Running with Knickers on Your Head: Lean Startup Application in the Public Sector

Editor's Notes

• #3: Backgroundto this particular client and programmeThe elements of Lean Startup that we used on the programme in questiondescribe some of the outcomes
• #4: I applied it to a large city council, in the top 5 biggest in England.What I discuss here in terms of the character and culture of the organisation are prevalent in numerous public sector bodies.Political – big politics – government, Department of Health, NHSPolitical – interpersonal, teams interpreting laws differently. Members and votersArduous – red tape – things done that way for yearsHurdles and hoops – getting approval for progress, difficult to do anything longer than 4 year timeframe or coming up to an electionEvery local authority has an urgent need to reduce expenditureBacklogs – create additional work – typical lean concept of generating failure demandFailure demand results in overloaded workers, results in overloaded team, results in overloaded service. It’s a circle that only gets worse without intervention.Typically slow to change, the pace is slower. It’s accepted that it’s slow to change
• #5: SceptismHeard it beforeBeen here before & it failed last timeNothing ever changesUnwillingness to analyseWe’re social workers, not analystsWe’re not a production line so systems thinking doesn’t applyWrong FocusWe don’t need technology, we need more staffSenior management are too removed from the workforce, they don’t understand the role anymoreAcceptance of status quoWe’re already efficientWe’re more progressive than other teamsResistanceWe can’t do that or service users will dieOr more extreme, we can’t do that or children will dieUsed to deflect change programmes and initiatives
• #6: Traditional waterfallPeople making the changes often at the other end of a chain from those who commissioned the changeWaterfall is the root cause of the other issues. It causes lengthy programmes and that’s the problem.Lengthy2 years is not uncommon. Createsopportunities for interruptions and changes.Staff move on More rife in public sector. Services often unprepared due to recruitment freezes. More secondments and acting-up (so a bit disgruntled), plus responding to crises LegislationAlways under threat of some consultation or other. So longer the programme, more likely it can be derailed by legislation.Not a case that legislation may change what you do, but rather there are always consultations and legislative changes in process while your programme is underway. It’s more a case of what will change and when.ResistancePassive resistance – not attending meetingsTaking on work but not doing any of itRidiculing ideasSabotageHistoricBeen here before, didn’t workThey tried that before, didn’t workAll this means that we have to change the way that we implement.
• #7: Some people use the two terms interchangeably. I see them as very different and for different purposes. Both viable, but choose your method according to what you want to achieve.Lean=improving a service so that the enterprise focusses on the value to the customer, through improving flow, reducing waste and organising around the value streamsLean Startup =creating an organisation in a lean manner, not necessarily creating a lean organisationIt’s that intersection that I’m interested in:Building lean organisations in a lean mannerAndTransforming existing organisations into a lean organisation in a lean manner
• #8: Multiple MethodologiesLean concepts using six sigma tools. Rather than Six Sigma itself which can be uncomfortable in a service operation Lean startup to measure and track progressDSDM in terms of timeboxes and approach plus MoSCoW rulesTheory of constraints – for which blockages to removePrince2 for standard governanceThere were many cycles within the programme, usually 2-3 running concurrently. They were also there to initiate service change as well as introduce new technologies (EDRMS, mobile working, fax gateway)2 or 3 cycles at any one time
• #9: Some were probably more viability tests rather than full MVPsEach cycle was expected to produce 30-100 proposals. Ranging from small, e.g. move the papertray from that side of the office to near the post to larger, e.g. work with NHS partners so that social care don’t receive unnecessary referrals and patients/service users are caused undue stress.Still recorded even the small changes to be able to prove value for money and that change happened.Some values could be in the 10s or 100s of £1000s per year. On average, half of the proposals were implemented as MVPs. Some that day, most in one week, some longer-term.The idea was that “as soon as it’s viable, test it and deploy the change.”
