I’ve worked as Chief Operating Officer at Indiana Regional Medical Center (IRMC) for 9 years and at the organization for 23. Since summer 2013, we’ve taken a traditional approach to lean transformation. We started by having our leadership learn and begin to use a new leadership and management system.
I had the opportunity to be a key instigator of the senior team starting with daily huddles, one-on-one problem solving, and visualizing results via a balanced scoreboard – then checking those results in weekly and monthly meetings. I’ve led direct reports through this process, and I coach others to lead the same processes with their frontline team members.
When I was first presented with the idea of a lean management system, I jumped into the deep end of the pool because it just made sense. We needed to change the way we led, managed, and interacted with each other, especially with regard to solving problems. But it’s been a challenge leading through this new system because it means learning, leading, and teaching… in short cycles, every day. Most leaders teach from their core training and competency and lead in their area of core competency. For example, a PhD in chemistry can teach chemistry, a manufacturing engineer can teach engineering. But this approach is different. I’m a seasoned COO, but now I’m learning a totally different style of leadership while I’m using it. It’s new to our organization and to me. Leading by learning (and focusing on helping others learn) is humbling, and this is a good thing.
A bit of background. Like many other organizations, for years we were successful at IRMC. But healthcare is changing so rapidly it’s more difficult to be successful now. Leading and managing the same way we always have would be easy; habit is easier than learning and leading a new way. But as leaders, we have a choice: Do we continue with the way we’ve always done things, or do we try a totally different approach? Why continue to use traditional approaches to managing people and work that we learned, say, 30 years ago? What do we have from 30 years ago that works in a completely different world and environment? Doing the same thing over and over again and expecting a different result – we know this is the definition of insanity!
But back to IRMC. When we first started building our lean management system, I didn’t immediately understand all of its components, but I could see its value. This was the first viable alternative I’d seen to just doing more and more, faster and faster. A lean approach to management focuses on teamwork; regular checks (Plan, Do, Check, Act cycles); and problem solving at multiple levels using root cause analysis. It’s not about firefighting or crisis management. Now when I’m engaged in problem solving, I’m more inclined to gather my team to produce a process map, focusing on process rather than faulting people. And I focus on coaching. I was recently invited to attend a department’s “top monthly problem” meeting, the team leader’s first for her area. Since I’ve participated in the senior team’s monthly meeting, and I lead similar meetings with my operational direct reports, I was able to coach, help, and lead this first meeting with her.
What’s next? We’re still changing our framework for how our leaders interact with each other and with staff. I can see that this leadership system is a path through the storm, a multi-year storm that’s ahead of us. Our approach to deploying this new management system has not only showed me and our senior team’s commitment to process, it’s reinforced my knowledge base. I know more now about the real challenges our staff face… exponentially more. And my approach to leadership now is about personal responsibility – each and every employee, each and every patient/customer encounter, each and every day. I used to be goal and results guy… That approach works early on when there is low hanging fruit, but it has limitations. To consistently improve and achieve results, something I’m ultimately responsible for, I need to deeply understand our organizational plans and processes and be actively involved in engaging staff. Am I an expert in all of the lean principles and tools? No. Am I learning? Yes, and it’s making a difference.
In terms of strategy, our board, senior team, middle management, and staff focus on alignment. Together, we identify problems and goals and check and adjust as we continuously seek to solve problems and achieve new goals. One thing I’ve noticed is that this lean management system works regardless of personality or leadership/management style… In fact, it enables all of us to transform our leadership styles and get on the same page. As a result, our strategy deployment process is becoming more and more robust. It’s allowed us to go beyond superficial visions and get to achieving real goals together.
What started as an intuitive decision to try out a lean management system has evolved now into an intelligent choice. And it’s one I trust will take us through the white waters ahead. As a leader, I will continue to learn, lead, and teach. And I will strive to help my team members do the same.
