As COO of a large urban hospital, I lived through a thoughtful and progressive transformation of my leadership approach over 4 years. I gave up control of things I had previously understood were my responsibility and, as I spent more and more time on the floors connecting with the people doing the work, built valuable relationships with the multidisciplinary team. I learned new things, then turned around to teach and coach leaders and staff to develop standard practices such as safety huddles, shift huddles, visual management and standards development. I changed my view of what was possible and was fortunate to have 3-4 valuable sensei coaching me along the way. I can honestly say, as hard as it was, I gained results and personal satisfaction in my job I had not yet experienced. I am committed to bringing that same value to leaders on their lean journey by walking side-by-side and learning to see together.
Physician engagement in lean processes is indispensable to the progress of improvement and key to satisfaction and avoiding burnout. Yet physicians often don’t have access to a strong coach. They often hold an informal leadership role on the care team, meaning they work largely through influence rather than a direct reporting relationship. They are seldom granted enough time to do the hard work and thinking. I have worked with and supported amazing physicians who served as key (thought) leaders by being on the floors with them when work is happening and creating short and meaningful huddle to exchange ideas. One physician told me “if only someone could follow me for a day and tell me where they see I might find waste or try another way of doing my work.” A good coach can ask the right questions to help people see patterns in behaviors, actions and relationships and design and walk through the day.
I work with Senior Teams to facilitate development of their “True North” and deployment strategy, whether or not they are pursing lean implementation. The ability to focus the organization on the “vital” few, deploy the work throughout the organization and manage the pace of improvement is key to growth and success.
These two quotes do a nice job of describing the lean leadership challenge:
“… the power behind TPS is a company’s management commitment to continuously invest in its people and promote a culture of continuous improvement. I nodded like I knew what they were talking about, and continued to study how to calculate kanban quantities and set up one‐piece flow cells. After studying for almost 20 years and observing the struggles [other] companies have had applying lean, what these Toyota teachers told me is finally sinking in.” – Jeffery Liker, The Toyota Way
“The key to successful Lean implementation is that leaders have to change. We have to change from the all-knowing, being ‘in charge,’ autocratic ‘buck stops with me,’ impatient, blaming person—who is a control freak—to the person who is patient, knowledgeable, a good facilitator, willing to teach, actually willing to learn, be a helper, an effective communicator, and be humble.” — John Toussaint CEO, ThedaCare Center for Healthcare Value
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