As part of a lean healthcare transformation or any organizational change effort, effective leadership is an essential and well-known criteria for sustained success.  For the leader, the first step on this journey might be getting the “talk” down.  Leaders will speak about the importance of improvement, of wanting staff to make changes, and for staff to feel comfortable and supported when surfacing problems.

When things do not go as planned, a leadership issue is typically at least a corroborating factor.  A lean healthcare transformation also requires changes to a leader’s work; what might not always be clear to those leaders is that they must both “talk the talk” and “walk the talk.”  Otherwise, to staff, this change might feel like any other attempted change effort, creating a “Lucy and the football” situation.

Most of us are probably familiar with the Peanuts comic where Lucy holds the football for Charlie Brown to kick. Lucy has pulled the football out at the last second a number of times, and each time, Charlie Brown ends up on his back.  Not surprisingly, Charlie Brown is skeptical each time that the outcome will differ from all previous encounters.  However, Lucy always convinces him by saying the right things; she “talks the talk.” Unfortunately, the story always ends the same way; Charlie Brown gives it another try and he ends up flat on his back.

As leaders, we can probably convince staff to come along on a journey, at least for a bit, just with “talking the talk.”  In lean healthcare, a message of staff-driven change and an acknowledgement that the people doing the work are the subject matter experts is certainly a compelling one.  But the goodwill runs out quickly, and sustainment is unlikely, if your actions do not match your words.  To be successful you must “walk the talk” as well.

Staff -led change means that the potential solutions or countermeasures that a group proposes might not exactly match your preconceived ideas of the “solution.”  It is very easy in this situation to simply tell them that you were expecting something different.  But think how this might feel to that team—you start by telling them that you want to tap into their expertise, but follow that up with discounting their work.  You’ve put that football out, but moved it at the last second.  And unlike Charlie Brown, there is a finite number of times your staff is going to attempt a kick.

In this scenario, your role is to ask questions, make sure the team considered all the important information, and then ultimately to provide the support, coaching, and encouragement necessary.  If either your words or your actions show a lack of support for the process, you can quickly stop progress. It comes down trust, and it has to work both ways.

Similarly, most leaders would probably agree that getting to the place where the work is being done, reviewing metrics, and ensuring that action items are completed is important. However, if you do not make the time to match your actions to these words, then it is unlikely that your organization will get the desired results. The “talk” is necessary, but in itself, insufficient.

Instead, let’s re-frame Lucy: make sure anyone set to kick knows why it is important, has the proper training, equipment, and support to do it well, and huddle before and after a kick attempt to debrief. And hold that football steady.

Today’s blog was written by Jamie Wilson.

Jamie is a Senior Manager with HPP and has more than 10 years of healthcare experience, spanning management consulting, hospital administration, business development, and hospital operations performance improvement. She currently leads Lean Healthcare transformations and performs specialized consulting for HPP.  Jamie received her B.A. in Sociology with a dual concentration in Health and Medicine, Deviance and the Sociology of Law, graduating Summa Cum Laude from University of Pennsylvania. Additionally, Jamie received a M.S. in Healthcare Management and Policy from the Harvard University School of Public Health.

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