Are You on an Island of Excellence Surrounded by a Sea of Mediocrity?

In January, the ThedaCare Center for Healthcare Value added a team member to start building educational products to help transform healthcare. Steven Bollinger comes to the Center with experience in publishing books and videos designed to share lean knowledge with the manufacturing industry. As part of the introduction to the team, we invited him to be a part of a Gemba walk through ThedaCare. In Steve's first blog post he shares some of his observations from that tour.

- John Toussaint, MD
CEO, ThedaCare Center for Healthcare Value

Are You on an Island of Excellence Surrounded by a Sea of Mediocrity?

Many, if not all, hospitals are practicing lean thinking in some shape or form. During slow times they may run a kaizen event or develop a value stream map of one of their more disorganized processes. From the readings I have done, this is how most medical facilities start on their lean journey. So, it's not wrong to begin to document standard work, or take steps to improve the culture within your hospital. It's just that at some point most groups within their hospital will reach a limit on what they can do with their part of the care stream.

This is where leadership must step up and start to examine this 'Sea of Mediocrity.' During a webinar in partnership with the Lean Enterprise Institute John Toussaint, MD showed a graphic of how a lean hospital should create their organizational chart. His graphic placed the front line staff members on the top and as the pay grade went up, the positions were listed below. I am not sure how the president of a hospital felt about being on the bottom, but what really matters is the front line workers are the people who are in a position to add the most value to the patient. Placing the front line workers at the top of the chart enables each level of leadership below to support the people who are adding value.

As each team of front line workers begins to develop their own 'Islands of Excellence,' the supervisors, managers, presidents, CEOs and board members are in a unique position to see the islands and all the problems between them. At this point in the lean journey, it would be wise for the leadership to dig deep into their safety, quality, and value data to begin to apply strategic thinking to their application of lean principles. Strategy Deployment is the common term that is used to define the steps involved in making sure  time and energy are being spent improving the right things.

During my first week at the ThedaCare Center for Healthcare Value I had the opportunity to visit the ThedaCare senior management visual room. This room is where the leaders meet and review all the performance data from the entire health system. I found it surprising that there were not thousands of metrics; only significant, meaningful and current data were on the walls. To make these charts and graphs easy to interpret, most had red or green colors indicating the status. Just think how much time is saved by not having to read the charts to see if their organization is safe, providing quality care and value to the patient. As a result, this now gives the leaders more time to focus on the everyday problems in the 'Sea of Mediocrity.'

To learn more about Strategy Deployment, you can view a preview of a DVD, Thinking Lean at ThedaCare: Strategy Deployment. Click here to view video.

- Steven Bollinger

Director Product Development

ThedaCare Center for Healthcare Value