Leadership & Process Improvement

I recall, not too long ago, having a conversation with someone in healthcare administration about his career. As we discussed how the latest crisis was effecting the hospital, our conversation settled on these questions:

  • Are you a leader that supports process improvement and innovation?
  • Do you cringe or withdraw when someone says they have a suggestion to make?
  • Are you constantly tabling ideas because the current model works?
  • Do you withhold information from your employees or keep details of decisions close at heart?
  • Are you exhausted by the number of complaints you receive from employees without any true solutions?
  • Do you find yourself thinking “you have no idea” when employees stop you to discuss broken processes?
  • Do people talk more about you than to you?

These are symptoms of ineffective leadership. This isn’t an accusation. We know you did not wake up this morning and think to yourself “I think I will stifle all innovation today”, but that is effectively what is going on. Most often this is something that infiltrates our daily work completely without our awareness. The constant daily struggle to battle the fires of funding, employee vacancies, patient and staff complaints, and more, take a toll on us. What started as managing, growing, and  transforming becomes just holding together. Employees leave, processes break, workarounds build up, and crisis after crisis presents itself. We drown in the water pouring from the dam we have been plugging for years. 

It is a pressure felt by most in leadership and it can result in our leadership becoming completely ineffective. But it does not have to remain that way. There is another way, and it begins with awareness of the problem. Try some (or all) of these:

  • Acknowledge the stress and difficulty of your job. Then, make a list. (I love lists). Put up a board and write down the improvement projects you want to complete. Keep it in front of you, in plain sight, where you can constantly be reminded of what you dream to do, instead of what you have to do. You will be surprised how fast time flies when you are focused on plugging holes in the damn.
  • Block time: Your schedule is ridiculous. You know it. Endless meetings and frequent double bookings find you at one meeting thinking about the next, unable to focus on what is really going on in front of you. Block time on your schedule for two things:
    • Walking; no, not in the garden. Walk the floor. See patients and families. See nurses and physicians working. Feel the pulse of your hospital and remind yourself what it is all about. Lean has a term for it (gemba), but it is not unique to the lean philosophy. Stop relying solely on what others tell you and go see it yourself.
    • Innovation time – call this what you want “improvement time” , “project planning” , “future building” , “process improvement”. You need to block time to listen to innovative ideas. The next time someone stops you with an idea, you should say “I really want to hear this and give you all my attention. I block time for new ideas so let’s fit you into one of those slots!”
  • Recognize innovation and reward it. It takes time to develop new ideas. Encourage employees to reflect on their work and how it can be improved. Convince them that you are there to facilitate their improvement ideas and not to watch them make mistakes.
  • Communicate: 
    • Do not withhold information. Explain the background, the regulations, the difficulties. Yes it takes more time, but sharing allows others to know what you struggle against and what it takes to implement their idea in today’s healthcare environment. This builds appreciation for what you do and shows them you are on their side. Share, teach, and collaborate. 
    • Fight the urge to make “no” the default answer and by all means, don’t treat people like children and say “we’ll see” or “I’ll look into it” if you have no intention of doing so. Change is hard; improvement is time-consuming; stagnation is far easier. Fight against the reflex response to dismiss or ignore. Whether it is spoken or inferred, people know when you are genuine in your interest and response. 
    • Be honest about what it will take and be sure you get back to that person with an answer, even if it is no.  A negative response with an explanation gives them reassurance you tried and explains why it is not possible. It also allows them to problem solve further based on what you explained. No response at all is insulting and tells them they are not valued, their input is not desired, and their opinion is of such little consequence that you do not make time to even reply. It is one of the worst behaviors in leadership and one of the easiest to perform by accident. We get busy, we forget. Make it a priority to respond.
  • Get Organized: You juggle many things, perhaps too many. You have an assistant, your assistant has their own assistant, and you have technology. Calendars, mobile phones, email, texts, and more. Input comes from so many channels and it is difficult to keep up.  Get organized. It makes no difference what list manager, method, tool, or software you use. Use it to help you stay on task and if it doesn’t work, find something different. A good assistant will manage your time better than you will. Your job is too important to be done poorly because of a disorganized approach. 

We need you in your position, and we need you making your hospital better. Patients and staff rely on you. You have the ability to transform your organization. Keep that goal in the forefront.

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