Why aren’t we seeing more CEO engagement in lean healthcare transformations?
It’s a matter of the CEOs themselves being hesitant to get involved in the transformations, for a couple of reasons. I've seen it many, many times. One, they may have a misperception of what lean is, i.e. them thinking, “Oh, it’s just some more improvement tools. The lean office can handle that.” The other reason is a misperception of their role in the implementation and long-term sustainment of lean - executive participation isn't an option. CEOs are needed to sustain improvements and drive further improvements. Both of those reasons lead to CEOs distancing themselves from a transformation.
Healthcare certainly has unique challenges that one might not encounter in other industries. Would you say this plays a role in the lack of lean engagement from CEOs?
Sure. There are so many pressures and changes in healthcare in general that it’s very easy to be pulled away to the next burning issue. Unfortunately, when this happens they distance themselves from the hard work of leading a transformational change…which is a daunting task, to say the least.
What would a healthcare organization without CEO engagement look like? What would the problems with the operational side of things look like?
You’ll see some initial successes on rapid improvement projects. The tools are taught to a unit or to a team and they attack a project. They do it and they’ll have success for six months, a year, 18 months. The senior leadership team is looking at these projects and is very happy to see the success, thinking, “Gosh, this is great! Continue to do more. Go faster.”
And then two years later on you’ll think, “Gee, what happened to those projects that that looked so successful two years ago? We can’t seem to sustain the results.” You cannot sustain results because without your CEO involved, there was never a management system set up to support the wins and keep the improvement efforts moving forward.
Now in contrast, what would a lean organization with an engaged CEO engaged look like? What advantages would it hold over the organization without the CEO involved?
The organization with full CEO engagement has a developed leadership team that understands its role as lean leaders. They have received their own development and training as lean leaders to the point they can confidently help train others, the people that report to them. Then the people that report to them go down a level and train their own direct reports, and so on. You have this whole sustained process and thinking system to continual development of people and focus on your strategies and how you’re going to achieve the desired results.
Those are the two biggest differences. For one, you have the alignment. Two, the senior leaders know their function as the role models. Others will learn how to conduct themselves on a daily basis to stay focused and continually improve.
What advice would you offer a lean coach who notices this hesitation in his or her own CEO?
To be very clear and upfront with the CEO about his or her role in the transformation. Emphasize less about the tools and more about their development as a lean leader; i.e., there will be a lot of change in the way they lead. It’s not an easy message to deliver. But development is really what it’s all about. Focus more on the development of the CEO than anything else and help them understand why it’s so important.