I realized when I was in graduate school that I needed to understand the concepts I was learning inside and out and be able to practically apply them, because this would be the work I would be doing for my career. I couldn’t simply memorize information to pass my tests, I needed to alter my thinking.
“Moving at the speed of trust” was the phrase a senior physician leader used during my recent Patient-Centered Strategy workshop. His observation was that senior leadership teams struggle because prioritization and deselection require real choice-making among alternatives. It requires a team to say “not now” to a good idea because the capacity does not exist to act on that good idea at the present time; and that can anger an important constituent. Such decisions require the team to put the options on the table and make decisions; but more importantly, to stick to the decisions made. And that requires trust.
Prioritization and deselection are not difficult in a one-time event. After applying criteria to the defined initiatives, people walk away with a list of their top priorities. But a common problem in healthcare organizations is that prioritization decisions don’t seem to stick very long. Deselected projects worm their way back into the work-in-process by returning in a different form, a revised scope, or with new sponsorship. This diminishes focus and breaks down alignment of human and financial resources on the most important breakthrough initiatives. It leads to organizational overburden and gridlock, and the result is susceptibility to fast-moving competitors or new entrants. Continue reading →
It seems that everywhere you look in healthcare today you find someone talking about innovation. In my previous blog post, I talked about the need to focus innovation efforts on care models in order to truly impact the delivery system and provide meaningful outcomes for patients. In an effort to avoid getting lost in the sea of new apps, artificial intelligence, or other technology, we have stopped using the word innovation to describe this work on care models. Is it innovative? Sure, but lumping it into such a broad category creates confusion and misalignment. Instead we are calling it what it is: New Care Model Development. In this post we will introduce the concept.
Recently, as I was driving across town (most likely shuttling my children to one activity or another) my son suddenly proclaimed, “Mom, you are a really good problem solver!” I immediately thought that this was an interesting comment for a first grader to make out of the blue. So, I did what most parents would do; I asked him to explain more.
“Oh yeah, what makes me a good problem solver?” I asked.
“Well, you always fix problems,” he replied.
While that answer is perfectly acceptable to a 7-year-old, it got me thinking. What qualities define a good problem solver? Continue reading →
“There’s always room for a story that can transport people to another place.” -J.K. Rowling.
In my earlier post, I wrote about some of the ways in which organizations can harness the power of story-telling. But, the question is; How do you craft a compelling story?
It was my first day in the creative writing course that I was taking. As my teacher walked in, here is what she said,
“I am not here to tell you what to write. That is your creativity. Your story matters and is unique. I am here to provide you a structure and tools to apply to your story which will make it more compelling and powerful.”
In many ways writing is about engaging the left brain and the right brain. Creativity and language arts come from the right brain, and structure and patterns come from the left brain. Using both is important to craft compelling stories.
So what are the key ingredients to craft a compelling story? Here is what I learnt from my Creative Writing course. Continue reading →
Over the past several months, I have analyzed and discussed the Shingo Model™ on this blog and in private meetings with thought leaders. This has led to a lot of feedback from various people – both in response to Shingo blog posts, to my personal LinkedIn account, and in one-on-one conversations. I deeply appreciate the passion and commitment of so many people to the Shingo Model™!
Any recommendations made by me were based entirely on direct observation of the learning process during the Shingo workshops. In other words, how could we change the Model that would help people learn it better or faster in that setting? As we all know, there are many other considerations to take into account than just the classroom learning experience. The feedback has helped clarify some of these other considerations which must be taken into account.
Let me do my best to articulate different concerns that have been raised:
I liked the recent Catalysis blog post on “How to Create an Area Scorecard,” but I’d like to use this blog post to build upon the helpful thoughts that were shared there.
The previous blog post focused on the important question of “what should we measure?” The recent book Measure What Matters by John Doerr has been popular with readers in many industries, even though the roots are from Silicon Valley. Healthcare organizations have an incredibly powerful “true north” (as we’d say in the Lean approach) that includes safety for patient and staff, quality and outcomes, timely access to care, staff morale, and cost.
There are dozens or hundreds of things we could measure related to our own personal health, and the same is true with measures of organizational health. We also ask, “What is the gap between actual performance and ideal performance?” It’s possible to prioritize the metrics we are focused on, based on where the performance gaps are the largest or the most meaningful. Is a gap in patient safety more important than a gap in appointment waiting times? Having more measures doesn’t necessarily lead to more improvement. Having too many measures can distract us from working on what matters most.
Part of my role at Catalysis is to work with our Catalysis Healthcare Value Network members to help them accelerate the cultural transformation at their organizations. One way we do this is through what we call the discovery process. The goal of the process is to get a broad perspective on how an organization is progressing on their lean journey. The resulting report identifies gaps and facilitates Catalysis and the organization co-creating a plan to close those gaps. During the discovery visit, the Catalysis team gains perspective by going to gemba, having conversations with, and observing the members of the senior leadership team, operations managers, and support managers. Continue reading →
It was a hot and humid day in Singapore. I had two big bags of groceries in my hand and was trying to herd my kids to the bus stop. If I missed this bus, I would need to wait at least 15 minutes. Simultaneously running and juggling my bags while egging my 10-year-old on and literally pulling my toddler, it happened. My 3-year-old started yelling, and lay down. He wouldn’t budge as much as I tried. I was at my wits end. My 10-year-old calmly suggested, “Mom, tell him Jonty’s story.” Continue reading →
Throughout my career, I’ve come across many healthcare organizations that struggle with performance management. What I hear and see are intelligent, dedicated people all trying to help their organization improve. Most EMR implementations do not include a clinical business intelligence strategy. Vendors have come in and convinced the organization’s leaders that their software can somehow automatically improve performance. The software is so easy to use it will be self-service. The vendor will demonstrate the ad-hoc data discovery capabilities that anyone can do. All the organization has to do is submit their data and the improvements will begin. Oh, there’s also a large expense of at least $250,000 just to start. Many organizations have spent much more than that and are not seeing any significant improvement. Why? Continue reading →
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