I recently worked with a local hospital. A vice president had received several calls that it was taking the cancer center too long to answer their phones.   The VP called the department leader to implement a phone tree to solve this issue. The director implemented a phone tree and the wait time for the patient became greater than prior to implementing the new system.

The further away or higher up you are in the organization from where the actual work is being done the less likely you are to truly understand the problems and are even less likely to be able to solve them.

An appropriate question when the VP called the department lead could have been, “Why is the phone tree necessary?” or “How do you know it’s a problem?”

As it turned out, the root cause was that no one was assigned to answer the phone on Friday when the assistant was out.

The success of a large-scale Lean Healthcare transformation depends on more than strategic and tactical plans. Plans, which are the traditional focus of senior executives, do not capture value. Value is realized only through the sustained, collective actions of thousands of employees who are responsible for designing, executing and living the change.  Many companies plan and execute sweeping change, but fail to realize that companies will reap rewards only when change occurs at the level of the individual employee.

No single methodology fits every company, but a set of practices, tools, and techniques can be adapted to a variety of situations.  One tool that can be used to engage the entire organization in the transformation is A3.

A3’s are used by all levels of a Lean Healthcare organization but are targeted for the front line to assist in creating an army of problem solvers.  It provides team members with the value of capturing data and taking observations of current state to better understand root cause.  It builds teamwork by visualizing the process and understanding customer-supplier relationships.  It also provides a sense of pride and ownership by the staff, “I can make my process better,” “I don’t need to rely on my supervisor to fix it for me,”  “I had no idea that my process caused that issue.”  It clarifies a method of creating and implementing change by testing possible solutions, measuring the change and follow-up to insure changes are sustained.

In Lean Healthcare organizations, leaders modify their behavior from telling staff to implement an idea to asking the staff to help solve the problem using the A3 process.  Leaders should provide direction on where the staff should focus their improvement effort based on the departments strategic and tactical plans. Leaders then become coaches to support the staff and stay engaged with the problem solving process.

And, the staff begins to ask why.

Linda_duvallToday’s blog was written by Linda Duvall, consulting director with HPP.

Linda leads Lean Healthcare transformation engagements for HPP. She has nearly 30 years of experience in business leadership, program management and lean transformation.  Prior to joining HPP, she worked for Vanguard Health Systems as a process improvement specialist providing leadership and support for regional and hospital level process improvement teams.  Linda holds a Bachelor’s degree in Industrial Engineering from the University of Evansville.

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