In a first-time 2008 study completed by the American Society for Quality (ASQ), 77 U.S. hospitals responded to questions on their level of lean or six sigma deployment[1].  While 2011 now leaves the study three years dated, looking back these respondents provided validated insight into what would become common deployment struggles for other hospitals across the country.
 
Of those who responded, 53 percent reported a level of lean deployment, and 42 percent reported a use of Six Sigma.  Those who reported ‘full deployment’ ranged from four percent for Lean and eight percent for Six Sigma.  While those numbers aren’t terribly impressive, what were truly important were the measures of roadblocks and struggles. The survey responses identified need for resources, lack of information, and leadership buy-in as the major factors for the lack of ‘full deployment,’ or if there was no deployment at all.
 
In the 2005 Institute of Healthcare Improvement’s (IHI) article edited by Diana Miller, “Going Lean in Healthcare,” with contributors including James Womack, Gary Kaplan of Virginia Mason, John Toussaint of ThedaCare, and others, identified leadership as a key driver in a successful “full deployment” of Lean Healthcare.  Looking at the ASQ survey’s three major reasons for the lack of deployment, all are in the leadership arena.
 
Paraphrasing on our friend Kierkegaard, a ‘leap of faith’ is accepting the unproven and acting upon it.  I remember back in 2005 sitting across John Toussaint’s desk, then President and CEO of ThedaCare, when he expressed his commitment to Lean Healthcare.  John shared that he was betting ThedaCare’s future and his reputation on this methodology.
 
The deployment became the priority.  There were no more competing initiatives, resources became available, and there was no question regarding his ‘buy-in.’ While there certainly was success in the early years, the following years have been unparalleled.  Some would say the results delivered are the model which healthcare should follow.
 
Even in 2008 there was no hard evidence that warranted this ‘leap of faith’ towards Lean Healthcare. Is a ‘leap of faith’ required by leadership to obtain improvement?  Absolutely not!  This was evident in the ASQ’s survey and IHI’s article identified above. Deployment can occur with a varying range of success and scope.  However, if leadership is looking to expand success from the ED, on the unit, in the OR, and across the entire healthcare institution, then, a ‘leap of faith’ is required.
 
 

This week’s blog was written by Joe crist, Senior Associate with HPP. For the past 17 years, Joe’s work has focused on operational improvements through lean transformations across North America and Europe.  Prior to joining HPP, he worked across a variety of industries in multiple leadership roles from the front line to the executive leadership team. Joe completed his undergraduate degree at University of New York where he received a B.S. in Engineering and Philosophy.  Additionally, Joe earned his Masters in Human Resources and Training and Development focused on Business Improvements and Balance Sheets from Webster University.
 
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