In 22 years of helping healthcare organizations with major business transformation and clinical improvement initiatives, I have learned that in most instances organizations rely on the front-line managers to implement and sustain changes. Ultimately, it is this group that holds the line on cost, productivity, service and quality levels. I also know from experience that, more often than not, there is a need for fundamental improvement in front-line management skills and tools to support desired change.
Even the most elaborately designed strategies and effectively redesigned processes cannot be implemented and sustained when those responsible have inadequate skills to support the change. The delivery of Lean Healthcare depends on people, process, and technology coming together. No matter how sophisticated the processes and technological investments, quality healthcare will always require people effectively managing other people.
Many front-line managers and supervisors are successful nurses, clinicians, or technicians who have not had the benefit of experiencing effective management. This leads to a results-oriented management approach. In this type of system, many front-line managers I encounter tend to focus on tasks and position themselves in a “fire-fighting” mode. They are typically less effective in the discipline of planning, forecasting, coordinating, leading and following-up on expectations. Often they lack important tools and information with which to manage effectively. Although difficult to quantify, there is a tremendous cost associated with the gap between current management practices at the front-line and ideal Lean management practices. These costs are evident not only in lost productivity and decreased quality, but may be expressed also in terms of low employee morale, patient dissatisfaction and lost business. Lean Healthcare organizations that are able to close this gap by enhancing the information and management tools utilized by their front-line managers will have a long-term competitive advantage in the marketplace.
Cognizant of client needs in the coming years of healthcare reform, we can map and analyze processes, collect data, generate practical improvement ideas tied to root causes, design and implement the perfect process with great rigor, and yet still fail to move target metrics and enhance process outcomes. What gets left out of most analytical approaches is a systematic method to manage. Ignoring management controls and skills means implementing perfectly logical improvement that people cannot or will not use. It happens all the time.
Getting Over The Hurdle
A good manager is one who knows how to manage both people and processes effectively. Organizations today are realizing that in the face of better technology development each day, nothing can substitute the human touch. A lot of thinking goes into designing more efficient processes which can help minimise waste and low productivity. Different tools like Kaizen, Lean principles, Six Sigma and Process Improvement have been used with outstanding results in many Lean Healthcare organizations. However, all these tools clearly outline the need to involve each and every employee up and down the ladder for a transformation to become successful. Empowering managers with the authority to make decisions, effect changes and giving them an understanding of various tools is the key to improvement.
I have found that implementing improvement at the mid- and front-line management level requires real-time floor coaching. The issue of crafting front-line and mid-level management discipline has typically fallen to training and development programs. Such programs, however, do not usually impact behavior directly or translate into bottom-line results. The daily pressure of continually “fire-fighting” at the front-lines gets in the way of managers applying their insights and making real, measurable progress. Therefore, in order to address the opportunities it is not sufficient to simply train managers in certain disciplines or skill sets. Focused management development should take the development process out of the “classroom” and onto the “work floor.” In this respect a mentoring relationship is created, where learning managers learn within their department and give the organization the best chance for real sustainable change.
Today’s blog was written by Jack Datz, Executive Director at HPP.
Jack has a 20-year successful track record in healthcare consulting, industry management and leadership experience. He has successfully implemented many programs that focus on process efficiency, management development, and patient satisfaction in clinical and non-clinical settings. He is recognized nationally as a change leader with extensive background in turning healthcare organizations into best-in-class operations, cost and quality. He has extensive experience in the implementation of process transformation, Lean and Continuous Improvement.
Jack received his B.A. from University of Northern Colorado. Additionally, he is trained in GE leadership and is certified from GE as a Six Sigma black belt.