit disappeared years ago,” says British Cycling’s head coach Iain Dyer. “People have been catching up because they saw the gains that we had started to make were things they could copy. Now the marginal gains have never been more marginal and aggregating that has never been more important.” Team GB won six cycling golds at the 2016 Olympics in Rio – three times as many as any other nation.
Before the 2012 Games, every sport was urged to share negative feedback on itself. A similar process transformed Seattle’s Virginia Mason Hospital. In 2014, pharmacist Andrea Sangrey reported herself for prescribing the wrong drug. “It could have caused harm to the patient,” she said. “I was nervous filing a report on myself, but I was thanked for calling myself out. They looked at how it happened and how to fix it.” That year Virginia Mason recorded 50,000 patient safety alerts (PSA). It now targets 1,000 PSAs per month, resolving most in 24 hours (it used to take 18 months).
PSAs enabled small – potentially life-saving – changes, such as better labeling of drugs. Stores of key supplies were moved to patient rooms, so nurses walked only 1,200 steps per day instead of 10,000. Nurses spend around 90% of their time on direct patient care, compared to 35% in most hospitals. Primary care – which usually loses money – makes net margins at Virginia Mason, even though it has reduced doctor hours and slashed lab result wait times by around 90%. Changing room layout and made the difference.
|“Aim for perfection by taking one small step each day”|
The paradigm shift followed a 2002 executive trip to Japan to study the Toyota Production System. Hospital vice president Cathie Furman was struck by “the empowerment of high- school-trained assembly-line workers who felt completely comfortable stopping a multimillion- dollar line rather than sending a defective product to their teammate.” What Furman witnessed was kaizen, which Toyota1 explains as “the day-to-day improvements members and their team leaders make to working practices and equipment.”
Kaizen is central to the Toyota Production System, which the automaker has been honing since the 1940s. In essence, kaizen is a philosophy, not a one-off initiative. Daily meetings focus on what “should be done” rather than “what can be done”– for example, the company estimates that 3,000 proposed improvements are made every year at its material handling production sites in Europe – and a focus on pride in the workplace. The credo is: “No process can ever be perfect but it can always be improved.”
Matt Parker, head of marginal gains at British Cycling during the London 2012 Olympics, said the team aimed to beat each world record by two seconds. And in Seattle, Virginia Mason’s target? The perfect patient experience. That is the kind of enduring competitive advantage every business would love to have.