Redesigning Clinical Workflows to Return Joy to Patient Care
Developing Lean Leaders

Tag Archives: Daily Management System

Developing Lean Leaders

We need a new generation of Lean leaders in healthcare. Too many of the current “old guard” don’t understand Lean, or won’t commit to transformational leadership.

I don’t mean that we necessarily need younger people in the C-suites of hospitals and health systems. What we need are people who have the energy and willingness to try something new.  We need leaders who not only understand that Lean is first and foremost about “Respect for People”, but who also have the courage to lead change in their organizations.

Why don’t leaders understand Lean? In part, we’ve done a poor job of educating them. After all, these are smart people. They didn’t get into their “Chief” positions without being able to identify and solve problems. Most have good people skills.

On the downside, they often are under intense pressure to fix problems quickly in high stakes situations. They need to rapidly turn things around. Such situations don’t lend themselves to introducing Lean. Not that it can’t work well if done right. In fact, it’s the best option in most cases. But it requires a leap of faith for most leaders to commit to something unfamiliar in the midst of a crisis.

Success with Lean leaders, particularly when change needs to happen fast, requires:

  • Full commitment by the top leadership, communicating frequently, in multiple ways, that this is the way we will be doing business.
  • Education for everyone in the organization about how Lean works, its basis in Respect for People, and its goal to maximize value for all, not simply to cut waste.
  • Redesign of the organization’s management system and culture, empowering those caring for patients, ensuring they have what they need to provide the best care in the best way.
  • Relentless pursuit of transformation, doing what it takes to overcome organizational inertia.

How can we develop Lean leaders, who will become bold, to take this approach?

  • Go and See: Take them to places where Lean works. Bring their teams with them so they learn together. Like all of us, we benefit when we see for ourselves, learn from our peers, and share the experience with our teammates.
  • Coach and mentor: Provide specific guidance early on. Self-discovery is important, but when we need to get to a new destination quickly, providing a detailed map can help avoid a lot of wrong turns and misdirection early in the journey.
  • Start with quick wins: Start with an energy boost. Starting with a revenue cycle value stream often provides rapid ROI with relative ease compared to working on inpatient length of stay. Imaging departments are also high potential areas with opportunity to improve throughput by 50% with simple workflow redesign.
  • Look for pull: Identify early adopters and start there. Trying to push resistors wastes limited resources early on. People will come along when they see good things happen. Always look for those pulling for help.
  • Empower problem solvers: Spread daily management focused on helping caregivers solve their problems quickly. Nothing builds engagement like empowering people to implement their good ideas to make their own lives better.

The pace of change in healthcare is not going to slow down anytime soon. A Lean leader’s ability to align everyone in an organization and empower them to solve problems is a key strategic advantage, because this ability makes an organization better able to adapt to changes in the external environment. And as Darwin said, “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.”


Sharpening the Saw to Prevent Burnout

I hear it all the time, “Doctors don’t have time for huddles or improvement events!” Really??? Have you heard the story of “Sharpening the Saw“? It stresses the importance of taking the time to ensure your tools are at working as well as possible, so that you can be most effective in your work. It’s… Continue Reading

Explaining Lean in Healthcare

One of the more frequent challenges I have is succinctly explaining Lean in Healthcare. May people are either unfamiliar with it, or worse, have had a bad experience with “Lean” – usually done the wrong way. This latter issue is such a problem that in our book, Preventing Physician Burnout, my co-author Diane Shannon and… Continue Reading

Want Physician Engagement? Engage with Physicians!

“How’s your physician engagement?” I’m directing this question to hospital and health system leaders, because they often as for someone like me to help them with it. I’ve been asked many times by the C-suite to help them get their doctors engaged in Lean or other forms of process improvement. What I commonly find is… Continue Reading

The Lean Lifestyle, Personally and Professionally

There are surprising similarities between getting Lean personally (losing weight) and getting Lean organizationally. Both are hard to get started, take a while to show significant results, and require personal change sustained over time. The benefits of both are also significant. Continue Reading

Executives – The Missing Stakeholders in Preventing Burnout

The National Academy of Medicine has launched an Action Collaborative on Clinician Well-Being and Resilience, but there is one missing stakeholder.  Last Friday, July 14th, NAM hosted it’s its first public meeting on establishing clinician well-being as a national priority. The inaugural sponsors include nearly many medical specialty societies, the major insurance companies, the American Associations… Continue Reading

How Does the EHR Drive Burnout?

How does the EHR drive burnout?  Let’s count the ways. By understanding this we can develop counter measures to lower the impact and reduce the risk of physician burnout. We’ve all seen the studies that show that for every hour we spend with a patient we spend two hours on administrative work, and we take… Continue Reading

Filed Under: EHR
Everything Has to Change

“If you want things to stay the same around here, everything has to change.” Richard Carr, an HR expert and Simpler colleague, shared this quote from The Leopard, written by Giuseppe Tomasi di Lampedusa. As described in this Wikipedia post, as the mid-19th Century Italian historical novel progresses, a prince is forced to choose between… Continue Reading

Go to Gemba to Show You Care

As a health care leader, you need to Go to Gemba!  Why? Because 82% of your physicians think that their leaders don’t care about their problems.  (It’s not just healthcare, in pretty much every industry 80-85% of front line workers think that those in the C-suite don’t care enough to offer help to the people… Continue Reading

Start Your Lean Journey With a Sprint!

“A Lean journey is a marathon, not a sprint.” That’s what our Simpler Sensei reminded us of more than once back in 2010 when we embarked on our Lean journey with the 300 physicians of the Sutter Gould Medical Foundation. (Actually, done right, it’s more like a multi-year trek into the wilderness searching for enlightenment. … Continue Reading


Each week for the next six weeks I will post a vignette from our book “Preventing Physician Burnout” that highlights actions leaders take to reduce the impact of physician burnout.  Here is the first, on engaging physicians in strategic planning as a way to connect vision and values… Engaging Physicians in Strategy Located in Washington… Continue Reading