We have come full circle on the role of a manager in engaging others in healthcare improvement with Lean Healthcare Exchange’s last blog sharing coaching’s importance. This week’s blog puts it all together for the manager in their work to make quality healthcare more reliable.
We improve healthcare to make it more reliable. Reliability may be defined as meeting expectations over an intended time. Readmissions is an example where reliability has not been met and we all know the increasing cost of readmissions as we enter this new phase of reimbursement. I thank a physician friend of mine at Massachusetts General Hospital for bringing this focus even clearer to me as I help organizations choose work for their teams. My company’s motto is, “Making Quality Healthcare More Affordable.” Improving reliability, in turn, improves affordability.
Let’s look back to a November blog with the story of Dr. Semmelweis and how his leadership failed in its role of coaching, supporting and leveraging unquestionable safety improvement – washing hands saves mothers’ lives. Finally, in a blog posted recently, “Leadership Advantage,” Brad Schultz shared the importance of coaching for continuous improvement and sustaining the gains – reliability. Let’s apply the key point of coaching and reliability to the story about Dr. Semmelweis. Dr. Semmelweis’ improvements met expectations in saving mothers’ lives, but his leadership failed to coach others in the techniques and also failed in its role of leveraging standard work. Thus, Dr. Semmelweis’ improvemenets failed to sustain and thus caused a lack of reliability.
In between these two blogs is “Closer To The Problem.” This is a very important point for managers at every level. Tom Stoffel writes, “Data and reports may be reviewed regularly by top leaders at a facility, however, when we move the data closer to the problems – day-to-day problems – we are closer to making lasting and necessary improvements possible.” The OR turnaround time improved – reliability improved – when measured close to the problem, and staff and management used the measurement system to control the process. Dr. Semmelweis had the data close to the problem by sharing it with his colleagues, we think, but what failed is the manager in his role to coach continuous improvement.
Key point: Managers who measure new ideas to improve reliability get new ideas from staff. What’s the saying; “If you want it, measure it?” If we want managers to coach others to improve healthcare, maybe the first data an organization should consider are the number of implemented ideas. Roll this up by manager and maybe we will find those managers who are better at coaching for continuous improvement and higher reliability.
Here’s a tip if you want to try these suggestions. Make measuring ideas easy. Simply count the number of legitimate A3s implemented. Place a bin in the work area and a chart above it showing the number of A3s implemented. Visual Management applied! Sometimes, just measuring will create the improvements. Good luck and let me know if you try it.
This week’s blog was written by Rick Morrow, a Director at HPP. Rick has 25 years of leadership experience in healthcare, aviation, automotive, supply chain and technology. Prior to HPP, Rick held the position of Director, Business Excellence with The Joint Commission and led the Center for Transforming Healthcare. Prior to the Joint Commission, Rick held senior level Continuous Improvement positions with United Airlines, Motorola, SKF and Eaton. As Vice President at SKF, a firm known as a leader in reliability, his LSS was credited with achieving Zero Defect processes which he then rolled out internationally. At Motorola, he directed the quality turnaround of its safety product, OnStar. He wrote Motorola’s corporate-wide Lean courses and led the strategic and tactical planning using TPS globally. Certifications include Motorola Master Black Belt and a MBA from the University of Illinois’ Executive Program. He is an international speaker on Lean and Six Sigma at conferences including NPSF, ASC and ASQ. Rick is a contributing editor on safety publications.
3 Comments until now
Hi Rick I just started reading your blogs and websites. Can you tell me a bit more what you mean by “We improve healthcare to make it more reliable”. I understood the definition you gave above but not jazzed by it if I were an employee and saw this. I’d love to understand deeper
Thanx in advance
Chuck Nemer
Hi Chuck,
Thank you so much for your time reading our exchange and question. You wish to understand more deeply my point about reliability comes from improving healthcare. Let me share an example that perhaps helps. There are two things any organization must do well to satisfy customers. In healthcare’s case, this means patients. The physician could state clearly what value it offers patients. In healthcare, this is anything from a cure to reduced pain or complications. Let’s say a patient with back pain requests relief from the pain. The additional expectation our clinicians give is a time frame or expectation how long an improved condition should last. Achieving reduced pain for a day is far less satisfactory to a patient if the clinician suggested the remedy will last for years. So, reliability is two dimensional. It is an improvement or value lasting a specified time. High reliability is achieving the reduced pain for the duration of expectation. In lean healthcare, we always start with the customer and what she/he values. Therefore, we get a good definition of what reliability means to the patient. Hope this helps the understanding. Please let me know how you use it, Chuck. We can learn from each other.
In general I think our healthcare is pretty good except for one annoying thing I have encountered in many a hospitals in Colombo, which is the time they take to prepare one’s bill. As a patient you wait anxiously till the doctor gives you the all clear to leave and then you have to wait about another one and a half hours to do so, which is very frustrating. I hope something can be done about this.
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