We recently sat down with Ronnie Daughtry, Associate Principal at Healthcare Performance Partners, to ask some common questions about management systems in healthcare.


Dan Littlefield introduced the concept of lean management systems in his blog, “Creating a Problem-Solving Army.” Ronnie, in your experience, what kind of results have you seen once management systems are implemented?

RD: Oh, it’s tremendous. You usually see reductions in length of stay, reductions in waiting times, and when management systems are applied in the appropriate context, you can see better use of scheduling, for example, in surgery centers’ outpatient centers where scheduling is key.

Management systems apply in all areas. We use the value diamond to talk about all aspects of value: Quality, Satisfaction, Time and Financials.  For example, Revenue cycle is vitally important to an organization’s financial health. Management systems applied there are tremendous in driving down days, where collecting fees is a premium. Also, if you apply it at the point-of-use, usually in an emergency room where copays are collected, you can drive copay collection up extensively from where you’re at in your current state.

So, in the big picture, what is typically the first step?

RD: The important thing, I think most of all, is to do some strategic alignment. It’s important to know where the organization’s actually headed from a strategic perspective. It’s important to align initiatives with the correct gauges that measure the process, both leading and lagging.

Figure out what strategic priorities actually mean to me in my organization, where I’m actually working. And then secondly, how do I measure that? How do I measure my effectiveness, in my department, with regard to the strategic initiatives?

So if I’m working in the emergency room, how does door-to-doc really relate to a strategic imperative of the organization? This is how I’m contributing, this is how I’m monitoring this on a daily basis, these are the things that we’re working on right now in my department that are, in turn, linked to the overall strategic priority.

And what are some common roadblocks that organizations might face later on in the process?

RD: Leadership. Without question, leadership. We often emphasize the importance of standards around patient care processes, but what about the standard work for leaders? If management systems are about anything, it’s really about hard-wiring a system so that leaders can actually change the behavior to drive and sustain improvement. You can measure things all day long, but until you actually get leadership in an interlocking accountability mode, where processes and systems are checked against standard work on a daily, weekly, monthly basis, it’s very hard to make management systems work the way they should.

When speaking of leadership in this context, we often talk about coaching as well. Why is coaching important?

RD: Implementing management systems by yourself is a little bit like doing an all-in diet by yourself. No support AP’s, no accountability partner, no trainer, no life coach. Odds of success are much lower, and if we indeed lose weight, which we would say is an important improvement, we most likely would gain it all back and then some. It requires a coach. It requires a life change. Successful management systems are like that.

We are asking leaders to practice different behaviors. To do that, they need new skills. Coaching skills, such as understanding how to coach with questions instead of telling, and data skills, such as using Pareto charts and run charts to drive and measure improvement. Training is not a one-and-done event. Leaders also need someone to coach the use of these skills.


Has your organization implemented a management system? Comment below with your insights, ideas, or questions.

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Ronnie Daughtry, Associate Principal at HPPThis blog is an interview with Ronnie Daughtry, Associate Principal at Healthcare Performance Partners.

Ronnie has spent 20 plus years in various industries around the globe developing and improving processes and coaching leaders around the Lean and Six Sigma methodology. With Ronnie’s diverse and well-rounded background he brings a unique perspective to the healthcare industry where he has consulted with some of the nation’s leading healthcare systems and hospitals in all disciplines of the value chain from the procurement of supplies and spend through the discharge and follow up with the patient for readmission prevention.

Ronnie holds a Master’s degree in Management and Organizational Development with a concentration on Total Quality Management, a Bachelor’s degree in Management and Human Relations from Trevecca Nazarene University in Nashville, Tennessee, and an Associate of Science Degree in Communications from Volunteer State Community College in Gallatin, Tennessee.

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