Redesigning Clinical Workflows to Return Joy to Patient Care
Lean Leadership: It’s Lonely at the Bottom

Lean leadership is not for wimps. When you step forward, away from the pack, encouraging others to follow, you take a risk.

First of all, there is the change thing. Change is hard. People don’t like to change. People only risk change when the pain of the current state is greater than the perceived pain of trying something different. Fortunately for healthcare leaders, there is plenty of pain in the current state.

inverted org chartNext there is uncertainty. We have good ideas that deserve to be tried. We don’t know for sure that they will work, even when we have thought long and hard about the potential failure modes and countermeasures. To encourage others to follow, we share our vision for how the change will make things better, knowing that as we implement the change the future state will vary from our ideal as we adapt to unanticipated problems along the way.

So how do we reduce the risk, minimize the pain of change, and engage people knowing full well that what we end up with will not be exactly the same as the vision we offered our followers at the start?

In lean leadership, we lead from the bottom. We invert the traditional org chart. We support those who provide value – the workers who directly take care of the patients. We go to the gemba to feel and understand their pain.  We engage them in developing the vision of the future state.  We provide the resources needed for the countermeasures they recommend to fix unanticipated problems.  We recognize and celebrate them when they try their best, and even a bit more when they succeed.

The biggest risk to leading from the bottom may be the process of inverting the org chart. That’s a tough one for many experienced executives to embrace.
Until we understand that leaving comfort zonesharing decision-making is not the same as relinquishing control, the uncertainty is unsettling to say the least.

Once we try it, the benefits of Lean leadership harnessing the power of everyone in the organization in problem solving become clear. Not only do we get better results, but we teach others how to coach, mentor, and empower those who report to them.  As this process continues through each layer of the org chart, the team gets better, stronger, and more responsive to new challenges.

Leading from the bottom of the org chart takes courage, but it’s a lot less lonely than leading from the top.

What do you think?

Are you ready to lead from the bottom?

Lean Leadership: It’s Lonely at the Bottom

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