Increasingly, those real-world settings include service industries: retailers like Tesco, repair outlets, and health-care facilities. “Whenever I find myself in a hospital, I start making notes,” Dr. Womack told a group of medical professionals in February in a telephone/Web seminar organized by the Boston-based Institute for Healthcare Improvement. “What time did I arrive? When did someone see me? How much time did each step take? Generally, I find that a few minutes of treatment require me to sit there for several hours.” He quickly added that he didn’t blame hospital staffers for treating their patients as inventory; “not the way the system is currently configured. But why can’t we reconfigure the system?”
That last question is the essence of the forthcoming Lean Solutions. Why can’t institutions, whether hospitals, government agencies, or shopping centers, be designed with more respect for human time, dignity, and community? “My fear about the health-care future,” Dr. Womack told the medical professionals, “is that financial pressures will lead hospitals, in the name of efficiency, to decrease the time for [emotional support] and bonding, which may in fact be the key to healing.”
In the authors’ view of utopia, when all the moving parts connecting the corporate world to the consumer are perfectly meshed, customs officials can process passports while airplanes are still aloft; a single computer help desk can diagnose problems for a wide range of equipment by diverse manufacturers; and car-repair shops can design schedules to eliminate long waits. They foresee diminished popularity for outsourcing production to remote offshore locations, as manufacturers discover that the hidden costs of transporting goods across oceans outweigh the savings from cheap labor. For example, they cite Nike’s decision to manufacture its customized backpacks in San Francisco, not China, because of the logistical nightmares of storing products at container ports, navigating them through customs, and suffering the lost sales and overstocks that delays tend to produce. “Lean thinkers don’t like large, slow ships,” says Mr. Jones. “They like small, fast trucks.”
This kind of intellectual and clerical renaissance would require companies to reimagine themselves as their customers would like to see them, not as they would like to see themselves. An airline, for example, might routinely book its regular customers on competitors’ flights, knowing that customers don’t care whose name is on the plane. This could result in less revenue per ticket, but it would eliminate the costs of half-empty duplicate flights. It’s likely that passengers would continue to patronize the booking airline as long as it provided the most comfortable, amenity-filled, and responsive service on the ground. Similarly, an automobile or refrigerator company might offer a cash incentive to people who make their purchases three weeks ahead of delivery, thereby complementing the natural flow of manufacturing and allowing the product to appear entirely made to order. A computer company could sell all its wares on a subscription basis, customized to the most detailed specifications, and deliver a package of printers, network devices, and home entertainment electronics preconfigured to work effortlessly together. Every six months or so, a smoothly integrated upgrade of hardware and software would arrive.
Some of this is already happening. Dr. Womack and Mr. Jones recount the story of Fujitsu Services, a computer help line outsourcer handling calls from British Midland International airline staffers. Facing an inordinate number of complaints about chronically malfunctioning printers, the previous outsourcer had pushed for faster printer repairs. Fujitsu, by contrast, decided that any repairs were wasteful, and lobbied British Midland International to replace its printers with more durable models.
The logical conclusion of lean thinking is a world in which every product is brought to life because a customer has specified that he or she wants it. Dr. Womack and Mr. Jones call this a “make-to-order” world, and they argue that it could be born out of the current system of mass production. In the long run, they imagine manufacturers shrinking the fabrication time for many products down to one or two days between the time the customer places an order and the time it is delivered to a store nearby.