Why You Need to Go-and-See

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One of the best parts of my job is meeting with healthcare leaders from across the country and hearing about their organization’s cultural transformation as well as their own personal transformations as leaders in a lean environment. I recently had the opportunity to spend time with Keith Knoll, President at Wellspan’s York Hospital. It was awesome to go-and-see at York Hospital and hear Keith candidly share about the cultural change that is occurring there. 

The conversations I had with Keith got me thinking about why a lean leader should go-and-see. Here are some of the benefits:

Ah-ha Moments

Often it takes going to see to bring on an ah-ha moment. As part of his civic duty, Keith joined the Board of Directors at Flinchberg Engineering Inc. (FEI). When he was offered an opportunity to tour the factory floor he jumped at the chance to go-and-see. As they toured the factory, Keith noticed that none of the FEI leadership team was speaking. The tour was being led by the workers on the front line who were doing the work and improving the work. This got the wheels turning for him and revealed the concept that for the front line to be engaged in the work, they must own the work and leadership needs to let this happen.

The beauty of an ah-ha moment that comes when you go-and-see is that it doesn’t matter how long you have been on a transformation journey, there is always something to be learned in the gemba.

Time for Reflection

If you are doing it right, going to see should always result in reflection. This could be self-reflection or reflection on a process. It is the reflection that spurs learning and this continuous learning leads to growth and further transformation of the culture. In fact, the leadership team at York Hospital feels so strongly about taking time to reflect that they have started scheduling desk time for reflection.

In Keith’s case, he began to reflect on how his own leadership style may be undermining or impeding the lean transformation at York Hospital. Keith needed to ensure that he was staying in his role and allowing the front line and managers to do their job. This realization caused Keith to work with the improvement team and other executives to define behaviors and roles for each level of the organization.

Ability to Adopt and Adapt

Another benefit of going to see is that it shows you what is working and gives you the ability to adopt and adapt practices or processes that apply to your situation.

Keith knew that the goal was to have the front line staff at York Hospital as engaged in continuous improvement as the front line he observed at FEI. For this to happen, he realized that they needed to focus on ways to keep leaders out of the weeds in daily operations and let middle managers do their job. They are now running an experiment that allows directors and managers to kick leadership team members out of meetings where they feel they are not needed. The message this sends is powerful. It says that the leadership team trusts directors and managers to do their job and that leaders are humble enough to know that they do not have all the answers.

This January, when Roxana Gapstur, PhD, RN, began her role as President and Chief Operating Officer of Wellspan Health, the leadership team at York Hospital had the opportunity to show how they have grown as leaders and gave the opportunity for their staff to showcase their work. They decided that for this visit those who do the work would show Roxanna the Wellspan Daily Management System and explain the improvements and metrics in their areas. Keith and the leaders were delighted to see the staff embrace this opportunity. Keith mentioned to me that it is important to get over your own baggage as a leader and let those you lead thrive.

My time with Keith reminded me how lucky I am to have the opportunity to go-and-see at many healthcare organizations. This year I intend to share my learnings and observations with you in hopes that we can all continue to grow together.

Please share your thoughts on the importance of going to see in the comments section below.


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