Lean Healthcare Leadership Standard WorkHow many years have we been hearing and reading about the decline in employee engagement?  If the research and surveys are to be believed, close to half of employees are unengaged in both their work and their employer.  There are countless solutions out there, yet the employee engagement numbers are holding steady. What can we do to get our employees on board?

Leadership standard work (LSW) can be a powerful response. It is a cornerstone to a Lean management system.  LSW specifies a leader’s daily, weekly and monthly practices that bring a disciplined focus to process, improvement opportunities and measurable outcomes of processes. This standard work is not ad hoc but rather documented with defined frequency of practice or, should I say engagement.  Importantly, these practices, which include a formal review of active performance improvement efforts and current performance against agreed to targets, takes place at the workplace—at the gemba.  Why at the gemba and not the traditional conference table preferred by many leaders?  Because that is where the work takes place by those unengaged employees.

A core element of LSW is coaching and teaching.  It is within the coaching process that leaders change the organizational conversation by engaging employees in the process of continual improvement. Think of what is being communicated when a leader shows-up in the workplace to conduct a review and coaching session.  In many cases this conveys the message “we are no longer in Kansas,” the past approach to work is no longer sufficient to assure success and conveys you and I are in this together.”  It affords a larger number of employees the ability to actively participate in a new way of talking with the leader about the problems they are confronted with and to share their ideas for continual improvement.  When done well, coaching in the gemba:

  • Provides employees an opportunity to contribute their ideas for improvement
  • Clarifies what is expected of them
  • Takes on real-time development opportunities with employees engaging in small tests of change
  • Provides recognition for work well done
  • Demonstrates a sense of genuine caring from the leader.

How many approaches to rounding have you initiated in your organization?  LSW provides a very important ingredient to overcoming leader reluctance to rounding.  Speaking from personal experience, rounding was intimidating because I thought I had to be all knowing and going to the workplace could expose my ignorance.  Many leaders having earned their stripes by being  perceived experts and giving orders from a distance. It worked, or so they and I thought. Going to the gemba violates that comfort zone.

LSW, with its coaching approach, allows leaders to mentor and teach using the Socratic method. It removes the responsibility of being all-knowing.  Coaching shifts from one way “communication” to active inquiry and teaching.  The many leaders I have worked with over the years find this a positive challenge and not an onerous task, once they know there is someone to coach and guide them.  It is our role as Lean coaches and advocates to coach and mentor leaders; to make it acceptable not to know everything; and to coach and teach them on understanding the PDSA cycle, quality and Lean tools.  The return for these efforts are engaged leaders and employees.


Today’s post was written by Bill Kirkwood, Ph.D., Director at HPP.

Bill has 30 years healthcare leadership experience in both system and individual hospital settings in the Mid-West and North-East, and oversight of change management activities and Lean Transformation engagements.  This experience includes serving in an executive capacity in Quality, Operations and Human Resources. 

He holds a Masters in Health Administration from Xavier University and a Doctorate of Philosophy in Organizational Behavior from the Union Institute and University.  

Share This
Like what you see? Receive our blog posts by email!

Like what you see? Receive our blog posts by email!

Sent right to your inbox on Tuesdays!

You have successfully subscribed! Look for our email on Tuesday!