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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