Steve, a Lean healthcare facilitator in a hospital I recently worked in, always starts his training the same way.  Everything has to be organized and laid out just the way he wants it—neat and in order.  It became very clear to those who participated in any of Steve’s training and coaching sessions that they were in for a treat.  His impeccable organization skills and his high energy, along with his charming and witty personality, added an extra element to learning and made the engagement more interesting.  I always looked forward to seeing what trivia, trick, theme or curve ball Steve had added to the training to get the participants thinking and seeing the big picture.  When listening to Steve from the back of a room, I couldn’t stop smiling at Steve’s development into someone who is one of the new leaders and champions for improving patient care in his organization.

It was 18 months ago when I first met Steve.  At first he was very soft spoken, shy at times, and very critical of himself.  It was evident that he was a perfectionist and you could see that his biggest fear was to fail or look like he didn’t know what he was doing or talking about in front of his peers.  The question that Steve often asked me was, “Alex, when do you think I will be ready?”  I would always respond, “Sometimes your best teacher is just going at it on your own. You have a lot of the right knowledge and mechanisms, not to mention your heart is in the right place.”

“Am I ready?”  It’s a question that most facilitators have asked themselves at one point or another.  I know I did, and I’m still learning and discovering new methods that help me develop my own Lean healthcare facilitation skills.

I often see organizations get caught up in relying on “the expert” and no less.  Experts are needed on some occasions to drive key operational functions of the organization.  A Lean facilitator must have experience, however, I believe that one can enhance skills and make improvements with guidelines from a coach.  At one time or another, most facilitators, coaches, and teachers started with a coach of their own, someone guiding them (For more on coaching, read The Blind Spot).

Many traits and skills must come together to create an effective Lean facilitator.  Danny Beckett, Jr., entrepreneur and start up blogger, outlines a list of successful facilitator traits in his article 6 Tips for Being a Good Facilitator:


    1. Stimulating discussion
    2. Generating ideas
    3. Fostering curiosity and excitement
    4. Simulating dialogue
    5. Separating neutrality from passivity
    6. Producing outcomes
    7. Listening, listening, listening

I agree with Beckett’s list and would like to add a few applications specific to facilitating a Lean healthcare rapid improvement project:

Keep the team focused on the scope:  Don’t get caught up in someone’s issues or agenda.  The focus should be and only be about improving patient care and the patient experience (Remember the lesson of “Defective” Facilitation.)

Don’t talk too much: This is hard for me sometimes. Talking too much sometimes seems like you’re pushing your solution to the team.  The goal for you, the facilitator, is to coach the team towards finding their own solutions and process improvements—not to mimic yours.

Learn the tools and material:  You don’t have to be an expert on every tool and topic, however, be knowledgeable and share your own experience with the team.  I often see this one overlooked.   I’ve heard, “Alex, if I see it once or twice then I can do it.”  Really?!  What about, “I have done it 10-15 times and I’m still learning.”  I can still hear my college coach saying, “Learn something new today, study it after practice, implement it on Saturday, and review and celebrate on Sunday.”  Again, you don’t have to be an expert.  Never stop testing new possibilities and ideas.

Stop sand bagging:  I’m not saying you have to be hard on yourself or the team.  However, we tend to often leave opportunities and better outcomes on the table.  Caving in to your environment can lead to okay results and not great results.  Coach and provoke positive thinking so the team and organization can test new possibilities and create high standards.  Don’t get stuck on good enough or benchmarks, it will only result in being as good as everyone else and not setting yourself apart.

Three months ago I said my goodbyes to Steve, not for good, but for now.  I sat in on a rapid improvement team’s  report out and saw someone bursting with confidence.  Little rattled Steve, no matter what the questions or challenges the audience asked him or the team, had a plan or answer for each one.  He was also confident to say “we don’t know” if something was asked that was not covered during the week.  It was very clear to everyone that the process was 100 percent better now that it was on day one.

Steve didn’t know everything about Lean or if he was going to be a great facilitator and he definitely made a lot of mistakes along the way.  What you could see in Steve is that he has moved from one level of performance to a level where the organization depended on his knowledge.  My last question to Steve was, “So, Steve, when did you know that you were ready?”  He looked at me with a corny smile.  “I’m not sure Alex!  That’s not my focus now. I’ll just keep doing and learning.”

In Lean healthcare you don’t have to become the smartest person in the organization, gain multiple graduate degrees, or become an expert with every tool and process.  Start learning something new today, practice it, implement it, and then observe the patients benefiting from it.  Oh, and don’t forget to celebrate!  So when are you going to be ready?

As a follow up to this post, John DeVries’ article, How to Eliminate Predictable Post-Event Disagreements will post on the on Tuesday to continue this series on effective Lean event facilitation.

Today’s blog was written by Alex Maldonado, a Senior Manager with HPP.

Alex’s professional experience includes process improvement, operational, and leadership positions in the medical delivery systems and appliance manufacturing industries with Baxter Healthcare and Whirlpool.  Alex has had a successful track record in improving results-driven processes with an emphasis in personnel training, project leadership, and operating systems designed to improve customer service and sustainability.  He has led the development and implementation of processes to support Lean initiatives that reduce critical path lead-time, reduce expediting costs, capital improvement projects, inventory reduction, and trained and educated staff/employees in Lean Methodology.

Alex has a B.S. in Industrial Technology Engineering from Mississippi State University and has also completed the Six-Sigma black belt program.

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