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Leading through Disruption: How Health Care Leaders Can Respond in Challenging Times

Health care organizations are facing a major new disruption: the recently passed reconciliation bill, H.R. 1. Its potential impact, such as deep Medicaid cuts, stricter eligibility requirements, rising administrative complexity, and shrinking coverage, promises to reshape the health care landscape, especially for providers filling a safety net role in their communities.

As health care organizations prepare for what’s ahead, we find ourselves at a well-known crossroad: the challenge of doing more with less. The central question becomes: How do we continue delivering high-value, safe care in the face of such disruption? But this moment isn’t just about survival—it’s a test of leadership.

Back in 2013, John Toussaint, executive chairman and founder of association corporate affiliate member Catalysis, published “The Promise of Lean in Health Care,” Since, we have observed success and failures in Lean implementations, all while navigating major disruptions like the Affordable Care Act, rapid technological change, and the COVID-19 pandemic.

Why Lean Thinking Matters NOW

Figure 1: Lean Guiding Principles, based on the Shingo ModelTM of Operational Excellence

With the upcoming disruption, leaders must address the immediate pressures coming from multiple fronts, while maintaining a strategic eye to the future. That’s where Lean comes, and many health care organizations have adopted it with great results, including association members like Zuckerberg San Francisco General Hospital and Trauma Center, in San Francisco, and UMass Memorial Health, in Worcester, Mass. These health systems have demonstrated sustained improvements in cost, quality, access, and patient experience through their long-term commitment to a lean framework. These cases, and additional research, make a strong case for Lean as a strategic approach to both short and long-term success.

What began as a promise for Lean has become the need for Lean. To meet this moment, organizations must commit to go beyond superficial, tool-based approaches. This requires deep, organization-wide commitment to a principle-based framework, embedded throughout the organization.

How Forward-Thinking Organizations Use Lean Principles in Turbulent Times and Beyond

Enable culture through respect for people and humble leadership
Disruption creates turnover, fear, and burnout. Your ability to retain, engage, align, motivate, and grow people, even in challenging times, will define your resilience. Here’s how:

  • Align behaviors with performance at all levels.
  • Use leader standard work—simple, consistent daily routines that keep leaders connected to the work, and support coaching, developing, and improving people and processes.
  • Cultivate a culture of experimentation and learning through problem-solving,
  • Model and reinforce coaching and curiosity: Advise less, ask more, and create psychological safety.
  • Develop people relentlessly, not just to perform, but to grow.

Develop an aligned, agile organization through constancy of purpose and systems thinking
A structured and agile strategy deployment system helps teams stay aligned, focused, and adaptable. Here’s how:

  • Use Hoshin Kanri to align strategy with daily improvement, maintaining focus on the critical few. This lean strategic planning and management system aligns an organization’s goals and objectives at all levels, focusing on Plan-Do-Study-Act cycles and people development.
  • Identify and track measures that matter to patients.
  • Design a disciplined strategy execution system across all tiers, maintaining flexibility and adaptability.
  • Link strategy to everyday operations with visible goals, rapid problem solving, and front-line engagement, known as a Daily Management System.

Flow and pull value: Redesign care delivery and access
Projected coverage losses could lead to increased emergency department visits, care delays, and uncompensated care. It’s time to rethink care models. Here’s how:

  • Leverage Lean Design Methods —such as rapid prototyping of care pathways, value stream mapping of patient journeys, and iterative testing of scheduling workflows—to build integrated care teams and pathways that manage patients with coverage gaps and improve access to care.
  • Co-design continuum of care pathways with community partners for timely, appropriate access to resources.

Relentless Continuous Improvement: Seek perfection, focus on the process, assure quality and safety, and embrace scientific thinking
New policies highlight the need to reduce administrative and clinical burden and complexity. Focus on reducing waste without cutting value. Here’s how:

  • Use process mapping to identify and eliminate waste in any administrative or clinical workflow
  • Apply standardized work and create systems that help maintain and improve it.
  • Integrate visual management to reduce human error, improve flow, and enhance clarity.

Integrate AI, technology, and business intelligence through a Lean lens
Artificial intelligence is here—and when used well, it can elevate care delivery, reduce burden, and improve equity. Here’s how:

  • Define a purpose-driven AI and business intelligence strategy that enhances human capability instead of replacing it.
  • Start with process clarity: map processes and eliminate waste before inserting technology.
  • Make AI and business intelligence a core capability.

Final Thoughts

Health care will continue facing financial, regulatory, and operational challenges that will test even the strongest systems. Lean offers much more than tools—it provides a mindset and leadership framework that prioritizes people, enables disciplined action, and builds agile, and resilient teams. Leadership commitment is the greatest success factor. Now is the time for health care executives and improvement leaders to lead with courage, clarity, and purpose and a vision on the future success and sustainability of their organizations. The road ahead is uncertain, but we’re not alone.

