Back in September, I wrote about our most recent “Lean Coffee” gathering in San Antonio, where people from different healthcare organizations talked about their improvement efforts.
As part of my visit to The Netherlands this week, Marc Rouppe van der Voort (pictured below with me), arranged a gathering of healthcare improvement professionals who participate in their national Lean healthcare collaborative network.
Being a group of ten people with shared interests, we decided to facilitate our discussion in the “Lean Coffee” format. Pictured above is our board as it looked when it was completed. We talked about five different topics that the group proposed and voted on… for either six minutes or 12 minutes depending on the group’s mood and willingness to continue.
As I also saw and heard during my three hospital visits (“gemba walks”), the types of challenges people face and the questions they ask are VERY similar to what people are asking and talking about in San Antonio, across the U.S. and Canada.
What “Lean Coffee” topics did we discuss here in Holland?
- Changing to Lean leadership from old management practices
- How do we motivate people to improve?
- How does “kata” or other small improvements (kaizen) lead to measurable results?
- Using visual management to improve, how do we introduce it?
- “Our CEO supports Lean” – what should that mean?
For topic #2, I posed that in a provocative way, also asking “can we motivate people or can we just get out of their way, assuming they already want to improve?” I think it’s better to think about creating an environment where Kaizen can happen — doing things (or NOT doing things) that encourage improvement rather than feeling like we have to force it.
I had also proposed topic #5 and we had great discussion. What does “support Lean” mean from a CEO? That they tolerate Lean’s existence? That they say good things about Lean? That they hire a Lean department? Or does it mean they play a very active role in modeling Lean leadership behaviors and concepts, directly participating and leading Lean?
Topics that were proposed but NOT selected were:
- Let the doctor connect with patients… how does Lean apply in the exam room?
- Shingo Prize adapted to Dutch healthcare?
- Does Lean work “bottom up?”
- How to connect initiatives?
- Are “quality circles” an underutilized approach?
- Culture or Tools (or both)?
- How to spark a Lean culture?
- How to keep focus on patients during times of financial pressure?
- Push vs Pull application of Lean (how to create “pull for Lean?”)
Hospitals here are certainly facing financial challenges. Healthcare is too large a piece of the Dutch GDP (12%+) and it’s increasing too fast. Hospitals have laid off employees to try to address the pressures on their payments. Patient volumes are lower as people have to pay a larger share of healthcare expenses under their new insurance plans (mainly private insurance, like the U.S., but all non-profit, unlike the U.S.).
The high-level challenges seem familiar, eh?
The detailed operational challenges are extremely familiar too.
The good news is that we can learn from each other instead of focusing more on how we’re different…
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