Mike Stoecklein, Network Director, shares his thoughts on the systems that have produced (and continue to produce) the kinds of thinking that drive our actions.
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We all went to the wrong school. The courses we took, the way we were taught, and trained and treated were all wrong.
It began early on in our lives, shortly after Kindergarten I think. The teachers started to emphasize grades, and tests, and scores. We could not collaborate with each other (it was called cheating). We were put in different reading groups based on our apparent abilities. We knew who the "slow kids" were and it was embarrassing. The school system had one way of teaching and if your mind was not compatible with that one way, you struggled.
It continued as we got older, and the competition for grades got more intense. We learned the tricks to take the easier courses so as to keep our grade-point averages up. We learned that the goal was not about learning, it was about results (grades) and the need to beat everyone else out for the few "A grades."
The lessons and the curriculum were all wrong. We were not exposed to the knowledge we would need for this world. The focus was on information, not knowledge (there is a difference, but how could we know?)
The lessons continued after the diplomas were conferred (or after we gave up and dropped out). The way we were taught, and trained and treated in our work was all wrong too. Why should we be surprised? It was based on the education model. We were rewarded and punished for individual results. We were exhorted to do better through posters, exhortations and other "pep rallies."
So, we should not be surprised that we now have a workforce (from top management to the line workers) that has the wrong ideas in our heads, and the wrong approaches for running our businesses. This is true for every industry.
Dr. W. Edwards Deming pointed this out in his books, seminars and consultations. In his 1993 book, "The New Economics," he compared and contrasted the "prevailing style of management" (present practice) and better practice.
Under the prevailing style of management we see:
- Lack of constancy of purpose.
- Short-term thinking. Emphasis on immediate results. Think the present tense; no future tense.
- Keep up the price of a company's stock. Maintain dividends.
- Failure to optimize through time.
- Make this quarter look good. Ship everything on hand at the end of the month (or quarter). Never mind its quality; mark it shipped. Show it as accounts receivable.
- Defer till next quarter repairs, maintenance, and orders for material.
Under better practice (which required theory of management, not just reactive skills) we see:
- Adopt and publish constancy of purpose.
- Do some long-term planning.
- Ask this question: Where do we wish to be in five years from now? Then, by what method?
The list continues and I urge you to read it in it's entirety.
The point is, we are all doing our best with what we have been taught and the way we've been treated, but it's all wrong.
We are now engaged in rework and re-education. Some of our businesses are becoming universities where we are learning what we should have learned years ago. This includes healthcare and there is evidence of some progress. Recently, I had the good fortune to visit an organization that is teaching and treating people in a new way. The company is WellSpan Health based in York and Gettysburg, Pennsylvania. They hosted what we call a "gemba visit" for fellow Healthcare Value Network member organizations. WellSpan is not the only healthcare organization engaging in this massive rework task, but they provide a great example of creating education systems for all of their staff. This includes the education and training for future doctors.
Dr. John Toussaint also wrote about this in his books, "On The Mend" and "Potent Medicine", and in this recent article in the Mayo Clinic Proceedings, and it has become a part of every presentation he makes. Like Dr. Deming, he shows us two lists:
White Coat Leadership (for clinicians and administrators):
- Exhibit an "all knowing" attitude
- Adopt an "in charge" posture
- Demonstrate autocratic tendencies
- Adopts a "buck stops here" approach
- Shows impatience
- Blames others * Controls others
Why should we be surprised? The prevailing education and work systems produced these results.
He contrasts this with "Improvement Leadership":
- Demonstrates humility
- Exhibits curiosity
- Facilitates improvement efforts
- Teaches others
- Learns from others
- Communicates effectively
How will we learn this new way? By becoming the schools and universities. By following the lead of WellSpan Health and others. By teaching the right things, and treating people the right way.
A great opportunity to start this re-education is by attending the 5th Annual Lean Healthcare Transformation Summit in Los Angeles, California on June 4-5, 2014. If you only take one "course" next year, this is the one you want to attend. Save the date now and sign up to get registration details.