Leading to Engage: The Psychology of Engagement

Look how a single candle can both defy and define the darkness.” – Anne Frank 

As healthcare institutions continue to increase activity around providers exiting the industry, unionization, and strikes, workplace engagement and well-being have become a key focus as healthcare institutions still try to recover from the drastic changes that COVID-19 required of healthcare institutions. One of the primary reasons for the above organizational challenges is that providers are burned out due to being overworked or needing more training to accomplish their jobs effectively, efficiently, and safely. However, there is hope to help reduce these feelings in exchange for more optimism for a brighter future. Continue reading →

Making Change Stick

Posted on by CATALYSIS

Written by: Amy Mervak and Mike Radtke

“Change the way you look at things and the things you look at change.”  – Wayne W. Dyer

Change can be hard. This isn’t necessarily a revelation, but instead a painful reality for many of us. We make New Year’s resolutions that we don’t keep, we have health goals that we can’t meet, and we have personal development goals that feel impossible to reach despite our sincere commitment and effort.  In frustration, it’s easy to become resigned and think that “maybe this is as good as I get.” Continue reading →

Healthcare Excellence Requires Problem-Solving and Psychological Safety

Posted on by Mark Graban

Whether we aim to be a “Lean” hospital or have a culture of safety (or, ideally, both), this level of excellence is built upon a culture of continuous improvement. As Greg Jacobson, MD, an emergency medicine physician, and CEO of KaiNexus says:

“We cannot have a culture of continuous improvement without a culture of learning from mistakes.”

Being able to learn from mistakes requires not just problem-solving skills, but also a culture of psychological safety.

We cannot solve problems unless the team and leaders are aware of them. What happens when medical professionals are afraid to speak up about mistakes, problems, or opportunities for improvement? Or if they just think speaking up won’t change anything? Continue reading →

Getting Results with a Lean Management System

Posted on by Kim Barnas

This is the final blog in a four-part series focused on sustaining lean transformation in healthcare organizations. To read the previous blog posts in the series, please follow the links below:

Blog #1 Establishing and Sustaining a Lean Management System

Blog #2 Maintaining Forward Movement

Blog #3 Four Core Elements to Implement a Sustainable Lean Management System 

The rate of change in the business of healthcare has been extraordinarily fast in the past two decades.

The shift to electronic medical records, mergers that create giant health systems, nationwide plans to insure more (or less) people – all these systemic transformations get rolled out with a hopeful promise that healthcare will be better for everyone.

These promises have not been followed with meaningful reporting of metrics or significant results. Continue reading →

Four Core Elements to Implement a Sustainable Lean Management System

Posted on by Kim Barnas

This is the third blog in a four-part series focused on sustaining lean transformation in healthcare organizations. To read the previous blog posts in the series, please follow the links below:

Blog #1 Establishing and Sustaining a Lean Management System

Blog #2 Maintaining Forward Movement

The critical step for any leader interested in Lean is to look beyond the tools and, instead, consider the following four core elements designed to help an organization and its leadership team to effectively implement a sustainable Lean management system.

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How to Stop Weaponizing Tools

Guest blog post from Jeremiah Hargrave – Director, Quality and Organizational Improvement at Torrance Memorial Medical Center

Weapon: a thing designed or used to inflict harm or damage, a means of gaining an advantage or defending oneself in a conflict or contest.

Would you categorize your PI tools as weapons? I definitely would. We use these tools in our quest to fight against waste and create value for our customers. They are weapons that help us make inefficiencies visible, think about a problem differently and identify bottlenecks. When used in the spirit of continuous improvement, tools are some of the best weapons we have to help teams improve processes. Our conflict with waste is never ending and we need to use every weapon at our disposal to gain an advantage. Continue reading →

A Summit Experience

Posted on by Landon Card

Catalysis’ internship program gives college students the opportunity to attend our annual Lean Healthcare Transformation Summit, learn about lean in healthcare, and make valuable connections to healthcare leaders and practitioners. We see this program as one way to invest in the future of healthcare by educating and connecting the next generation of healthcare leaders. This blog is from one of our interns, Landon Card (pictured right). 

When I arrived at the Summit in Chicago, I didn’t know what to expect. Coming from a suburb in Iowa, the crazy traffic and constant honking of Chicago had me on high alert. After I parked, I made the one block trek to the hotel where I was greeted with a warm smile by Angela, who guided both me and my buddy Will Bickel throughout the whole process. I checked into my room, and immediately felt relaxed. The city seemed completely separate from the inside of the hotel. Continue reading →

Catalysis Summit Reflection

Posted on by Will Bickel

Catalysis’ internship program gives college students the opportunity to attend our annual Lean Healthcare Transformation Summit, learn about lean in healthcare, and make valuable connections to healthcare leaders and practitioners. We see this program as one way to invest in the future of healthcare by educating and connecting the next generation of healthcare leaders. This blog is from one of our interns, Will Bickel (pictured left). 

Going into the Catalysis Summit I was not sure what to expect, however, I had two personal goals of what I wanted to get out of the experience. I wanted to have conversations with as many healthcare professionals as possible and develop my leadership skills. Both of these goals are important to me as I look to explore the healthcare field as a potential career and I want to continue growing as a leader. Continue reading →

Recap of the 2023 Lean Healthcare Transformation Summit

Over the last three years, the healthcare community has found innovative and resourceful ways to not only combat challenges, but also thrive and grow. That is why the theme for this year’s Lean Healthcare Transformation Summit was Learn, Share, Connect: Accelerating change during dynamic times. Our presenters shared about developing their teams, building a resilient and equitable culture within organizations, and transforming both operations and systems. Continue reading →