LeanHealthcare_OrganizationalChangeAfter a trying session with a client leadership team, I returned to Peter Senge’s The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning Organization.  I felt stuck.  This team had been going about “Lean” for a few years but was frustrated with the speed of change and adoption.  They wanted someone to come in and accelerate the change process for them — not an uncommon occurrence when organizations are going through transformational change.

The executives were doing the right things to prepare themselves.  They were well read on Lean and had taken it upon themselves to visit other Lean organizations in addition to committing internal expert resources for Lean.  During that first session, they had openly expressed that they were not as clear on how “the Lean puzzle fit together” as probably they should be, yet there was an undertone of “it’s someone else’s job”—be it outside consultants, internal staff, a let’s just do it mentality, and so on.

Seeking a new perspective, I re-read Senge’s opening section on Learning Organizations and the first two disciplines Personal Mastery [“learning to expand our personal capacity to create the results we most desire…” p. 6] and Mental Models [“reflecting upon, continually clarifying and improving our internal pictures of the world and seeing how they shape our actions and decisions” p. 6].  A blog is not the place for a lengthy explanation of these two disciplines let alone the other three which are necessary to create a learning organization.

My reflective process helped me get unstuck.  I realized the need and importance of slowing down to see the actual personal changes required for transformation. For such a change to unfold, there is the need for the change within the change — meaning individual change must occur prior to organizational change.  The personal change comes about through the challenging of existing mental models and the practice of behaving one’s way into a new way of thinking.

The second workshop with this leadership team was expressly designed to surface individual mental models through a reflective process utilizing my organization’s Lean Leader Self-Assessment.  Each leader assessed his or her adoption of “lean” behaviors and then again assessed peers.  This afforded them the opportunity to share and reflect on their existing behaviors and mental models, offering a way for them to compare their leader behaviors to the Lean ideal.  By then developing their personal Leadership Standard Work, they were able to re-define an aspect of their leadership behavior as well as an internal accountability commitment.  The standards should become more visible and interlocking over time with practice, but for right now they will serve as a small step forward.

The CEO of this team shared with me shortly after the workshop that he thought he was beginning to get it.  He shared how throughout his career, he and his co-workers had been through every iteration of quality, from quality circles to present-day Lean.  He had read the books, attended the seminars and talked with peers.  However, something was beginning to shift for him.  He began to realize that he had a role to play — one that was about more than delegating to underlings.  He admitted that he was unsure exactly how to do this but was committed to trying while asking for support for he and his team. He was honest, acknowledged past failures, expressed urgency, accepted he too needed to change and needed support to accomplish the personal and organizational change.

This CEO was realizing that the Lean transformation success was dependent on his ability to change his way of leading.  He acknowledged that he had to be involved and involved in ways heretofore he had not been.  His mental model of leadership is beginning to shift.  He also accepted that he was unsure exactly on how to do it and asked for help in his learning journey.  And this is a keystone to Personal Mastery.


KirkwoodBillRSToday’s blog was written by Bill Kirkwood, Ph.D., director at HPP.

Bill has 30 years of healthcare leadership experience in both system and individual hospital settings across the United States.  His experience includes change management activities, Lean transformation engagements and 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.

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