Lean Healthcare Exchange

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I was recently asked by a hospital executive what I think is the True North in healthcare. The reply I gave: “It is “Hoshin Kanri.”

Hoshin Kanri, or strategy deployment, are complicated words to describe a very simple concept: breakthrough initiatives to improve the health of patients. It can be likened to the way that the point of a compass always points towards the North Pole.

Hoshin Kanri is more than a compass for steering the direction of your organization and your processes. It is the strategic means of control that allows your organization to make quick turns, changes, and adjustments before you become trapped in a crisis.  Success in a highly competitive healthcare environment requires more than focus and direction. You must have innovation. Hoshin Kanri is the means for keeping the actions and innovations of your people aligned with your organization’s strategic intent.

Another definition explains Hoshin Kanri as a method to set breakthrough priorities to transform healthcare, and then to obtain feedback from staff closer to the work on how to prioritize and implement them.

Traditional Japanese management system ideas flow bottom-up from the workplace to management.  However, in Hoshin Kanri there is also a top down approach to planning change. Strategic direction must be determined by discovering the alternatives for achieving the organization’s vision and choosing the direction that will accomplish it.  This direction is modified through the power of the incremental change to act as the rudder that steers the ship by making finely tuned changes to the general direction of the strategy.

I see a critical need for healthcare organizations today to align their strategic direction with their daily work systems so that they work in concert to achieve the desired state.  Alignment must include linking cultural practices, strategies, tactics, organization systems, structure, pay and incentive systems, building layout, accounting systems, job design and measurement systems – everything.  In short, alignment means that all elements of the company work together much like an orchestra leader integrates various instruments to conduct a symphony.  Organizations that apply the most mature aspects of Hoshin do not put in place any random mechanisms or processes. Instead they make careful, reasoned, strategic choices that reinforce each other and achieve synergy.

As I told the healthcare leader who asked the question, the main focus of Hoshin Kanri is to deploy and track only a few priorities at each level of the organization.  Given all of the rapid changes and increasing distractions that healthcare organizations face today, individuals must be able to focus on the things (the vital few vs. the trivial many, as my boss always says) that offer the greatest advantage to the organization. The clearer the priorities, the easier it will be for people to focus their energies on what really counts. How often has your healthcare organization made dramatic improvements in a process that suddenly became obsolete due to the lack of these communication tools?

Invest in Hoshin Kanri. Drive your healthcare organization in a focused strategic direction for the future.

Today’s blog was written by Michael Kellner, a Director with HPP.

With more than 30 years of experience, Michael has optimized organizations’ delivery systems through Lean, Six Sigma and continuous quality improvement methodologies.  He has led lean transformations in Healthcare for both private organizations and the military, including the Office of the Surgeon General.  Michael has also held senior leadership roles with Johnson Controls, Tenneco Automotive, and Warner Electronics.  Additionally, he served with the U.S. Navy in Vietnam.

Michael holds a Bachelor’s degree in Industrial Technology from Tennessee Technological University. He also holds a Senior Sensei and Master Black Belt Certification.

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Lean Healthcare has the potential to radically improve hospitals and healthcare organizations, yet its impact is often limited in many organizations that try to implement Lean principles.  This notion alone magnifies the importance of Lean leadership in organizations that plan to make a larger and broader impact with Lean.  Organizations that aspire to transform through Lean Healthcare must have a transforming leader.

The qualities of a transforming leader include:

• The ability to create a lean vision for the organization
• Understanding that people are a major source of information
• Being visible where the work is performed (Gemba)
• Listening twice as much as speaking
• The ability to persuade and influence, rather than coerce
• Focusing on operating processes
• Mentoring and motivating people to determine how to get it done
• The ability to coach

True Lean Healthcare leaders always spend time in the Gemba. So, let’s discuss what your daily standard work should look like as a leader:

• Do you go to the Gemba? Is this part of your daily system and do you model this to other leaders in your organization?

• Do you recognize waste when you see it, and do you work to eliminate it? Do you discover and resolve problems? Are your managers, staff, suppliers, and partners identifying and eliminating waste?  Or, do you still own it all?

So, what makes Lean leadership different? An effective Lean leader must be a good coach. Lean is about “shared thinking” along with common philosophy, ideas and principles.  A Lean leader needs to be a source of endless energy that drives the organization into action.  They need to create positive tension — not stress — around the gap between the current reality and the ideal state. Lean culture involves action, experimentation and new thinking so a Lean leader must be an innovator and risk taker. Lean leaders should be able to lead through visible participation and not by mere declaration.

In the past 20 years I have heard a lot of excuses coming from leaders about why they can’t make the transformation to Lean thinking and Lean leadership to truly lead their healthcare organizations to become the best they can be and deliver exceptional care and value to their customers. My answer to all these excuses is to get out from behind your desk and spend time in the Gemba and help staff make changes happen. True Lean leaders embody this and drive the Lean Healthcare transformation in an organization.

Today’s blog was written by Michael Kellner, a Director with HPP.