• #10: Borrowing from Lean, we introduced visual management = Proposal MatrixCan share ideas across teams and display progress.Two forms:The bottom, easy to read view – daily at-a-glance of what’s happeningThe upper, more detailed view – weekly/monthly management reviewBoth simplified with a few columns removed for purposes of presentation.Important part is that the bottom one is easier to see and get engaged with. Idea is that anyone can see the progress on the bottom one, then click to view the top one for more detail if they want it.Used SharePoint as a visual boardSo can share across teams and across locationsCan use on matrix for all changes from all teams, concurrent or not. Easier to identify conflicting proposals
• #11: CRM:My background’s in large Customer Relationship Management applications so I see Cohort Analysis largely as a form of CRM customer segmentation. RegardingSocial Care Metrics:Implementation of metrics in social care can be lacking anyway, often biased towards central government returns to show that the authority isn’t failingSo no realneed to avoid vanity metrics, just question reality of the government returns.From Lean:From Lean, we were more interested in flow and amount of value being added per activity, cycle time, cycle efficiency, takt time.From Lean Startup:we wanted to see what changes were happening with the cohort100%:Even a cohort of 100% of customers can be useful. It’s about seeing the change in what the population are doing rather than viewing each line independently
• #12: Fabricated data due to personal dataThis is fabricated data based on something I noticed when working with a team installing and monitoring care alarms. I’ve fabricated it as the original involves sensitive personal data. The charts display volume of referrals into the alarm team per month.Top ChartLooking at the top chart, we see a slight increase from Feb to March 2012 (makes sense as there are only 28/29 days in that month so we’d expect fewer referrals). On the whole, there’s a bit of a wavy line for the volume of referrals coming into the service, but nothing that stands out. This is the typical vanity metric.Bottom ChartNow if we look at the cohort of 100% - so all the put segments together to always sum to 100%, we can see some comparisons.This time, we look at the same data but expanded to a percentage of the whole cohort, it’s now easier to see the bump for December 2012. If you look at the top chart for December, you can see that the volume for Health referrals (the large grey one) was pretty consistent. By looking at the underlying data, we noticed that Health put through the same number of referrals in December as in other months, but that the other services had referred less during December. Potentially people concentrating on Christmas and New Year, rather than referring themselves for alarms.Two differences between normal Cohort Analysis:This is analysis of a current service rather than monitoring effectiveness of pilot or MVP actions.We’re not trying to go viral and grow the number of users – instead we’re using the intelligence to understand the service and its users
• #13: Each cycle produces learning/knowledgeThe first cycle was 10 weeks, that informed the following cycles.I originally designed the cycles from speaking with directors, heads of service, team managers and social workers/care managers. However the cycles mainly involved social workers/care managers and business support. Feedback was that team managers wanted more input.So following cycles were changed to include themAdditionally, the first cycle was partly derailed by the team venting their frustrations. Rather than let this become toxic, I turned it into something positive by introducing a Discovery Event in the first week of the cycle. This allowed the team chance to rant constructively. It also provided the change team with valuable information about what mattered to the workers and laid the foundations for a smoother cycle.One iteration focussed on implementingvalue streams (separating out community teams into an assessment team, a duty team and case management/complex case management teams). That’s something that I’d wanted to implement for a while, but the change team (project manager and business analyst) on one cycle thought their next cycle could be the vehicle for that change. That spin-off
• #14: Multiple sessionsHow to manage several sets of proposalsAt one time, we could have 50 x 3 = 150 proposalsMany complementarySome contradictoryOne analyst and project manager could run two teamsHad to split time between the two teamsDifferent locationsDifferent culturesCascading changesSince many of the teams perform the same function:How do you cascade changes from one team forwards?How do you cascade changes from one team back into previous teams?For example, introducing the value streams had to be implemented to teams that we had already changedFollow-upWhat’s the best way of following-up the changes?
• #15: For The ProgrammeChanging the programme plan due to what we learn from one cycle and how to best apply it to future cyclesE.g. involving team managersThinking like this made it easier and more responsive than typical change request managementPivot the CycleRecognising when the 10-week cycle isn’t the appropriate vehicle for changePer ProposalWhen the proposed solution will not work, e.g. we weren’t aware of some intricacies or quirks in the process that made it riskierOverallPart of the job of the methodologist/lead analyst
• #16: Difficult to create a rolling lean cultureHow to help staff own the work themselves while we’re not thereDifficult to address visual management with a mobile workforceI like simple whiteboards and paper, easy to change, cheaper, etc. But don’t work well when your team is distributed and mobile.Really dependent on the maturityThe better the management skills, the easier it was (which doesn’t mean that the best social work team managers had the best results)We always encounter resistanceShort timescalesMaking changes in 5-6 weeks is challengingEspecially when partners are involvedAs it’s public sector, partners are usually involvedIt can become its own brandPeople wanted a 10 week cycle to happen to their teamTeams outside of our scope wanted it
• #17: Greenfield– easier to change something new, e.g. social care or health commissioning to create a new community project to improve healthScope - Don’t tie your teams down,allow them to pivotGovernance – stakeholders need to know that they are not defining the changes, but approving themOpen – lots of people will be affected, so don’t hide the process of change or the lists of proposals.Lean start-up – hire someone who’s done it, join a group, form a group. Don’t just read the bookCommunicate frequent – pivots and MVPs introduce change quickly – so tell people what’s going to happen and when.
• #18: A care manager was resisting the changes and the process. She said she’d run round the office with her knickers on her head if we made any of these changes happen. True to her word, the following week, that’s what she did. We chose a few simple changes to make. However it was enough so her reaction was recognition that we could make a difference and acceptance that the process works.