Like most members of healthcare organizations, executives and managers are very busy and have no extra time to take on additional responsibilities and execute them well.  So, in order to support a Lean transformation, their work must be redesigned – not added to.  To address this, consider conducting a rapid improvement activity focused on senior leadership or management and their work.

What is value for a meeting?

  • Are decisions being made?
  • Are problems being solved?
  • Do the topics on the agenda require discussion, dialogue, and clarification to reach consensus? Or is the time spent on status type information that may, in fact, be communicated as effectively with an email.

Eliminating non-value added time in the leader and management roles can play a critical role in helping leadership find the time to support their organization’s Lean efforts.

What is the connection between senior leadership and front-line staff?  Middle management.

Senior leaders’ roles must evolve to focus, not only on the process improvements, but also on developing the people at all levels of the organization.  Middle management, being the critical link from leadership to front line staff, should be a key focus activity to support your continued success.

If we want the front-line staff to perform job tasks to specific, agreed-upon, best practice standards (standard work), surface problems and begin solving them immediately, then their managers will need to be knowledgeable of the standards, observe the work on a regular basis and coach the staff.

What are the skills needed to do this?

  • Process observation and all basic Lean process tools (value stream mapping, workplace organization, A3 problem solving)
  • Measurement and managing with data (leading and lagging indicators, run charts, Pareto charts, visual management boards)
  • Coaching skills (listening to understand, understanding social styles, coaching with questions)

In We Wait Too Long to Train Our Leaders, Jack Zenger noted that managers first get leadership training about 10 years after they begin supervising people.  If the mid-level management is not developed, Zenger states, “Practicing without training ingrains bad habits.”

We need to provide training for mid-level management including observation, measurement, and coaching skills for process improvement implementation before, during, and after rapid improvement activities. This is necessary to enable area leaders to sustain improvements and lead their staff who are newly empowered with Lean tools.  Senior leaders should observe and coach the creation of standard work for mid-level management to be able to perform these functions effectively.


Ken Lowe, Director for Lean Healthcare and Process Improvement at HPPThis week’s blog was written by Ken Lowe, senior consulting director at HPP. 

Ken leads hospitals, clinics, and healthcare related organizations through Lean transformation and specialized consulting.  He has worked with prominent academic medical centers and community hospitals across the United States.  With nearly 40 years experience, he has a proven background to be a change agent, utilizing business metrics to analyze and develop lean strategies that address the voice of the customer.

Ken holds a bachelor’s degree in Finance from Bethel College.

Image by Freepik

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