The famous system thinker theorist Russell Ackoff once wrote: “The more efficient you are at doing the wrong thing, the wronger you become. It is much better to do the right thing wronger than the wrong thing righter. If you do the right thing wrong and correct it, you get better.”
It seems to me today that we do many of the wrong things better and better in healthcare. There have been many remarkable breakthroughs during COVID-19. Patients not waiting in waiting rooms, or at registration desks. Patients being examined in cars before being safely ushered to where they need to be. Virtual visits exploding. Why didn’t this happen before? I contend we have been trying to improve wrong care processes. We continue trying to improve fundamentally flawed care processes. We are stuck in old thinking that is not based on customer value and our challenge is to break out of traditional thinking into the future of healthcare. Continue reading →
The goal of the management system for organizational excellence is to develop people to solve problems and improve performance. An effective management system will also open lines of communication from the CEO to the front-line staff, the front-line staff to the CEO, and every level in-between. As recent events plunged the healthcare system into crisis mode, we witnessed many organizations relying on this management system to help them adapt to rapidly changing conditions. This has prompted numerous organizations to consider implementing a management system.
A management system cannot be built overnight, it takes time and dedication to create a strong and successful system. Through my own work and experience with many healthcare organizations I have noticed some common struggles that organizations face as they develop their own management system. Continue reading →
In Becoming the Change, a new book by John Toussaint, MD, and Kim Barnas, leader behavior is described as a condition in the workplace, saying “ this means that it must be considered as a factor in operations, and therefore, is open to improvement.” Throughout interactions with many healthcare organizations around the world, leaders at Catalysis have found that the use of a personal A3 is a great way for leaders to focus on their own behaviors as a means of supporting and sustaining the organization’s continuous improvement journey.
A personal A3 is not a problem-solving A3, rather it is intended to help leaders focus on their strengths and opportunities and allow them to measure their progress toward personal goals. Here are some things to keep in mind when working on your personal A3. Continue reading →
Making processes and data visual is a powerful way to communicate and give everyone in an organization the ability to see together what is going on so they can make decisions and continuously improve.
During one of our CHVN member sharing sessions, Children’s Mercy Hospital discussed the work they have done to improve OR on-time starts, as well as the work they are doing to ramp back up with elective surgeries after COVID-19. One consistent theme through their presentation was how they made things visual in order to communicate, drive behaviors of accountability and ownership, and create a positive experience for patients and their families. Continue reading →
Safety is an essential focus of healthcare organizations on the journey to organizational excellence. For Hennepin Health in Minnesota, patient and staff safety is a top priority. Consequently, it comes as no surprise that when the COVID-19 pandemic hit they chose to use their problem-solving skills to come up with a creative way to approach PPE use and safety.
At the start of the pandemic, concerns about PPE and risk of exposure was at an unprecedented level. In response to this, Hennepin Health created the PPE Buddy program – to protect their patients by protecting their staff. These buddies, who were staff from areas that were required to shut down (physical therapy, diagnostic imaging, etc.), helped provide extra support for all staff in donning and doffing PPE with COVID-19 positive or rule out patients. So how did they set up this program and make it successful?
Purpose, values and principles make up the foundation of the transformation house and these elements help define the culture of an organization. When you put stress on any structure it displays the integrity of the foundation. If there are hidden cracks or defects, they become visible and will have wide-reaching effects through the whole structure.
In a recent Catalysis Healthcare Value Network member sharing session, John Woodrich and George Carr from Bryan Medical Center explained how the foundation and culture they built at their organization prepared them for the pandemic and enabled them to respond effectively.
Looking through the lens of their employment engagement survey, they were able to get a snapshot of the culture and the effects of the work they have done to create it. They ranked in the 94th percentile for employee engagement and 93rd percentile for physician engagement – with an 88% response rate. This says a lot the environment they have established.
Have you ever started heading somewhere and accidentally started driving to work or home? After traveling to the same place hundreds of times, it is easy to end up on autopilot. This can happen with any routine that we get into because of how our minds are wired.
If you are on a transformation journey, it can be easy to unknowingly continue in well-worn paths and ways of thinking. It is difficult to change behaviors and line them up with the principles of operational excellence when we have paths we are used to following. To behave differently involves gaining insight into your bias/mindset.
When we are aware of our bias/mindset, we have the opportunity to consider how this impacts our thinking, which then impacts how we act. If our goal is to change our behaviors, reflecting on our mindset is an important place to start because it allows us to understand where our thinking and actions are rooted.
Organizational culture and climate are undeniably related, yet distinct and separate. Understanding the differences and how one influences the other is helpful when transforming an organization. One way to illustrate the relationship between culture and climate is through the story of the Chinese bamboo tree.
After the bamboo tree seeds are planted the soil must be watered and fertilized. After a year of constant care, no growth can be observed. This cycle of care continues with no growth for four years. Constant care, but no visible growth. Then during the fifth year the bamboo grows 80 feet in six weeks. The only way to grow the forest is with patience, faith, and perseverance. In this example, the first four years are creating the climate that produces the culture, the bamboo forest.
The worldwide spread of COVID-19 has caused a great deal of uncertainty in many areas of our lives. The change has impacted our work lives, our home lives, and everything in between. Frontline healthcare workers have been working tirelessly to save patients and adjust processes to ensure safety, administrative staff are working from home or furloughed, and businesses everywhere are working to find new ways to meet customer needs so they can stay afloat. No matter what your specific situation is, we all have one thing in common; we are trying to find ways to persevere through the uncertainty and move forward.
Below are strategies from our team that they have found helpful in the midst of challenging ambiguity.
Many of our work habits and processes have been disrupted due to COVID-19. Some important questions come to mind as our organizations think about the future: How will we do our work? What should we return to, what should change, and how will we determine a new norm?