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“Being Lean” is Much Rarer Than “Doing Lean”

Dr. Gene Lindsey, December 5, 2017

There are many steps along the way from the initial introduction of Lean to the day when Lean becomes its operating system and the foundation of its new culture. Read more from Dr. Gene Lindsey

“Being Lean” is much rarer than“doing Lean.” There are many steps along the way from the initial introduction of Lean into an enterprise to the day when Lean becomes its operating system and the foundation of its new culture. Good organizational intentions without effective supports can be frustrating. Just exhorting individuals to work harder to meet organizational goals leads to managerial frustration and frontline burnout and cynicism.

On a recent gemba walk at one of Indiana University Health hospitals I saw first hand how “becoming Lean” rather than just ‘doing lean had allowed IU Health to “turn strategy into action” across their huge delivery system. As I listened to the leadership talk about their “journey,” memories of my own Lean journey flooded my mind. IU Health started its journey for reasons not much different than the ones that motivated my organization. They needed to lower their costs, improve their services, and revive their staff if they were going to succeed while realizing the external pressures of payment reform, demands for greater transparency, and a growing number of regulations and requirements associated with the demands of both public and private payers.

What I heard the medical professionals at IU Health saying was that Lean enabled them to do what they had always wanted to do. From executives to medical assistants, the staff talked about the joy that Lean had made possible because with a Lean culture they were able to do more for patients. Helping patients is why they went into healthcare.

In every organization that I have visited that has gone through a few years of implementing Lean there has been improvement in the measurements of employee and patient satisfaction as well as in the quality and business metrics. I can confidently say that Lean, “when done right,” can help any organization do today’s work more effectively than it did yesterday’s work. Organizations that give Lean a chance and have the initial help of an experienced consultant and the alignment of its board, senior management, middle management, and clinical leadership, will experience remarkable results.

Just doing today’s work better than you did yesterday’s work is necessary but hardly sufficient for tomorrow’s success. Tomorrow’s challenges will surely be greater than today’s work. Being satisfied with the achievements of 2017 means that your practice or health system will be floundering in 2018 or 2020. Change is not a choice. Change is what is forced on us by external realities and forces over which we have little if any control. “Doing Lean” improves you today. “Being Lean” and learning how to effectively use Lean to develop and deploy breakthrough strategies requires a cultural transformation. My heart skipped a beat when I heard the nurse leader for transformation say that their goal was a “cultural” transformation that would enable them to fulfill their mission of better serving their community.

Healthcare professionals will engage in the deployment of strategies for improvement if they have effective Lean leaders who understand that their Lean role is to be seen frequently where the work is done and earnestly practice their role as effective coaches, mentors and teachers. When Lean fails, it is usually because senior leadership has retreated to its offices and endless meetings and tries to succeed by announcing difficult to achieve objectives described with numbers and opinions devoid of input from the people who do the work. Lean tools don’t work for long without the participation of senior managers.

The key ingredient in any Lean transformation is a cultural change that creates a sense that the employees can trust the process. Words alone are insufficient. Turning “strategy into action” with Lean requires that senior leaders demonstrate by their own participation and their own personal transformation that Lean is not a set of tools that are “the flavor of the month.” They must be convincing in their use of Lean as the “operating system” of the enterprise.

Tomorrow’s work can be exciting. Lean can be used to shape an organization like IU Health for tomorrow from many distributed pieces. The innovations built with big data, augmented intelligence, and creative applications of telecommunications will be much more beneficial when they are woven into workflows and strategies with the benefits of Lean thinking and culture. Being Lean is the greatest competitive competency a provider of healthcare can develop to insure that their mission will survive a future that seems harsher with each passing executive order.

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