I am often asked by healthcare organizations beginning their Lean Healthcare journey, “What is the role of the executive steering committee during the transformation?”

In Lean Healthcare, true transformation involves the development of competencies that may not exist or may lie dormant within the enterprise.  Over time, these will become the way we work.  Therefore, the primary responsibility of the executive steering committee during a Lean Healthcare transformation is to provide oversight and direction until this becomes the way the enterprise works.

The key responsibilities involved in guiding the Lean Healthcare transformation efforts include:

  1. Define a vision and transformational roadmap for the organization.  This helps employees at all levels of the organization understand where the organization is going, why it is important, what success will look like, and what they need to do, individually and collectively, for the enterprise to get there.
  2. Support the vision/roadmap with a set of established milestones and goals.  This means developing and implementing a measurement system that supports appropriate levels of review.  Monitoring and measuring progress against these milestones and goals and, more importantly, making appropriate course corrections where necessary.
  3. Define which value streams will be worked in and prioritize major improvement activity based upon relevance to strategic initiatives, customer impact, and ROI.  Improvement activity not linked to strategic breakthrough finds its way to the back burner fast.  Moreover, improvement requires investment of resource.  Nothing sustains investment like a solid ROI and thrilled customers, both external and internal.
  4. Evaluate the effectiveness of Kaizen activity continuously.  Where it is ineffective, we need to understand why and adjust accordingly.  Where it is effective, we need to define mechanisms to redeploy resources or realize the value delivered by improvement events.
  5. Drive the alignment of systems and structures to support the transformation.  Often, as we aspire and begin to develop something new, we continue to reward old behaviors and fail to recognize the new behaviors we are seeking.  When we get the behavior change, we transform the enterprise.  The specific elements involved include:
    • Organization Design – Lean organizations are typically flatter, more horizontal, and less vertically siloed.
    • Recruitment & Staffing – Lean leadership attributes should be included in job descriptions and postings.
    • Training & Development – All employees should be trained in A3 and PDSA.  These should be included in new employee orientation.  No promotion into operational leadership roles without demonstrated experience in implementing and using lean management systems.  No promotion into executive roles without demonstrated fluency with Hoshin and change management.
    • Performance Management – Lean transformational goals should be in everyone’s goals and objectives.  The performance management system includes not only results, but also the means by which results are achieved.  This plays out at both an individual and organizational level.  Service lines and departments have scorecards or dashboards that link into next-level efforts and are therefore predictive of next-level results.
    • Reward & Recognition – This is most critical in the early stages of transformation and includes recognition of transformational efforts with incentive compensation tied to implementation and breakthrough results.
    • Resource Allocation – If you want improvement, you must staff for it.  This can get expensive unless you have a systematized method for recognizing where waste was eliminated and freeing up resources to engage in further improvement.
    • IT Integration & Leverage – Unless they support what we are doing, our IT systems are useless.  Often the data necessary to populate a simple dashboard, must be extracted from multiple and disparate systems.
    • Communication – At a macro-level, we need to make sure we are transparent and communicate how the enterprise is doing with the transformation.  This needs to flow down in like kind, or rather, be emulated from the largest service-line to the smallest department.  At a micro-level, we need to make sure the hand-off between teams or departments are direct and in compliance with rules-in-use within all of our key processes.

This covers the primary roles and responsibilities of the executive steering committee in a Lean Healthcare transformation.  Over time, as we do transform, the items listed above are just the way we work and there is no longer a need for a steering committee.


This week’s blog was written by Brad Schultz, a Vice President with HPP.

Brad serves as a Lean Healthcare facilitator, business consultant, and executive coach internationally with HPP.  Brad began his career in manufacturing with GE Healthcare and joined GE’s Performance Solutions during its infancy and remained with the business unit for seven years. He provided significant leadership to adapt the firm’s products to the unique needs of healthcare clients and to translate the firm’s published materials into the language of healthcare.

Brad’s educational background includes a B.S. in Business Administration from Cardinal Stritch University in Milwaukee, Post Graduate Certification in Quality Engineering from Milwaukee School of Engineering, a M.A. in Business Administration from Marquette University in Milwaukee, Six Sigma Master Black Belt Certification from General Electric, and Front-Line Leadership Development Certification from Achieve Global.

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