Maintaining Forward Movement
This is the second blog in a four-part series focused on sustaining lean transformation in healthcare organizations. To read the previous blog post in the series, please follow the link below:
Blog #1 Establishing and Sustaining a Lean Management System
American educator and author, Reed B. Markham, once said, “If you are standing still, you are also going backwards. It takes great effort to maintain forward movement.”
We all understand that leading any organization, large or small, takes great effort. But leading people through complex organizational change, creating new management systems and improving processes every day, while empowering each employee on the team to take action – these continuous improvement efforts require extraordinary diligence and constant attention.
Organizational change only works when leaders have a shared desire to improve their organization and make those improvements stick – all the way down to the frontline and each individual employee.
Sit back for a moment and contemplate Lean as an underpinning of the management system.
In this system the chief executive officer provides a vision that is supported by the strategic engagement of the entire board and executive team. These focused strategies are deployed through the organization using Lean breakthrough tools and methodologies. The Lean management system comes into play to help identify and remove waste, manage strategic priorities and sustain breakthrough improvement while engaging all staff in daily continuous improvement. This system becomes the way we know and improve our business. This methodology is consistent and used for improvements both big and small.
Unfortunately, many healthcare leaders who attempt to implement change quickly stumble on a large hurdle that separates strategy and action. Perhaps the entire leadership team isn’t on board with the plan. Or maybe, the anticipated “quick” results don’t happen. Or, perhaps another crisis gets in the way that demands attention and sucks momentum away from the plan.
An important first step to successful Lean implantation is the creation of the organization’s True North (the vision, mission and priorities that support these statements). True North is the way we see the overall health of the organization and success of the systems. Often the True North metrics include the development of measures around customer experience, people, quality, safety and financial stewardship. These priorities are then translated by the leadership team through strategic and breakthrough initiatives that cascade to teams and staff throughout the organization.
With True North Metrics in place, organizations can move forward with a Lean management system that is centered around a Strategy Deployment System – a process designed to ensure that every person on staff understands the top strategic priorities, how these priorities impact the True North metrics, and how the work they do every day connects to what leaders have identified as being most important. Strategy Deployment also helps executives focus and align their organizations around the most important goals. Goals and plans are cascaded down and up in an organization – senior leadership to middle management to frontline staff and back up – for repeated review, input, actions, and revisions (Plan-Do-Study-Act [PDSA] cycles). While senior leaders may focus on True North Metrics and high-level strategies, the rest of the organization collaboratively translates these goals into specific plans, targets, and actions. And unlike traditional planning, it’s not an annual exercise but an iterative approach for transformation and continuous improvement.
With True North and Strategy Deployment in place, senior leadership can learn and stay focused on sustaining improvement and supporting the cultural transformation. The leadership behaviors they will need to develop will be supported by leader standard work. With these tools in hand, senior management comes to better understand its role in leading and supporting the Lean transformation.
Even in a small organization, there are always too many things to accomplish, too few resources, and too many distractions. Strategy deployment helps to focus and align teams within the organization on the goals most meaningful systemwide, connecting them to the actual work that delivers value to patients, and spurring meaningful and systematic conversations about how these goals should be tackled, measured and reported.
When I spoke with Marianne Griffiths, CEO of Western Sussex Hospitals NHS Trust (Western Sussex), and Chief Executive of Brighton and Sussex University Hospitals NHS, about the overall success of their patient-first program she shared that in addition to the daily continuous improvement focus, the need for an aligned strategy deployment process was a very important element in their overall transformation.
“One of the keys to our success is the ability to focus on the most important priorities,” Griffiths said. “Strategy deployment or SDR as we call it (Strategy Deployment Review) and the conversations it prompts are critical to our success. This process requires that we deeply focus on the most vital strategic and breakthrough initiatives.”
Of course, finding success starts with some significant change to traditional leadership behavior. An article published by McKinsey & Company makes it clear: Leaders need to know not only what they need to do differently, but why changing their behavior matters. What’s more, leaders typically have more years of old habits that must be unlearned in order to adopt the Lean behaviors needed to achieve results. Most leaders, therefore, need coaching and support to master this new way of leading.
This journey is long. But it’s sustainable when True North is established, strategy deployment is used to stay focused and the Lean management system is in place as a guide every day, every week and every month.
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