Poka-Yoke in Medicine, Atul Gawande

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One Pillar of the Toyota Production System is “Respect for the Human” or, more commonly known outside of Toyota as “Respect for People.” That Pillar has given rise to an approach to improvement that is uniquely Toyota’s and is starkly different than the Taylorist approach proposed by Frederick Winslow Taylor, which fails to see the individual and under-appreciates the physical and psychological differences in people and in how people prefer to work.

The Toyota Production System, I argue, appreciates the individual and empowers the individual to improve her work within the System; by doing so, a firm can increase its ratio of problem-solvers to problem-finders. But, this article is not about Taylorism versus The Toyota Production System — ignoring my propensity towards tangents for a moment — this article is about Root Cause Analysis, Genchi Genbutsu, and Human-Centered Design — all elements I found in the book Better: A Surgeon’s Notes on Performance, by Atul Gawande.

I recently read a short excerpt from the book Better: A Surgeon’s Notes on Performance, by Atul Gawande, which is an excellent example illustrating the relationship between Root Cause Analysis, Genchi Genbutsu, and Design. The book is a series of essays that explain, with heart-felt candor, how difficult it is to be a physician and also points out the weaknesses and vulnerabilities of the system, the physicians, and its impact on the rest of us.

Eye Injuries & Poor Design

In the excerpt that I read today, battlefield physicians noticed that soldiers and marines were getting a lot of eye injuries. They physicians asked the patients why they weren’t wearing their protective eye coverings. The answer? — The soldiers didn’t want to look like dorks! This point may seem subtle, but is a critically important one: These are soldiers on the front-lines, facing death everyday. Any amount of humanity — even vanity — that they can hold on to is important to them. Part of good, human-centered design is that the product must be elegant — in it’s design and functionality.

So, the goggles were redesigned to look like cool sunglasses, and the eye injury rate went down. This is also a great example of why you need to ask users about problems with products.

This is also an example of Poka-Yoke: to mistake proof our systems, processes, and devices.

poka yoke, medicine, atul gawande

Conclusion

In conclusion, we see the physicians quickly arriving at the Root Cause of eye injuries. They “went and saw” for themselves by asking the patients themselves why they weren’t wearing the protective goggles. Then, the practical solution was to redesign the goggles to make them more attractive. The result? — reduced battlefield eye injuries and cooler-looking sunglasses.

I’ve already ordered the book. I can’t wait to read it.