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How metrics, used right, can drive learning in your organization: Measure to learn – The Bungsu metrics code

This is a guest post by Marcus Hammarberg, author of Salvation: The Bungsu Story, How Lean and Kanban saved a small hospital in Indonesia. Twice. And can help you reshape work in your company. (available on Amazon)

This is the fourth and last post on a series by Marcus Hammarberg about how metrics can help engage, motivate and ultimately push a team towards success! (See other blog posts in this series here)

When we first started to work with the Bungsu hospital they were in a devasting situation.

Fast forward 1,5 years and you would see a hospital that was making money every day.

In the end, we turned the hospital from a situation where only the director and her closest staff cared, to a situation where 100 people in the hospital were actively engaged in everyday improvements.

How is this possible? What kind of magic was applied?

Visualizing the right metric

Each morning we showed the result and it was good we had loud cheering among the staff. But for bad days it was mostly silence, head hung low.

I also noticed that the lady that was in charge of gathering the numbers, Ibu Elly (Mrs Elly) the directory secretary, behaved a bit different for days with bad numbers. She was almost reluctant to present them and quickly went over the whole thing.

We had talked about what we wanted to learn about the numbers and I had written “KENAPA” (WHY) beneath the graph. Because I wanted us to learn from the metric we were collecting and visualizing every day.

For example on this graph – can you see something that stands out?

See those regular dips? If you asked “KENAPA” and counted the dates, you could probably figure out that those dips are Sundays… People don’t go to a hospital, as much, on Sundays.

“KENAPA” – what can we learn? Well, we could (and did) try to be more open on Sundays, but pretty soon realized that it would be very costly to keep more staff around and that it was a cultural thing keeping people back.

Until that point, most of the management team understood the KENAPA-question, but it made Ibu Elly feel ashamed for bad days. That troubled me, until one day when she was bustling with joy. We had made an excellent result yesterday: 138 patients served in one day. The first time, above our goal of 134 patients.

As she entered the numbers and headed back to her seat I asked… “Kenapa, Ibu?”

She stopped in her step and turned around with a puzzled look. “No, you don’t understand. It was a good result, sir.”

I did understand that it was a good result but I pressed on. “I know, but why was it good”.

Poor Ibu Elly looked around for support and then back to me with an even more puzzled look. “Well… in the polyclinic, we had 32 patients, and then for the ER we had 12 patients and …” I interrupted her gently.

“I understand all of that. You are showing me the math. But why was it good yesterday?”. At this point, she gave up and just said “I don’t understand” and took her seat.

I felt bad for her but we had an important learning point here, so I pressed the others. “Anyone else knows why it was good yesterday? Kenapa?”.

After a few moments of hesitation, someone offered “Well, yesterday we had three doctors in the polyclinic, rather than our usual two. Dr Paula did an extra day for us.”

“AHA!” I exclaimed, a bit too loud if I’m honest… “So what can we learn?”

We eventually concluded that more doctors probably means more patients. At least that was a hypothesis we could use to run an experiment.

More importantly, with the visualized data and by continuously focusing on learning we found that knowledge nugget. We now had understood the value of asking “WHY” the data behaves as it behaves. And from this point on we viewed the graph differently – it was now a source of learning, regardless of the result.

There’s a lot more to talk about metrics, and how simple practices can transform your organization. The book shares a lot about that, of course, but here’s a podcast episode where I talk with Vasco about the same practices.

Do you need the one metric that matters to engage your team? This booklet is for you!

In the Bungsu’s Pirate Code for Visualization downloadable booklet I will go into details on how we made this “one metric that matters” engaging, kept it relevant and ultimately saved the hospital by keeping our focus there – using what we referred to as the Bungsu Pirate Code. Click here to download your guide to using the “one metric that matters” in your own team.

This is a very actionable tool that you can you use today in your organization to make your visualizations matter to everyone all the time.

The Bungsu Story is a fascinating account of a real-life crisis, and how Agile, Lean and Kanban saved the Hospital from bankruptcy! Twice! Get ready for the journey, it’s going to be a bumpy ride!

About Marcus Hammarberg

Marcus is the author of Salvation: The Bungsu Story (available on Amazon), an inspiring and actionable story about how simple tools can help transform the productivity and impact of an organization. The real-life stories in The Bungsu can help you transform the productivity of your team. Marcus is also an renowned author and consultant in the Kanban community, he authored the book Kanban in Action with Joakim Sundén.
You can link with Marcus Hammarberg on LinkedIn, and connect with Marcus Hammarberg on twitter.

How focusing on a single metric improved team performance – Guest post by Marcus Hammarberg

This is a guest post by Marcus Hammarberg, author of Salvation: The Bungsu Story, How Lean and Kanban saved a small hospital in Indonesia. Twice. And can help you reshape work in your company. (available on Amazon)

This is the third post on a series by Marcus Hammarberg about how metrics can help engage, motivate and ultimately push a team towards success! (See other blog posts in this series here)

When we first started to work with the Bungsu hospital they were in a devasting situation.

Fast forward 1,5 years and you would see a hospital that was making money every day.

How is this possible? What kind of magic was applied?

How focusing on a single metric improved team performance

Now that we had a metric that mattered to everyone and this truly was the “talk of the hospital”, we experienced a wave of change.

