Interesting post by Mark Graban, healthcare LEAN expert, this week - in this post, Mark provides a few examples of hospitals with formal programs to engage staff in identifying cost-savings opportunities. This sounds like common sense, right? Mark points out, however, the barrier to this being a wide-spread strategy:
I’ve heard staff members at many hospitals complain that they’re expected to just show up and do their job — don’t try to make things better, don’t make waves, or you might get branded a “troublemaker.” Sad.
Toyota teaches their employees they have two jobs:
1. Do their work (follow the standardized work)
2. Improve their work (“kaizen”)
Do hospital staff and physicians have the same expectation? When you are expected to help improve how work is done, that’s your outlet for creativity and problem solving, even if your work is being done in a more standardized way. Let’s not be creative in figuring out how to insert a central line — let’s do it in a standardized way and be creative in finding ways that work better and lead to further reductions of infections.
What these hospitals have accomplished is creating a culture where innovation, engagement and collaboration are expected and rewarded. It’s tough to say how one hospital creates such a culture and how another one doesn’t. What we know about Toyota and similar organizations, however, is that they deliberately go about creating that culture.
This includes an approach to talent selection and development that targets these specific behavioral competencies. Michael Hoseus, co-author of the bestseller Toyota Culture, The Heart and Soul of the Toyota Way, notes that, “Most companies miss seeing the blood flow of TPS – the human resource philosophies and strategies that make it work at Toyota.” (Liker and Hoseus, Toyota Culture, the Heart and Soul of the Toyota Way, forward, McGraw-Hill, 2008).
Want to create a workforce that is engaged?
- Do a better job defining the specific behaviors that are needed, at various levels of the organization.
- Build a deliberate selection and promotion process that targets these behaviors.
- Hire managers and supervisors capable of developing and encouraging these behaviors.
For more information, see our vlog topic by Ted Kinney, Ph.D, on the “cultural hourglass” where senior leaders want these behaviors, but front-line managers create the “sad” work environment that Mark talks about above.