Adventures in #Lean Healthcare Hiring, Part 1 Observe the process, but don't talk to people?
I'm not looking for a traditional, full-time job, but a lot of job postings cross my path, as people are looking for referrals. A lot of what I see makes me shake my head, such as a job posting for “Lean” that requires a “Six Sigma Black Belt.” There's a lot of confusion.
Yes, part of our job, as experienced Lean practitioners, is to help the confused, but when they don't ask for help (or don't accept feedback), it gets frustrating.
Don't Talk to Them!
A reader of Lean Hospitals reached out me for some advice in their interviewing process for a health system on the west coast. I don't have the job posting (and can't find it on their website), but he was emailing me about something in the interviewing process that concerned him (and it struck me as very odd too).
I know what organization it is, but I'd rather not name names. I did a Google search using some phrases from what he sent me and that doesn't find any public document or page online. This health system's text is in italics. My comments will be non-italics and indented.
You have been asked to do a preliminary assessment of a process in an area new to performance improvement.
You will have approximately two hours to observe the process and prepare for a report-out to the team. The report-out will be to actual Quality Management staff portraying members of the process team.
- One person will be the director
- One person will be the manager
- One person will be a front line staff person
- Other individuals may be present but will be silent observers during the presentation
So we have role playing? I wonder if the ability to do effective role playing was part of their job description? Did they need to go through simulated role playing during their interviewing process?
You will have up to 40 minutes to facilitate your report-out with the team. You will have no prep time in the room.
- Agenda for the report-out
- A visual of the process
- Assessment of current state
- Teaching on an improvement concept that relates to the process
- Issues and improvement opportunities you saw
- Recommendations and next steps
At the start of the exercise, you will be escorted to a nearby area to begin your observations of the process. Please avoid interacting with staff, customers, and patients while observing.
This really has me scratching my head.
For one, I'm uncomfortable with the model of a solo lone wolf “P.I person” assessing a process. What about respecting and involving the people who do the work?
In Lean Hospitals, Chapter 4 is about process observation. When I worked for ValuMetrix Services when it was part of J&J, consultants like me would often be sent in, alone, for a day or two, to try to do an initial assessment of a department or value stream.
More ideal is the consulting teaching staff members and managers how to observe and study their own processes, on more of a peer-to-peer basis. This is respectful AND more effective. For example, it's easier for me to teach and coach a nurse on process observation, allowing the nurse to then combine their domain expertise with Lean and basic industrial engineering methods. My role as coach was to be “fresh eyes” and maybe help challenge things they would take for granted as an insider.
During an assessment, I'd have to work alone because the organization had not yet made the commitment to the Lean improvement process, which in our work meant dedicating time for staff to study their process and to work on improvement (in projects like this one or this one). It wasn't ideal, but it was start.
But, you know what I did to help make sure I wasn't making a faulty assessment or jumping to conclusions about anything?
I talked to staff, customers, and patients!!!!!
Their input and perspective was CRITICAL. Now, there's a time and a place for this interaction. You have to be discrete and polite. You have to not get in the way of work. I wouldn't barge into an exam room and I wouldn't interrupt, say, a nurse who is doing medication administration (because interruptions increase errors).
I don't understand why a hiring exercise that's being used to evaluate a job candidate would specifically say DO NOT TALK TO PEOPLE.
I don't understand how that's a helpful application assessment exercise and I don't understand how that's a helpful method once the person is hired.
The work and the process to be observed in healthcare is not a repetitive assembly line cycle, with somebody doing the same work every 45 seconds. Even in that sort of manufacturing environment, wouldn't it be respectful to, at some point, talk to the employee to get their input or to ask them questions?
Any necessary supplies for your observations will be available, including:
- For your report-out, please use only the following, which will be provided:
- dry-erase board & markers
- pen & paper
The candidate said they were uncomfortable with the stopwatch. Yeah, I would be too. That sounds like old-school industrial engineering. That's perfect that they will also have a clipboard… that completes the “time study man” stereotype from back in the day.
What, no pocket protector???
Laptops, tablets, etc… will not be permitted.
I'll be the stereotypical Lean person and ask, “Why? Why no devices?”
What's the “etc.” here? If I were having to time a process, you know what I'd use that would be more discrete and maybe less off putting than a stopwatch? My iPhone.
That said, timing a process has to be done respectfully. I'd make sure people in the area knew what I was observing and measuring – and why.
That means TALKING TO PEOPLE, not sneaking around with a stopwatch.
After your report-out is complete, we will open up to the whole interview team to ask any questions about the exercise, and then transition to a traditional interview.
Time study isn't bad… but it should be done in a respectful way, as I blogged about here:
Have you seen an organization use some sort of “process observation” scenario as part of the hiring process? What do you think about that, or process observation in general? Do you talk to people? What methods have you found to be most effective?
I'll probably write another post for next week about a healthcare systems “senior process improvement director” role that also had me scratching my head for a dozen reasons or so… I'll expand upon this discussion that's taking place on my LinkedIn post from yesterday.
Here is Part 2:
Check it out…