Lean Leadership for Healthcare: Approaches to Lean Transformation PDF

Preface

In late March 2011, I completed the manuscript for my first book titled Taking Improvement from the Assembly Line to Healthcare (CRC Press). This book was my translation of the application of Lean within the healthcare industry. While not everyone was able to figure out what the assembly line had to do with improving healthcare, the book's title was an homage to the greatest management system in operation across the world today, the Toyota Production System.

Before the book was published, I had a chance to reflect on the message I intended to convey to the many dedicated healthcare professionals working hard to deliver worldclass care to the patients, families, and communities they serve. The book was a comprehensive approach to Lean improvement. Topics included understanding of the fundamentals of Lean improvement, understanding the tools and the applications of these tools to help us "see and eliminate" waste in the healthcare setting, and a review of several case studies that demonstrated the change that can occur in terms of both performance and culture when a focused team of individuals applies the Toyota Production System in the healthcare setting. I included the necessary steps an organization must take prior to applying the Lean model, and closed with a chapter on leadership behaviors essential for success.

Throughout the development of Taking Improvement from the Assembly Line to Healthcare, I simultaneously operated my consulting business. My company services a wide range of clients in creating a culture of improvement through the application of the Toyota Production System. The majority of this client base consists of healthcare organizations servicing patients and clients with the continuum of care. Although it was critical that our consulting practice dedicate a large amount of time to teaching organizations the tools and techniques of Lean improvement, I found that I was spending the majority of my time teaching organizations to lead change and my efforts were largely focused on leadership development. Perhaps the most important part of creating a culture of continuous improvement is "leading" the change. Despite this fact, there are few resources available that help to develop these skills at the various management levels. This book, which you are about to read, Lean Leadership for Healthcare, was created to provide healthcare leaders a resource on how to lead transformational improvement within the healthcare industry.

Why leadership? Why not management? I frequently hear in my work that "our organization needs to better the job of managing improvement." Rarely do I hear, "We need to do a better job leading improvement." Organizations certainly spend a lot of time on management development, and universities and colleges teach myriad management courses. Fewer university courses and public workshops are dedicated to leadership, and organizations spend significantly less time on leadership development. What's the difference?

Management is the set of work processes that keep a complex organization- one filled with departments, people, and technology-operating effectively and efficiently. There are many aspects of management, including planning, budgeting, staffing/scheduling, and controlling. Organizations spend a lot of time and resources optimizing these management systems. Leadership is the set of processes that creates organizations and then helps these organizations change to meet ever-evolving business conditions. The key aspects of leadership include creating a future vision (the direction of the organization), aligning the resources, and then inspiring people to realize this new future.

In creating a culture of improvement, are we trying to create a management system to plan, budget, organize, control, and staff our way to improvement? Or, are we trying to create a new direction for the organization, aligning the resources and then inspiring our people to realize this vision in spite of the obstacles we are sure to encounter along the way?

In reality, we do need some management systems to be successful. I will discuss several of the management systems, tools, ideas, and behaviors necessary to foster a culture of continuous improvement. However, we also need plenty of leadership. This book will provide you with many Lean leadership approaches, thoughts, visual tools, and applications to put your healthcare organization on its way toward world-class performance and culture.

This is a place your organization has likely never been, and any transformation process will require great leadership. Done well, you can create an environment where worldclass healthcare quality, patient safety, and customer service are the norm. The workplace can be transformed to one where medical staff are engaged in their work and inspired to do better and be better every day. You can help shape a healthcare system that delivers more "value." Value from a healthcare system perspective is broadly defined as outcomes divided by cost. My goal is to help you create a healthcare system that, through your people, continually improves outcomes at lower and lower costs.

There will be plenty of skeptics along the way, and perhaps some of you who are reading this book are already skeptical. "Lean" is not common sense; rather, it is counterintuitive. It takes a long time to learn and a lifetime to master. But, those organizations that have applied Lean thinking to their processes, with the diligence of effective management and strong leadership support, are already realizing the benefits of their efforts. And, many of the benefits far exceed what was thought possible just a few years ago. If you speak with a "Lean" hospital, "Lean" clinic, or "Lean" healthcare service provider, they will tell you the reward far exceeds the efforts. To be successful, these organizations had to provide the leadership to create their future state. I hope to leverage many of their leadership stories, successes and failures, plus a few of my own, to help you transform your organization using Lean leadership.