Lean Healthcare Leadership Gemba WalksImagine a class of graduate students in a Master’s of Health Administration Leadership Course. They are engaging in a discussion board assignment regarding leadership behaviors that build trust and respect.  In comes the avalanche of affirmations for the “open door” policy that became prevalent, at least for me as new administrator, in the early 80’s.  This upcoming cohort of healthcare leaders begins to advocate, even sing, the virtues of the open door. One after another shares experiences of leaders they had worked for or been mentored by who had open door policies and how valuable the practice was to how the leader built a transparent and trusting environment.

Certainly the intent of the open door policy is worthy.  Easy access to leaders for safe discussions regarding work matters has merit and was a step in breaking down organizational barriers and bureaucracies.

Yet, I question whether the open door approach is an effective approach to building trust and respect.  Years in organizations where leaders have touted their open door policy approach to only find the leader I sought was always in a meeting or “unavailable” has jaded me towards what the graduate students were enthusiastically advocating. With that observation, what is the answer? What is an alternative means of building trust and respect in all levels of the organization? It is Leadership Standard Work and going to the Gemba.

Lean Healthcare Open Door Policy Vs. Gemba Walks

What I have experienced in organizations with Leader Gemba walks are purposeful discussions about what matters to the managers and staff of the work area (transparency), leaders acknowledging good work in real time (respect) and leaders, managers and staff committing to taking specific action to remedy barriers and obstacles and actually doing just that (trust).

Please know that I was not reticent in sharing my perspective with these emerging healthcare leaders. I take every opportunity I have to expose capable aspiring individuals to proven leadership methods.


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 in the Midwest and Northeast. He has overseen change management activities and Lean transformation engagements.  His experience includes 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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