Practicing what we Preach – Creating and Implementing an Executive Management System

Meghann Brock, MBA, LSSBB, Director of Strategic Initiatives at Kaiser Permanente Medical Center Santa Rosa, California, one of our Catalysis Healthcare Value Network members, shares below about their implementation of an Executive Management System.

Effective leadership is crucial for the success of any organization. Leaders must not only be skilled in deciding which systems to implement in their organization, but they must also be willing to examine and address their own leadership systems. At Kaiser Permanente Santa Rosa, we recognized the need for an Executive Management System to improve our leadership team’s infrastructure and oversight, and we are already experiencing positive results from employing this system.

Routine Meetings Are Not a ‘System’

Before implementing this system, we relied on an organic, unintentional approach to leadership that involved meetings with conflicting priorities and agendas. This left us exhausted and pulled in many directions, a feeling only exacerbated by the pandemic. We also recognized that we needed a structure to connect us to the department-level systems to have accountability and oversight. We learned that creating a system from scratch can be a daunting task. There was no end to the competing priorities on our leaders’ time. It was challenging to find the time to not only educate the leadership team but also to develop and implement. One of our most successful experiments was to select a smaller sub-group of the leadership team to draft, refine and re-draft standard work before presenting it to the larger group for further input and iterations.  

Visualizing the Hidden Work

The initial bias we had was that implementing a system creates work in addition to our already overwhelming workloads. We started to realize that instead, it was a way to surface and visualize all the work that had been hidden previously so that we could better prioritize, helping us manage the workloads.  Our leaders had been functioning unknowingly in silos. Different leaders were implementing various initiatives that impacted the same groups of physicians and employees. As we started visualizing the work on our wall, we realized that we had been metaphorically flying planes with no air traffic control. It was no wonder that our ‘planes’ at times collided and resulted in conflicting priorities and change fatigue.

Over the course of the year, our executive leadership team developed a way to visually manage our large-scale work in progress. Anything that impacted more than one department and would take more than 40+ hours to initiate went on the wall to be visually managed from pending through to completion. For organizational goals, we developed standard work for reporting the progress and barriers at the executive team level. As a result of this system, our leadership meetings became strategic working sessions where meaningful discussion and prioritization started to occur. There was opportunity for questions and discussion, which deepened our collective understanding of the work. Our agendas evolved and became more intentional, with a focus on gaining alignment and prioritization. We use standard work to run our meetings, and our leaders know what to expect when they report on the status of their goals or large-scale initiatives, which allows more time for dialogue and questions.

Prioritization Helps Sustain Improvement Efforts

We are a little over a year into our journey implementing an Executive Management System and we can already feel the benefits. We have said no to things- something we did not previously consider doing. We have strategically adjusted our resource allocations. We have also had difficult conversations challenging our status quo that we had not been having previously. The executive team’s feedback was that this is incredibly helpful and allows us to continuously align and prioritize the work of our medical center. Our system has supported and enhanced the effectiveness of our leadership team and our hope is that as it continues to evolve, we will create more stability and sustainability in our improvement efforts. Implementing an Executive Management System requires constant attention and intention, but the rewards are worth it. The lean management system should work at every level- even the most senior leader.  

Related Items

Catalysis Healthcare Value Network

Customized Education

Leave a Reply

Your email address will not be published. Required fields are marked *