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Lean the Virus: An Opportunity for Response Redesign

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Kate McGovern
December 15, 2020

We have witnessed a stunning failure of governmental response during a crisis of epic proportions. Facing the darkest days of the pandemic, those of us in public administration are called to understand what went wrong and how to do better going forward.

Turning the page will not be simple. To do so, we must reckon with the consequences of the nonfeasance of the administration in power in 2020. We must also examine the impediments to an effective response that predated this crisis. Addressing those impediments will require more than a change in administration.

As a practitioner of Lean process improvement techniques, I chose to evaluate the response through that lens. What we witnessed was the antithesis of the Lean principles of quality, efficiency and standard work. There were bidding wars between states amidst supply chain chaos, inconsistent and redundant data collection and erratic and conflicting public health guidance.  

A Patchwork of Policies

Within the country ironically known as the United States, each state devised its own strategy to deal with a global pandemic. Policies on masks varied by state and local jurisdictions. A comprehensive approach that could have saved more than 95,000 lives and 5% of the GDP was undermined by the President and others. States developed a confounding variation of unenforceable interstate travel policies in an attempt to limit the contagion.

“The inconsistency of the response is what’s been so frustrating,” said Dr. Irwin Redlener. “If we had just been disciplined about employing all these public health methods early and aggressively, we would not be in the situation we are in now.”

Non-standard data collection made it difficult to get a clear picture of the extent of the contagion. For example, states have different testing strategies, so reported positivity rates can be misleading. The percentage of positive results of the total tests includes those who are tested regularly. States with robust surveillance programs continually test those in high-risk jobs. This is essential to contain the outbreak in healthcare and congregate settings. However, the positivity rate of those tested for the first time may reveal more about the level of community spread. Both figures have value, but only in context. Without uniform reporting criteria, state by state comparisons are full of noisy data which obfuscates decisionmaking.

The global health initiative Resolve to Save Lives urged policymakers to address the information catastrophe, noting that, “Unlike many other countries such as Germany, Senegal, South Korea and Uganda, the United States does not have standard, national data on the virus and its control. The United States also lacks standards for state, county and city level public reporting of this life-and-death information.”

The data collection dilemma predates 2020. As journalist Fareed Zakaria noted, “America is paying the price today for decades of defunding government, politicizing independent agencies, fetishizing local control and demeaning and disparaging government workers and bureaucrats.” The capacity to fight COVID-19 was further impeded by what he characterized as, “America’s crazy quilt patchwork of authority with thousands of state, local and tribal public health departments.” Zakaria closed the commentary by affirming that the most successful governments are well-funded, efficient and responsive. A perfect description of Lean government.

The Road Ahead

In the midst of a crisis, there is a risk for an unlean over-correction. Under pressure to act, policymakers tend to create new agencies, programs and regulations without assessing and fixing what is already in place. Alternatively, Lean can be used to design efficient data collection, regulatory processes and procurement processes. For example, practitioners Beau Keyte and Robert O. Martichenko have proposed strategies to deal with the supply chain and the Strategic National Stockpile. These approaches can avert the inclination to add more complexity and redundancy.

A multi-disciplinary effort will be needed to improve the functionality of overlapping political jurisdictions. Scholars and practitioners of public administration can assist policymakers in addressing systemic complexities and resource requirements. Concepts of Lean management can be of use in this endeavor.

Within the continuous improvement wheelhouse is Kata, a structured problem-solving technique developed by researcher Mike Rother. Kata combines the scientific process of inquiry and experimentation with routines of deliberative practice. Understanding that knowledge is not static, the methodology is built to incorporate new learning and to adjust accordingly. Kata is a meta skill, well-suited to counter anti-scientific bias. It is among the core components in the practice of Lean management.

Organizational principles of quality, efficiency and standard work should be incorporated into the assessment and redesign of the response to this crisis. Management practices based on these concepts are universally applicable to public administration beyond the massive challenges posed by the pandemic.

Author: Kate McGovern, MPA, Ph.D. is a Lean trainer and practitioner in the public sector. Formerly a professor for the State of NH, Kate is a consultant with Daniel Penn Associates and instructor at College Unbound. She is the author of A Public Sector Journey to Lean: Fighting Muda in Times of Muri. [email protected] @KateMcGovern_

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