With more than 30 years of experience, Michael has optimized organizations’ delivery systems through Lean, Six Sigma and continuous quality improvement methodologies.  He has led lean transformations in Healthcare for both private organizations and the military, including the Office of the Surgeon General.  Michael has also held senior leadership roles with Johnson Controls, Tenneco Automotive, and Warner Electronics.  Additionally, he served with the U.S. Navy in Vietnam.

Michael holds a Bachelor’s degree in Industrial Technology from Tennessee Technological University. He also holds a Senior Sensei and Master Black Belt Certification.

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Is the process sustaining?

I hear this question all the time from healthcare leaders and managers.  We have strong data showing that the consistent application of a handful of Lean Healthcare skills is the key to the success of any new and promising transformation (from adopting Lean to shifting to a problem solving approach).  We also see data that shows it is possible to make rapid and significant progress when teams use these skills, even in resistant organizations.

This is the true foot stomper though: “How can you ensure that the new crucial lean skills don’t just become another ‘flavor of the month’ club?”

There are two possible scenarios:

1. There are organizations where leaders eventually stop paying attention to how they and others apply their Lean Healthcare skills. Well documented organizational policies are insufficient to stimulate change.  Predictably, their change efforts flounder and eventually fail.
2. I have seen more cases where lean leaders become so strong in their lean vision and skills and so committed to using them that it has profoundly affected the way they lead their organizations to enjoy significant and lasting change for their patients.  It takes continuous concentration and attention to ensure the application of Lean Healthcare skills in the organization. 

Are you in scenario B?  What do you do daily, weekly, and monthly to prove your commitment to your organization?  Can you do more? 

Today’s blog was written by Michael Kellner, a Director with HPP.

With more than 30 years of experience, Michael has optimized organizations’ delivery systems through Lean, Six Sigma and continuous quality improvement methodologies.  He has led lean transformations for Healthcare for both private organizations and the U.S. Air Force, including the Office of the Surgeon General.  Michael has also held senior leadership roles with Johnson Controls, Tenneco Automotive, and Warner Electronics as Plant Manager and Vice President of Operations of multi site operations.  Additionally, he served with the U.S. Navy in Vietnam.

Michael holds a Bachelor’s degree in Industrial Technology from Tennessee Technological University. He also holds a Senior Sensei and Master Black Belt Certification.

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Some months ago I was at a healthcare facility working on implementing a Lean Healthcare system and it was very apparent that something was missing.  After some reflection, it became very apparent what was missing…

Communication.

There is no silver bullet to transform an organization from traditional leadership to Lean leadership—but all transformations must include effective communication about Lean initiatives.  One of the keys to successfully implementing robust communication via Lean Healthcare is to realize that the executive leadership must play an integral part, and not just be an afterthought.  Hospitals should think of communication as a lever to drive Lean principles throughout the organization.  Communication is one of the most important processes in any organization.  Even in this technology based era, most Healthcare organizations could better communicate their lean transformation to the whole organization.

When a healthcare organization embarks on a Lean Transformation or journey, the executive staff often under-communicates the Lean plan to the organization.  Typically, communication only takes place once or twice, up-front, but does not continue on and integrate the lean vision of the organization across the board.

The executive group, without exception, should create and share the Continuous Improvement vision and acknowledge its importance to the organizational success at every level.  Create a burning platform or business case for your Lean Vision.  Communicate the vision continuously and repetitiously down through the organization.  Communicate the campaign to the organization—even to the point of over communicating.  Senior leaders should be involved up front in delivering information and formal communication throughout the organization—they will communicate more effectively.  When ambiguity is high in a healthcare organization, use face-to-face communications channels, which allow for rapid information flow and for the clarification of meaning in real time (one-on-one conversations and small group meetings).

Today, healthcare executives are embedded in a complex network of healthcare relationships.  Communication is the core of these relationships and is dependent on the executive’s ability to listen, assimilate, interpret, gather, and share Lean information in all disciplines and hierarchies within healthcare.  Lean communication is a critical part of everyone’s job.  Remember, silence is no more than adamant agreement, you must communicate the Lean strategy and vision at all levels continuously.

Have you registered for the Lean Healthcare PowerDay yet?  Spaces are filling fast!

 Lean Healthcare PowerDay

April 9-10, 2012

Mandalay Bay Convention Center and Resort—Las Vegas, Nevada 

Featured Speakers:

 Click Here for More Information, Session Topics, Pricing, and Accommodations

With more than 30 years of experience, Michael has optimized organizations’ delivery systems through Lean, Six Sigma and continuous quality improvement methodologies.  He has led lean transformations for Healthcare for both private organizations and the U.S. Air Force, including the Office of the Surgeon General.

Michael has also held senior leadership roles with Johnson Controls, Tenneco Automotive, and Warner Electronics as Plant Manager and Vice President of Operations of multi site operations.  Additionally, he served with the U.S. Navy in Vietnam.

Michael holds a Bachelor’s degree in Industrial Technology from Tennessee Technological University. He also holds a Senior Sensei and Master Black Belt Certification.

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