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.
All of us working with Agile and Scrum are used to the (sometimes) large transformations that these approaches can have at work. But it is not everyday we see the impact, the amazing impact, it can have on other types of work. How about this: 
Meet Ibu Elsye! Ibu Elsye is the lady dressed in black in the picture or “Mrs.” Elsye if you don’t speak Indonesian ;).