Presented by Dalton Edge Mercer University

1. Lean Hospitals: Improving Quality, Patient Safety, and Employee EngagementMark GrabanCh.11 Engaging and Leading Employees Presented by Dalton Edge Mercer University

2. Improving the Way We Manage • Lean isn’t just about tools • It’s also a distinct management method that guides what we do as managers & how we lead our employees • Lean goes beyond getting through initial project • Create an environment where people want to continually improve • “How are we supposed to change when you are managing the same way?” Dalton Edge

3. What Is a Manger’s Role? • Responsibility to set direction and lead the way • Intrinsic motivation • Strategy Deployment • Gary Kaplan, MD, CEO of Virginia Mason Medical Center • Kaizen methods • Recaptures passion • Intrinsic motivation Dalton Edge

4. How goals & ideas flow up and down in a Lean Organization (pg 242) Dalton Edge

5. Engaging Employees in Change • Leaders try to force change • Engage people that are actually doing the work • Avera Health • CPOE • Involved physicians, nurses, pharmacists, and others before it “went live” Dalton Edge

6. Strategy Deployment • Virginia Mason Medical Center, ThedaCare, Baylor Scott & White Health, and St. Boniface General Hospital • AKA “policy deployment” or hoshin kanri • Aims to create alignment at all levels of organization • Aligned does not mean identical • Not just top-down! Dalton Edge

7. Common Management Problem • Various hospitals across nation seem to have the same problems • Most successful, or most personable nurses to supervisor overnight • Waste of talent Dalton Edge

8. Daily Lean Management System • Successful hospitals implement a daily management system to maintain improvements as well as kaizen • This management system consists of methods that include: • Process audits, or rounding • Performance measures • Daily stand-up meetings, or “huddles” • Kaizen and suggestion management Dalton Edge

9. Process audits, or rounding • Used to ensure standardized work is followed (and that it can be followed) • Observe process • Not to catch employees doing something wrong • Gemba walk • Post results Dalton Edge

10. Performance measures • Ability to measure performance effectively is necessary for CI • Honesty is key • Timely measures give more helpful info than infrequent averages • Posted in high visibility area • Control Charts • SPC Dalton Edge

11. Daily stand-up meetings, or “hudddles” • Daily update and communication meetings • Stand-up format, often where metrics are posted • Keep meetings short (5-10 mins) • Harvard Vanguard Medical Associates • Kenmore Clinic in Boston Dalton Edge

12. Kaizen and suggestion management (pg 260) • Employees’ creativity and thinking are important roles in CI • Toyota Kata Dalton Edge

13. Kaizen and suggestion management con’t • Proper balance between bureaucracy and uncontrolled changes • Kaizen card, or idea card • Follows PDSA cycle • After a suggestion is made, action should be taken ASAP Dalton Edge

14. Lean Lessons (pg 267) • Lean is not just about asking our employees to change; managers need to change their methods as well. • Managers must inspire their employees to take initiative to improve the system, while keeping them aligned with the big picture. • Standardized work applies to managers and how we manage; auditing the standardized work is a form of standardized work. • Employees should know how their processes are performing, but we should not pressure them to improve results by working harder. • Daily, visual metrics are more effective than monthly averages. • Employee ideas and suggestions should be managed in a way that avoids chaos, yet is not bureaucratic. Dalton Edge