Dos and Don’ts of Implementing a Management System

A management system can help you understand your business, create alignment throughout your organization, measure and review performance in real-time, enable problem-solving in the gemba, and sustain improvements. These are just a few reasons why hospitals and healthcare systems around the world are implementing management systems. Data has shown that hospitals with management systems in place were able to respond to crises better than those without because these hospitals were able to rely on the process to communicate from the front lines to leadership and from leadership to front lines effectively.

If you are working on implementing a management system here are some things you should keep in mind.

Dos

• Do Start with a Model Cell (or Two) – When implementing a management system it is helpful to start within a model cell (or two). Think of the model cell as your experiment site or learning center. Try learning in two areas that have some similarities but some differences (i.e. an inpatient area and an outpatient area) to keep focused on the big picture and avoid creating a standard too specific for future spread. This will help your organization learn the elements and get processes in place before spreading throughout the entire organization. If you try to start a management system in all areas at the same time it may be too overwhelming and would be difficult to maintain.
• Do Focus on a Few Elements at a Time – Start by focusing on one or a few related elements together, keeping focus on one function at a time. Remember that all the elements of a management system are designed to work together. Try it, learn from it, and adjust the standard before spreading or expanding to the next element. While it is helpful to implement a few elements at a time before adding more, it is essential that you eventually add in all elements to get the full benefit of a management system. Incorporating all elements will also help to sustain the system.
• Do Utilize Enthusiastic Staff – It’s natural that some of the staff may be more enthusiastic about this change than others. Make sure you utilize them and their positivity. Often people will listen to the thoughts or opinions of co-workers over management.
• Do Select a Model Cell with an Engaged, Humble Leader – When selecting a model cell you will want to look for specific qualities in the leader of that cell. You will need someone who can embody the principles of organizational excellence to help this change be successful.

Don’ts

• Don’t Use a Cookie Cutter Approach to Spread – Remember that different areas (or units) will have different needs. Consequently, what works for an inpatient unit may not be ideal for an outpatient unit or a support team. When standards are created make sure that there is a reasonable amount of flexibility so each area can adjust to fit their needs and the pace of their work. For example, perhaps the standard says that each area should set up a huddle schedule, but the area can determine how frequent those huddles should be based on how rapidly their work moves.
• Don’t Forget to Study and Adjust – It is important that you set time to study how the processes are working and make adjustments when necessary. For example, if you have been running a daily huddle for a few weeks and notice that you are not getting through the standard agenda in the allotted time, you may need to reconsider the agenda. Or if you find you are not getting the right information in a status sheet exchange you may need to reconsider the questions.
• Don’t Forget to Document Learnings – Documentation is essential during the process of implementing a management system. Not only do you need to document standards, but you should also document learnings. This will prove beneficial as you spread to other areas. It can help you avoid pitfalls or anticipate when you may experience setbacks.
• Don’t Rush It – Expect that implementing a management system will take time. It is not something that you should rush through. And the amount of time it takes may vary by area. The spread of the management system is an iterative process. Remember to focus on the intent or purpose of each element when starting out. The “Why” you are doing this work will be more valuable in the beginning than a standard tool.

Implementing a management system will not happen overnight, it will take plenty of discipline, but a management system will transform the way you work. As you build your management system, remember to incorporate the principles and behaviors of organizational excellence into each element.

Please share your learnings from implementing a management system in the comments section below.

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