I'm teaching a daylong class on Lean healthcare today in San Antonio. It's something I've done twice a year for the past four years or so. My day here is part of a six-month program for healthcare professionals and different methods for improving patient safety and clinical effectiveness.
There's only so much you can accomplish in a classroom setting, as opposed to learning by doing. The participants, which are typically doctors, nurses, and various health system leaders, are all part of a project team that's trying to improve outcomes for patients.
I'll be using a number of exercises to allow people to learn and practice Kaizen or continuous improvement methods. I'm also going to be using my version of the Deming Red Bead experiment.
But as we discuss these topics, it gets me wondering about how much impact a project can have. The staff and leaders in the room probably aren't at a high enough level to really influence the culture and management system. Why do executives send relatively low-level staff (no offense to them) for education like this instead of coming and bringing other executives with them?
As Toyota's Jamie Bonini says, the philosophy of Lean and the Toyota Production System matters a lot:
Dr. Deming said quality starts in the boardroom… that's true in healthcare, right?
No offense is meant to the people who are in the class. They're all smart people who are capable of improving something in their work. But will their local efforts and small projects transform their organizations?
The other day, Facebook reminded me of this blog post from four years ago this week:
As I wrote:
“I recently gave a lecture at a hospital that had hired two engineers from Toyota. The engineers were very sharp and they seemed to be effectively making the transition into healthcare. But, two engineers, no matter how good they are and what their backgrounds are, can't save an organization of 5,000 people if the leaders aren't on board.
In the class I taught, there were about 20 nurses and front-line staff, including a few charge nurses. The higher-level managers who had been invited all had a reason to skip out and not attend – apparently, there was some fire to fight (isn't there always?) and their attendance was apparently not mandatory.”
I'm happy to spend a day teaching Lean to people who are interested. But, I can't wonder if we're educating the right people to really make a meaningful and sustainable impact in healthcare?
As I asked in the post in 2013:
“Why are we teaching front-line staff about Lean when their leaders are not participating in the learning?”
What do you think? Is it a case of “all education is beneficial?” or should we wonder why executives think they can delegate culture change and their safety/quality results?
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