What is Our “True North” in Healthcare?

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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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One thought on “What is Our “True North” in Healthcare?”

  1. Hoshin Kanri is a method. I would have answered that the “true north” is things like patient safety and quality, reducing waiting times, and stronger financial performance over the long term.

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