Change Your Behavior, Change Your Results

Posted on by Paul Pejsa

The day the world changed concept

Many healthcare organizations are coming to the realization that tool-based implementations are insufficient to sustain continuous improvement. This is leading organizations to take a principle-based approach to operational excellence.

Adopting a principle-based approach can seem daunting, and many leaders are not sure where to start. Here is some advice: 

Gain an Understanding of Your Role in Operational Excellence

Often when organizations begin their improvement journey they start with a tool-based approach. This tends to get delegated by senior leadership to the improvement team or somewhere closer to the front lines in the organization chart. The truth is culture change and operational excellence cannot be delegated. Leadership must set the example and the tone for the entire organization.

To achieve operational excellence, the role of leadership is to establish direction for the organization, motivate and mentor staff, and reveal break-through thinking. Success in these areas requires specific behaviors that are very different from the traditional way leaders operate.

Your Role Will Require Different Behavior

When going down the path of cultural transformation through operational excellence, leaders will need to change the way they behave with respect to goals and strategies. Leaders need to set reasonable goals and communicate about the strategy and direction of the organization on a regular basis.

Another behavior change required for this culture shift is that leaders need to be in the work. They need to be out in the gemba watching and listening to the front-line staff. Leaders should openly embrace failure and celebrate even small successes. These behaviors will set the tone and demonstrate what is expected for the rest of the organization.

Behaviors Need to be Based on Something Other Than Values

In nearly every organization I have set foot in there is a set of values on the wall that are intended to guide the organization and tell everyone how they should behave. Although values are set with the best of intentions, there is one problem with them when it comes to pursuing operational excellence; values are situational.

I often hear people using the bank robber analogy to illustrate this point. Some very common corporate values are teamwork, loyalty, and dependability. If we have a team of bank robbers, they would likely all hold these same values. They must work together, depend on each other, and remain loyal to carry out their mission of robbing a bank. In this scenario, these values have a much different connotation than they were intended when an organization carefully chose them and put them on the wall as a reminder of how their staff should behave.

The best way to understand the behaviors required to achieve operational excellence is to go back to fundamental principles. At Catalysis we generally refer to the Shingo Principles of Operational Excellence. These will help you build a foundation for success that enables a culture of continuous improvement, aligns the organization, and positions the organization to achieve results.

Paul Pejsa, Director



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4 Responses to Change Your Behavior, Change Your Results

Tony Heath says: 03/19/2019 at 10:21 am

Thank you for the strong reminder that quality/continuous improvement must live in the hearts of leaders. I believe this wholeheartedly. I’d appreciate it if you’d throw a few crumbs to people like me, the poor souls that try their best to improve things AND are not executives. Sometimes I wonder what I really can do.

Sara Thompson says: 03/21/2019 at 7:49 am

Tony, Thank you for your feedback on topics for our blog! We will work on addressing the “stuck in the middle” situation, as I am sure many are in the same boat.

Paul Pejsa says: 03/24/2019 at 2:10 pm

Hi, Tony.
I think there are a few things that improvement leaders can do to engage teams from the middle of the organization. Engaging front line staff in daily readiness huddles, helping them to implement small “just do it” improvements that teams can do without senior leadership approval, and simply being present with principle based behaviors (respect for the individual, leading with humility, PDSA thinking) will all advance the culture. In my wife’s work with Optum, the front line staff at the SNFs she supported as an NP implemented numerous small improvements that over time caught the attention of senior leaders. We can all start there…

Bob Emiliani says: 08/19/2020 at 6:14 am

Despite newer and better information, Lean promoters continue to work off the old flawed model that “changed behaviors = changed results.” This model, some 100 years old, ignores leaders’beliefs and assumptions (informed by preconceptions) and is thus ineffective. See “Culture shift” requires destroying one’s preconceptions which occurs not when leaders watch and listen, but by participation in kaizen. CEOs’ case against Lean is formidable because their preconceptions are rooted in archaic classical management. See There are eight major categories of preconceptions each containing 15-20 preconceptions. Progress is unlikely if people continue to proffer models that do not accurately reflect the current state of leadership.


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