LeanHealthcare_VisualManagementVisual management is one of the core elements of a Lean Management System (LMS), and is frequently employed in organizations committed to improving the delivery of value to customers.  Some commonly used examples of visual management in healthcare include bed boards, patient tracking systems, surgery flow boards, strategy deployment boards, and daily huddle boards.  Regardless of its specific form, visual management helps organizations do several things:

  • Communicate about things that matter
  • Have everyone pulling in the same direction
  • Create transparency and increase trust
  • Create common information for shared decision making
  • Share and spread improvements

The underlying reason visual management is so beneficial is the feedback loop it creates for staff.   Motivation has typically been described in the organizational behavior literature as a set of psychological processes that cause:

  1. Initiation of behaviors
  2. Direction of behaviors
  3. Intensity of behaviors
  4. Persistence of behaviors

As posited by Norbert Weiner in 1948 as part of his cybernetic hypothesis (a forerunner of today’s motivational control theories), the feedback loop is the fundamental building block of action.  In its simplest form, a feedback loop consists of four elements:

  1. A referent standard or goal
  2. A sensor or input function
  3. A comparator
  4. An effector or output function

Consider a thermostat controlling the temperature of a room as an illustration of control theory.  With a thermostat, the referent standard is the temperature the thermostat is set at, the sensor is the element monitoring the current room temperature, the comparator is the mechanism that compares the current and desired temperatures, and the effector is the HVAC unit.

Obviously, human control systems are more complicated than a thermostat.  With people, feedback involves much more than simple mechanical sensing of the environment, goals are not predetermined inflexible standards, and there are many alternatives to reducing discrepancies.  But despite their complexity, human control systems operate in the same basic way as the thermostat by utilizing feedback to ensure the attainment of goals.  Consider, for example, a department that has adopted a goal of improving patient satisfaction (the referent standard or goal).  The sensor or input function could be direct patient feedback or ratings on patient satisfaction surveys.  When this information is compared to the referent standard or goal, staff are able to form a perception of how their department is performing and how close they are in achieving the goal.  If this comparison reveals a discrepancy, some corrective action(s) can be taken to improve patient satisfaction.

I hope this helps readers understand the power behind visual management and the role it helps to play in maximizing performance.  By setting clear goals for staff to achieve (i.e., the referent standard) and using visual management (i.e., the sensing or input function) to provide feedback, leaders can make it easier for staff to compare how they and/or their department are performing and to see how close they are in achieving a goal.  Assuming staff are motivated to improve (a topic for another blog!) staff can then take corrective action(s) to resolve discrepancies between current and desired performance.


Aaron Fausz, Director for Lean Healthcare and Process Improvement at HPPToday’s blog was written by Aaron Fausz, Ph.D., director at HPP.

Aaron has twenty years of experience helping organizations align and improve their personnel and technical systems to accomplish strategic business objectives.  He has consulted with leading healthcare organizations across the country and has proven success guiding organizations through strategically driven changes and enhancing business performance.  Aaron also has significant experience in needs assessment, best practice analysis, performance measurement, process improvement, and behavioral change management. 

Aaron holds a Ph.D. in Industrial/Organizational Psychology from the University of Tennessee with a minor in Industrial Engineering.

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