“Learn as much as you can from those who know more than you do, who do better than you do and who see more clearly than you do.” – Dwight Eisenhower
No organization has “arrived” as a learning organization, but some are definitely learning and improving more than others. It doesn’t happen by accident. Leadership must invest time, energy and resources if they want to reap the myriad benefits a learning organization has to offer. And most importantly, they must be avid learners themselves. In this regard, ego is the enemy.
There are simple ways to know you are building a learning organization. Here are real world questions to ask:
1. Do you know how much knowledge is required to run a healthcare system?
Knowledge is like the Pacific Ocean and the brightest among us has absorbed what would be found in a small pond or a large puddle. We should all be humbled by our ignorance—what we don’t know yet. Do your leaders realize they can’t possibly know all that is needed to run a hospital? Do they feel safe to admit it? Do they know how vital it is to have everyone learning and sharing knowledge?
2. Are you aligned?
Is everyone constantly learning about how to improve the 20% of the organization’s systems, processes and issues that will drive 80% of the improvement as laid out in the strategic plan? Was this plan built by learning from customers and using data, or is it just guess work?
Is the organization aligned or scattered? How do you know? Are you working on too many projects? Can you stay focused or do you suffer from an “organizational attention deficit disorder” (OADD).
Does every department or service line know what they need to learn to do their part to achieve the overall strategic goals of the organization? Do providers and staff know? Can they articulate the most important metrics and processes to work on? If asked, could they share what they have learned about making these processes better?
3. Are you listening to your customers…really listening?
Does every department or service line know who their customers are and can they list the processes they are responsible for managing and improving?
How often do you talk to your customers? What are they saying? Are you listening to their suggestions? Are they more pleased than they were last week, last month or last year? How do you know? Do you have data to prove they are more pleased?
Can you articulate what your customers need from you—not what services or product you offer, but what need those services or products meet? Can you describe innovations or improvements that you have put in place recently to meet these needs better?
Do you know how your customers, internal or external, judge the goodness of your products and services? (e.g., makes my life easier, reasonable cost, solved a problem for me, were friendly, did no harm, listened to me, turn-around time, accuracy, respected my privacy, your responsiveness, your attitude) Have you turned these product/service characteristics into metrics?
4. Do you know more than you did last week?
Do you know more today than you did yesterday, last week, last month, last year about pleasing your customers (internal or external) and running your business efficiently? Can you articulate what you have learned?
Are you testing new ideas to make things better using A3 or PDSA? Have you trained all workers to be capable of doing this?
When you do well on important metrics are you able to say why?
Do you have an army of excited problem solvers working to learn and improve every day? If someone outside the organization asked providers and support staff what they learned and improved in the last couple of weeks, what would they say?
Make A3 your Best Practice
5. Are leaders learning from people who do the work?
Do leaders go frequently to the gemba and listen to those who actually do the work? How frequently do leaders go—daily, weekly, monthly, yearly? What are the people who are doing the work saying?
Are workers afraid to speak up in the presence of leadership? Do they feel safe to disagree? How do you know? People only say what is safe to say. If you are not hearing from anyone, that may point toward a problem with your leadership style.
Gemba Walk or Robotic Rounding?
6. Do you use and share data freely?
Are you transparent with your data? Does every department know how well everyone else is doing so the best performers can teach others specifically what they are doing to perform better? Wouldn’t we want everyone to know so they can get better? Why would we be afraid to do this?
Do you know the difference between lagging (outcome) indicators and leading (process) indicators? Do staff know what the targets are and how they are doing on a daily basis? Can they point to daily metrics that show they are getting better on important leading indicators? Can you answer the question, “Did you have a good day and have data to support your answer?” Staff enjoy seeing how they are improving on a daily basis.
7. Do you ask for feedback?
Do you welcome constructive feedback? Do you ask for it? Do you know what a gift it is? Can you share improvements you have made due to feedback you have received recently?
Do you realize that everyone in your organization is a teacher and a student regardless of rank? Rank never ensures wisdom.
Do leaders feel free to say, “I don’t know”? This freedom is the beginning of learning.
Do you have a plan to provide leaders, providers and staff the tools and concepts to help them learn and improve better?
8. Do you know what learning is required to hold the gains?
Do you know how to sustain improvement once you achieve it? Can you articulate how ongoing learning is critical to sustaining improvement? Can you provide examples? Can you see entropy at work and are you learning how to fight it with ongoing extermination and determination?
There are many more, similar questions. By keeping them simple and out of the realm of the abstract, it will be easier to see how much progress you are making toward building a learning organization.
Today’s blog was written by Terry Howell, Ed.D., senior principal with HPP.
Terry has 30 years of healthcare leadership experience with a focus on performance improvement, patient experience, quality improvement, and strategic planning. Previously, he served as chief quality officer at a large academic medical center in Minneapolis where he was responsible for oversight and coordination of performance improvement, patient experience, clinical risk, safety, accreditation and organization-wide planning.
Terry received a Doctorate of Education degree in Counseling Psychology from the University of Tennessee followed by post-doctoral work in Organizational Development. He served on the faculty of the Institute of Healthcare Improvement, the Healthcare Quality Improvement National Demonstration Project and has taught graduate courses in Tulane University’s International Medical Management program.