tag:blogger.com,1999:blog-32053362.post2823856412136309073..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Is Lean persistent?Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-32053362.post-55544408059676859272010-05-31T15:03:20.580-04:002010-05-31T15:03:20.580-04:00Lean is an upside down approach to leadership for ...Lean is an upside down approach to leadership for sure, at least that was its original design. The ways in which these ideas have been taken up in the US corporate (and healthcare) contexts have of course, led to certain cultured appropriations and misappropriations. It is about cultural change, more so than process or design change, and unless those central principles for flow, quality and respect for people are adhered to, we will end up with contract struggles, leadership frailty etc. I follow Mark in that I wish there was more talk of the intangible goods that come from such a shift such as morale, satisfaction, care, wellbeing, pride etc...laurahttp://bit.ly/neeblognoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-61917430226443357942010-05-27T16:35:51.759-04:002010-05-27T16:35:51.759-04:00Mark;
As I read more links about the City of Hope...Mark;<br /><br />As I read more links about the City of Hope debacle, I believe Medical Quack is trying to say it's a poster child for how difficult close cooperation/integration between hospital administrations and physicians will be, going forward. Of course physicians must be an integral part of any Lean initiatives, as they are an indispensable part of the teams. If, however, they see this as imposed on them by administration, their buy-in will never be achieved and any PI efforts will fail.<br />This is why, as Paul has said in other forums, having at least one passionate physician champion along with the CEO is critical to bringing along the medical staff.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-76609753963747616332010-05-27T15:57:59.991-04:002010-05-27T15:57:59.991-04:00That's great about Denver Health, but I'd ...That's great about Denver Health, but I'd hate for anyone to get the idea that lean is only about money or cost savings.<br /><br />I'm sure that Denver Health has had positive results in other elements like safety, quality, patient access, and staff morale.<br /><br />That's certainly the case at ThedaCare and other leading lean hospitals -- a balanced set of improvement measures, not just cost or ROI.<br /><br />Lean isn't traditional cost cutting. Lean is quality improvement that leads to bottom line savings. There's actually a big difference even if that sounds like the same thing...Mark Grabanhttps://www.blogger.com/profile/07953086531083611251noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-53340656879904564572010-05-27T15:40:49.950-04:002010-05-27T15:40:49.950-04:00Many years ago, Joseph Juran defined the "non...Many years ago, Joseph Juran defined the "nondelegable" roles of upper managers. These roles apply to any type of improvement initiative, whether it is lean, six sigma or whatever. These roles still hold true today. When the leaders do their part, breakthrough improvements in performance can be achieved and sustained.Er Ralstonhttps://www.blogger.com/profile/17923013552113173612noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-25607231130821485112010-05-27T13:48:05.358-04:002010-05-27T13:48:05.358-04:00Just left Dr. Pattry Gabow, the CEO at Denver Heal...Just left Dr. Pattry Gabow, the CEO at Denver Health, who has been a leader in using lean to rid processes of waste, and she told me that DH has reached $50M of waste reduced over the last five years. I think she'd say it works with a persistant leadership focus and the great staff at the front line!Maureenhttps://www.blogger.com/profile/11649648364924910937noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-68146350223629504672010-05-26T23:28:46.824-04:002010-05-26T23:28:46.824-04:00I can't figure out what The Medical Quack'...I can't figure out what The Medical Quack's link and that lawsuit has to do with "Lean"...Mark Grabanhttps://www.blogger.com/profile/07953086531083611251noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-7714684321553778902010-05-26T14:43:07.473-04:002010-05-26T14:43:07.473-04:00Flattening of salary structure as a mark of return...Flattening of salary structure as a mark of return to financial sanity and recognition of common enterprise with all employees. This must be a cultural transformation across industries. A few gallant souls ain't gonna do it. This is not at all a knock on you or other CEOs; just a statement about the hideous imbalances that have grown over the last 50 years in most sectors. <br /><br />The Chocolate Factory is always going to change hands. But the wise new CEO will understand that the Oompa-Loompas were there before him or her and will be there long after!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-55115509881903510322010-05-26T14:40:37.702-04:002010-05-26T14:40:37.702-04:00Sounds like you're starting to understand what...Sounds like you're starting to understand what an undertaking a Lean transformation can be. Getting the staff engaged at the start, in my experience, is the easy part. Keeping the management team engaged throughout...not as easy. In my opinion, you're right, though, to focus on the mentality of leadership rather than the tools (observation, value stream maps, A3's, etc.) as you move forward. Anyone can learn the tools of Lean, but becoming a servant culture as you call it, is the more challenging and rewarding part. Good luck.<br /><br />Jimmy UdallJimmyhttps://www.blogger.com/profile/13889086751863790641noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-68535684424421766982010-05-26T12:56:32.816-04:002010-05-26T12:56:32.816-04:00Skeptic must have previously worked at my hospital...Skeptic must have previously worked at my hospital system. (:<br />From my failed experience, I believe the CEO must be consistently relentless at driving and cheerleading the transformation, from the bottom up, imbuing the upper layers of the pyramid with the tenacity to persist through the inevitable difficulties with achieving buy in and implementation.<br /><br />This takes, above all else, absolute passion. The nanosecond that the staff perceives a weakening of the CEO's commitment, entropy sets in; because this is very hard work. Lip service, delegation of support, and passive attendance at meetings just simply do not cut it.<br /><br /> This is a huge commitment for a CEO and is why there are so few nationally known for it, such as Paul, Brent James, Gary Kaplan, and a few others. Only time will tell if their successes will survive their tenure; this will be an important piece of evidence.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-12455822688862280952010-05-26T12:14:40.435-04:002010-05-26T12:14:40.435-04:00I think finding balance is tough these days as the...I think finding balance is tough these days as there are so many more factors that appear that need attention than we had in days past.<br /><br />In California, we have a battle that has erupted over "lean" here with a lawsuit filed by the City of Hope against there own doctors which could stand to set a precedence of how physicians and management work together in the future here and the doctors claim patient care will suffer. It's a long entangled mess of course, but long and short of it is money when it gets down the bottom of the barrel, like everything else. <br /><br />The City of Hope also provides a very active research area with Cancer and of course is just about known nationwide for what they do. The medical group put out a press release which I posted a couple days ago stating their lack of faith in how contracts are being handled at the facility.<br /><br />http://ducknetweb.blogspot.com/2010/05/city-of-hope-files-lawsuit-against.htmlMedical Quackhttps://www.blogger.com/profile/12443589277651479846noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-5188995382111777752010-05-26T10:16:59.598-04:002010-05-26T10:16:59.598-04:00Paul as an admirer of Lean for health care I appre...Paul as an admirer of Lean for health care I appreciate your addressing it in the context of leadership as service and empowerment. Remarkable how a tool that started as a way to reduce manufacturing inefficiencies can be so closely tied to cultural change.Jane Sherwinhttp://www.WordDriveCommunications.comnoreply@blogger.com