In 1976, Dr G Venkataswamy (Dr V) decided to "eliminate needless blindness" and started the 11-bed hospital staffed by four medical officers, called Aravind Eye Care. But he soon realised that to achieve his vision, the current way of working would not be enough to serve large volumes of people and making patients wait was something he did not want. So, he decided to bring in the unique assembly line approach and improve his productivity tenfold. Today, Aravind Eye Hospital is the world's largest eye care provider (4.5 lakh procedures in a year and to top it all, it does not charge 50 per cent of its patients. You can read more about this productive powerhouse at www.aravind.org.
So, what does ‘De-skilling’ have to do with this? A lot provided the principles are understood before implementing the practices. How and what could an eye hospital learn from an assembly line and implement it to get ten-fold gains?
Let's change our perspective and see what McDonald's has done to maintain the same standards globally, considering people working in any outlet are not "cooks or chefs.” So how is it that the French fries are the same, irrespective of the outlet you go to? Well, that's the practice of de-skilling at work. So, what did they de-skill, and why?
Both entities above essentially did two things: first, they managed to segregate the "style" of work and "standard" of work and second, they separated the "physical work" from the "thinking work.” Once these two were done, the process steps were standardised (either by digitisation/mechanisation or automation) to such an extent that they could squeeze the "variability" out of the process to the maximum. A consistent, sustainable, repeatable, and continuous process remains when you do all that.
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