I recently read Management on the Mend by John Toussaint and found myself inspired to act. I am a medical director for a large residency clinic. We have many areas we can improve upon. I will list some of my ideas here.
Mr Toussaint states,
There are two jobs available in a lean organization: problem solver and problem solver support staff.” p3
As the medical director, I am a support staff for the clinic problem solver. I think the difficulty is finding ways to encourage those who can solve problems to realize they are empowered to do so.
The author describes a shortcut to team unity:
Focus on creating common goals. p24
Being able to keep the senior leadership on the same page and working together will help us come together. Too often I have seen conflicts between what clinicians want to accomplish and what “operations” wants them to accomplish. Unifying this will help the clinic succeed.
It is important for an organization who is undergoing a lean transformation, which I believe is a cultural shift, to incorporate 5 guidelines the author identified:
1. The Model Cell must be focused on a business problem that is important to the organization.
2. The scope of the project for the Model Cell must be limited, usually to one unit or clinic, even though the ideas being tested are intended fro the entire organization.
3. Create a new system based on standard work.
4. Tie the Model Cell to the common goals described already (author calls this True North)
5. This work must involve senior leadership if at all possible. p29-30
Model cells should shoot for 80% waste reduction.
Teams working to meet the requirements of the customer will create processes with far less waste than if workflow is designed to suit internal needs. p40
Standard work is the single most important tool to help an organization shift from a culture of shame and blame to one that focuses on process, on rooting out the bad work sequences and improving flow. p63-64
He recommends limiting strategic initiatives to less than 5, and most importantly how these relate to the “True North” p67
In discussing spreading the work, it is important to keep these things in mind: (p106)
- Standardization – The work should be standardized
- Customization – The work should be able to be customized
- Fingerprints – The unit should be able to place their fingerprints on it (ownership)
I love his description of Lean:
…lean is very simply a system for developing people. To do this, managers need time to be mentors. p111
As a leader, I need to learn:
…to be comfortable and productive at gemba, use visual management, create and stick to True North metrics, and focus on the most critical projects with strategy deployment. p174
There can be no improvement without standard work in place. p175