Visuals are such an important part of Lean Healthcare, and everyday life for that matter, that it is not surprising that most people focus on the Daily Management Board component of their Daily Management System. After all, it’s a visible part of the system, right?.  This notion can be a bit misleading and can cause employees to miss the true power of the system, akin to ignoring the submerged portion of an iceberg.  A true, disciplined Daily Management System should be the nucleus of a sustaining, engaging Lean transformation process. It’s not about the boards!

Here’s a high-level framework. In addition to the “tip of the iceberg,” is your Daily Management System composed of these pieces?

Daily – It is absolutely crucial that everyone in the organization meet daily for 15 to 30 minutes to discuss how they did against yesterday’s goals, what they need to accomplish today to satisfy customer demand, and what problems they need to solve to meet their goals.  While work and outcomes occur in minutes and hours (and sometimes seconds), we in healthcare are conditioned to look at monthly and quarterly metrics.  By then, it is too late to adjust processes to positively impact those metrics.  Both outcome and process metrics must be reviewed and acted upon by management daily.

Management – Managers organize and lead teams to achieve the organization’s goals in support of its mission.  A brief huddle at the beginning of each day with the manager’s team sets the tone for the day by keeping everyone focused on the team’s objectives and giving them frequent feedback on their performance.  The longer it takes to provide feedback, the less valuable it is.

System – A system is an organized set of processes which delivers value to customers.  It is interesting that the customers of the Daily Management System are the managers and team members.  The ultimate beneficiaries, however, are the patients.  The processes in a Daily Management System include updating the boards each day before the meeting, the meeting itself, and completing the action items that come out of each meeting.

The Daily Management Boards are a powerful visual tool to make the Daily Management System efficient.  The boards are not the system.  They allow each team and individual to see how they are doing at a glance, which allows them more time to use their teamwork and problem-solving skills.  I believe that healthy Daily Management Systems are the single most important ingredient to sustaining a Lean culture in your healthcare organization. 

Has your hospital implemented a Daily Management System?  Share with other readers in the comment section below:  What has made it effective (or ineffective)?

Today’s Blog was written by Dwayne Keller, Executive Vice President of Operations at Medical Reimbursements of America (MRA). 

Dwayne is leading the implementation of Lean in MRA’s revenue cycle operations. Prior to MRA, as COO of Healthcare Performance Partners (HPP), he coached hospital executives and all levels of leadership in the implementation of Lean Healthcare, resulting in significantly improved outcomes.  Dwayne served as a general manager over two manufacturing plants at Alcoa and was also responsible for driving business results through Lean implementation in five Alcoa business units as an executive Lean coach. 

Dwayne holds Master’s and Bachelor’s degrees in Mechanical Engineering from Bucknell University and a MBA from Clemson University.


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