Not surprisingly the first groups to engage was the people in charge of bringing more people to the hospital; the marketing team.

It turned out that making the “number of patients served”-metric visible throughout the hospital, was what was needed to get them activated. But when we did, the lid of their passion and creativity jar was blown off! We started to see real ownership in their behavior. As if The Bungsu was their very own hospital.

Before I knew it, I found myself in a workshop where the two ladies of the marketing department blurted out 25 ideas on how to get more patients. And 3 or 4 of them were really low hanging fruit that we could do the very next day. For example:

Go to the nearby clinics and advertise our availability for surgery and treatments that the clinics could not handle
Offer free transport from the big hospitals to our hospital for treatments that the big hospitals had a waiting list for
Suggest that our freelancing doctors would do all their surgery in our hospital

These were very simple changes that had been dragging on in decision-making boards. Now the decisions were quick to make – because the need and impact were clear to see.

Just a few days after we started to track “number of patients served per day” these actions brought the metric up to a whopping 133 patients served per day! Twice the normal number of patients and a level that has not been seen in a long time.

This taught me, in a very impactful way, how a single metric can transform the performance of a team. In this case, the marketing team.

Do you need the one metric that matters to engage your team? This booklet is for you!

This is a very actionable tool that you can you use today in your organisation to make your visualizations matter to everyone all the time.

The Bungsu Story is a fascinating account of a real-life crisis, and how Agile, Lean and Kanban saved the Hospital from bankruptcy! Twice! Get ready for the journey, it’s going to be a bumpy ride!

About Marcus Hammarberg

How a single metric can help the team members engage and become a real team – Guest post by Marcus Hammarberg

This is a guest post by Marcus Hammarberg, author of Salvation: The Bungsu Story, How Lean and Kanban saved a small hospital in Indonesia. Twice. And can help you reshape work in your company. (available on Amazon)

This is the second post on a series by Marcus Hammarberg about how metrics can help engage, motivate and ultimately push a team towards success!

When we first started to work with the Bungsu hospital they were in a devasting situation.

Fast forward 1,5 years and you would see a hospital that was making money every day.

How is this possible? What kind of magic was applied?

Click to learn more about how you can help your PO

Keeping engagement when the bad news hit – Becoming a team!

Continue reading How a single metric can help the team members engage and become a real team – Guest post by Marcus Hammarberg

How the right metric, communicated the right way can engage your team. By Marcus Hammarberg

This is a guest post by Marcus Hammarberg, author of Salvation: The Bungsu Story, How Lean and Kanban saved a small hospital in Indonesia. Twice. And can help you reshape work in your company. (available on Amazon)

When we first started to work with the Bungsu hospital they were in a devasting situation. Their finances were at an all-time low after years of decline in patient visits. Their operational permit had not been renewed and they were operating on probation, the staff was disengaged and blasé … oh, and one more thing: the roof of the entire second floor had collapsed.

Still, to my great surprise, not many people were upset, engaged or even cared about the survival of the hospital.

Fast forward 1,5 years and you would see a hospital that was making money every day, had not only an operational permit but also got awards for their services, happy and engaged staff … oh yes, and they had a newly renovated roof.

We didn’t hire or fire a single person during this time – and all the work to save The Bungsu was done by the people in the hospital, I merely acted as a guide for new ways of working.

How is this possible? What kind of magic was applied?

We soon realized that the scary state of the hospital’s finances was not only our number one priority but it was also too vague for the staff when expressed in numbers. Billions of rupiah in deficit didn’t mean a thing for the staff.

First of all, those numbers were unrelatable for the average employee, even if we broke it down per day. Saying “we need 18.000.000 rupias per day” to someone that earns 1.000.000 per month doesn’t spark engagement.

We need 18.000.000 rupias per day!

Secondly, and perhaps most important, the staff in the hospital was not interested in budgets, forecasts or financial plans. They worked with patients! We needed something more concrete and closer to their day-to-day reality.

Armed with those two realizations we started to track “the number of patients we served per day”. We hoped this concrete metric would engage the staff. The numbers of presented were truly awful; our financial target was 134 services sold per day and we were averaging on 60-70. Half of what we needed to be able to improve the financial situation!

our financial target was 134 services sold per day and we were averaging on 60-70. Half of what we needed to survive!

I was shocked but the reaction in the room was something very different. Indifferent, unfocused or the occasional shrug. Almost angry, I got up and added a new line, for the number of patients required to break-even; 120. In my upset mood I blurted out:

Below this line we lose money by having the hospital open and we may need to close it!

That got their attention. The jaws of the 70 people in the room dropped to the floor at once. We now had our one metric that matters and most importantly: everyone understood it.

In the next blog post, you will see how this metric, visualized and understandable not only helped us focus on what is important but also made us into a team.

Do you need the one metric that matters to engage your team? This booklet is for you!

This is a very actionable tool that you can you use today in your organisation to make your visualizations matter to everyone all the time.

The Bungsu Story is a fascinating account of a real-life crisis, and how Agile, Lean and Kanban saved the Hospital from bankruptcy! Twice! Get ready for the journey, it’s going to be a bumpy ride!

About Marcus Hammarberg