Paul O’Neill on Lean Leadership for Healthcare

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Hat tip to Dan Markovitz for pointing out this excellent post on John Toussaint's blog: “The Key Leadership Behaviors in a Lean Organization?

The post is a letter written by Paul O'Neill answering a question from a hospital leader. Paul O'Neill is a great leader in the patient safety movement and you can listen to my podcast with him here.

The whole letter is worth checking out (and see the rest of the great content on the ThedaCare Center for Healthcare Value website).

One excerpt:

3.    A leader who articulates and establishes aspirational goals for the institution    

By aspiration, we mean goals that are set at the theoretical limit of what is possible.    

For example, zero nosocomial infections, zero medication errors, zero patient falls, zero work place injuries for all employees, zero wasted time spent hunting and fetching, zero duplicative or repair work for things not done correctly the first time, i.e., lab work or imaging studies.    

(Setting goals at theoretical limits sharpens the understanding of the size of the opportunity relative to current performance.  Benchmarking against national averages or even better performers can create the illusion of success or satisfaction with “good enough”.)

O'Neill's words remind me of the great Vince Lombardi, who said:

“Perfection is not attainable, but if we chase perfection we can catch excellence.”

Setting a goal like “zero” is not a target or a mandate or a quota. We don't punish people for not reaching zero defects. As leaders, we inspire them to always work toward that goal for the sake of the patients and for their own professional satisfaction. Leaders and healthcare professionals work together toward this goal. As O'Neill has said previously, zero is the only moral goal to set. Will we get there next year? Maybe not, but time to get going on the improvement.


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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.

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