Leaders, Leaders, How

Does your Garden Grow?Tools to grow a culture of problem solvers.

Elizabeth Alley MD and Shelly Randazzo MN, RN

Washington State Government Lean Transformation Conference

October 17, 2017

Federal Way Regional Medical CenterOutpatient Surgery Center

Leadership

Team Cohesiveness

Resources and Support

Lean Processes and Methods

Leadership

Traditional Management

Weeding out the “bad” US vs. Them

The courage of leadership

is giving others the chance to succeed

even though you bear the responsibility for getting things done

Leadership

Common Mission

Clear and Transparent

Communication

Common Core Values

Mutual Respect

Complementary Competencies

Dyad Leadership

Team Cohesiveness

Transformational Leaders:

instill the value of commitments to the team

Front Desk GI

OR PACU

Psychological Safety

Encourages speaking up

Enables Clarity of Thought

Supports Positive Conflict

Increases Accountablity

Mitigates Failure

Promotes Innovation

Removes obstacles to

success

Isolation leads to burnout

• The team is safe for intrapersonal risk taking

Team psychological safety

• Questions and reflections

Team learning behavior • Ideas, insights,

solutions

• Put into action

Team performance

Resources and

Support

A person who is appreciated will always do more than expected.

“What is your skin in

the game?”.

Communication

“Drive by”

Helping Hands Drive By

Identifying best place for everyone to grow.

Slow bloomers Producers

Special talents Rewards

Resources and support

Lean Processes

and Methods

VMPS

Daily Kaizen Production Boards

Daily Huddles

Flow Mapping

“Dry Run” Simulation

Highlight performance gaps

Reduce variability

Actively employ

countermeasures

Promotes Teaming

Production board

Promotes Teaming

Highlight performance gaps

Reduce variability

Actively employ countermeasures

Kaizen is continuous

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Daily Huddles

Flow Busters

Role modeling

Planning

Removing barriers

Crunch times

Removing silos

• The team is safe for intrapersonal risk taking

Team psychological safety

• Questions and reflections

Team learning behavior • Ideas, insights,

solutions

• Put into action

Team performance

Visual Controls

Team

Com

munic

ati

on

Invento

ryPro

ducti

on B

oard

Standard Process

PDSA

Huddle

Tools

VMPS Daily Kaizen

How do we do our work?

•Use the PDSA method

Plan-Do-Study-Act

• Continuously test/refine ideas

• Focus on results

Example:

Observation &

Develop a

New Vision

DOACT

PLAN

CHECK

Awareness-

A Change

In Thinking

Observe

and develop

a new vision

Rapid

Implementation

– Give it a try

DOACT

PLAN

STUDY

Study the results

Standard Process

PDSA

Huddle

Tools

Flow Mapping

waste

Information

flow

forms

Information vehicle

Flow Mapping

Behaviors Purpose Leadership skills

Transparency Move from working in silos to collaboration Inspiration and Vision

Sharing Transition from narrow focus to system-focus Inspiration and Vision

Listening to understand Assumption busting and increased knowledge for the

team

Intellectual Stimulation

Coaching/mentoring/

training

Allows for all team members to share stories Individualized Consideration

Respect for People

behaviors

Infusing these core principles throughout all of our

interactions

Idealized Influence

Quality Improvement Intentional checks of key process for deviations

from the identified Standard Work

Individualized Consideration

Dry run simulations

Opening new unit

New procedures

New Processes

Mock Codes

“Best” tools

Leadership

Team Cohesiveness

Resources and Support

Lean Processes and Methods

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Great Barrier Reef

Continuous

Resilience

Leadership

Improvement

Daily

Recommended Reading

http://www.healthcatalyst.com/5-Deming-Principles-For-Healthcare-Process-Improvement

http://www.leanblog.org/2014/07/report-to-president-obama-endorses-lean-systems-engineering-in-healthcare/

Senge, P. The Fifth Discipline The Art and Practice of the Learning Organization. Doubleday 2006.

Scholtes, P. The Leaders Handbook. McGraw-Hill 1998.

Nemeth,C PhD. Et al Minding the Gaps: Creating Resilience in Health Care. http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-

resources/resources/advances-in-patient-safety-2/vol3/Advances-Nemeth_116.pdf

Edmonson, Amy. Teaming, How organizations learn. Wiley, John & Sons, Incorporated 2012

Hu, Q et al. The connection between organizational learning and lean production. POLS 23rd Annual conference. Paper No. 025-0234

http://www2.warwick.ac.uk/fac/soc/economics/staff/eproto/workingpapers/happinessproductivity.p

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