Continuous Improvement at UMass Memorial Health
UMass Memorial Health has built a lasting culture of continuous improvement by encouraging thousands of small, frontline-generated ideas, not just large projects. Under CEO Eric Dickson's leadership, teams prioritize ideas with the biggest impact and smallest effort, resulting in 75,000+ implemented improvements. The key lesson: sustainable Kaizen in healthcare comes from believing in people, supporting daily problem-solving, and valuing idea flow–not just financial results.
I was really happy to see this recent blog post from my friend Dr. Eric Dickson, the CEO of UMass Memorial Health System:
Leadership and Continuous Improvement at UMass Memorial Health
More than 75,000 Ideas and Counting!
Update: It's now over 200,000 ideas!
Eric writes:
“Other than seeing patients, huddling with frontline caregivers is my favorite part of this job. The one constant at the huddles is that there are always more ideas coming from the team then there is time to implement, and that's a good thing. I coach the teams to have the courage to prioritize the ideas that will have the biggest impact with the smallest amount of effort.”
Avoiding an “Idea Traffic Jam”
He makes a good point about not only focusing on BIG ideas:
“Some ideas are huge and will take months to accomplish. If you take too many of these on, you will have an idea traffic jam of sorts.”
Why Many Small Ideas Matter More Than a Few Big Ones
Many many small ideas can make a difference, as UMass Memorial has learned, as Eric writes, “… often these ideas are true innovation.”
This kind of idea-rich environment depends on leaders cultivating psychological safety, where people feel safe to speak up, experiment, and learn from small failures as part of daily improvement.
Measuring Continuous Improvement Beyond Financial Impact
It's helpful to count HOW MANY ideas have been implemented, not just a financial impact (something that's NOT reported in Eric's blog post, and I think that's fine):
“To date, we have implemented 78,087 ideas! That's incredible! I don't know of another company in New England that can say they've implemented that many ideas from their frontline teams.”
Leadership Belief as a Foundation for Kaizen
I think it's great how Eric plays the role of encouraging MORE kaizen — stating his belief in people:
“And let's keep the ideas coming. We generally generate 13,000 to 15,000 new ideas a year. Do you think we can exceed that goal and hit 100,000 by the end of fiscal year 2020? My money is on “yes we can”!”
I hope you find this to be inspiring.
More Examples from UMass Memorial's Improvement Journey
Here is a 2014 blog post about his goal of a culture of continuous improvement:
You can also see what I wrote about their work five years ago:
And you can listen to our podcast from earlier this year:
A Culture Built One Idea at a Time
The story from UMass Memorial Health is a powerful reminder that a culture of continuous improvement isn't created through slogans or occasional big initiatives. It's built day by day, idea by idea, when leaders consistently show respect for the people doing the work.
By encouraging many small ideas–not just the “big” ones–leaders signal trust in their teams' judgment and creativity. Counting ideas, celebrating participation, and coaching teams to prioritize wisely all reinforce the belief that improvement is everyone's job, every day.
Just as importantly, sustaining this level of idea flow depends on psychological safety. People need to know that speaking up is welcomed, that not every idea has to be perfect, and that learning matters more than blame. When those conditions are in place, it's no surprise that tens of thousands of improvements can emerge over time.
The lesson for any organization is clear: if you want better results, start by believing in your people–and create the environment where their ideas can turn into action.
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If you’re working to build a culture where people feel safe to speak up, solve problems, and improve every day, I’d be glad to help. Let’s talk about how to strengthen Psychological Safety and Continuous Improvement in your organization.
I feel joy for the ideas being implemented and I feel horror for the small ideas withheld. Small ideas are necessary for the building of your new management system. Coaching staff to focus on big ideas is a concerning message. What will staff do when the big idea is obstructed by many small barriers to implementation?
It sounds like you found a bottleneck for your huddle system. What is the constraint that is preventing the flow of small ideas to implementation? If an idea is small, it doesn’t risk harm or cost money, does staff have the authority to try it while they work? Keep elevating ideas and don’t sacrifice the small for the big.
Thanks for your comment, Steve. I can’t really answer your questions on behalf of UMass. Maybe Dr. Dickson will see this and will reply after I tagged him on social media.
It is great to see this approach being utilized. These small ideas can lead to large impacts down the road, and on occasion can be more successful than large undertakings. I personally have been in positions where I have seen multiple meetings a week built upon addressing smaller ideas, and the opposite where multiple large projects have been occurring at the same time. Thank you for sharing, and it will be very interesting to see the improvements they make to their Kaizen practices going forward to reach that goal of becoming a world class organization.
Number of ideas is a rather unbalanced key metric to focus on and compare to other organizations. It my experience it created a culture of misreporting (to show progress) and submission of completed tasks versus valuable ideas of any size. I guess you really do get more of what you reward. Perhaps balance this more valuable metrics of improvement.
I was asked by somebody at UMass Memorial Health to share this job posting for “a blackbelt in the transformation group.” It’s a “Lean Six Sigma” role, as it’s framed.
Click here to learn more
Here is another blog post from Dr. Dickson’s blog (written by their Chief Quality Officer and Chief Informatics Officer):
“Quality and Patient Safety are Job #1“
They did, by the way, surpass 100,000 ideas:
https://blog.kainexus.com/customer/celebrating-100k-ideas
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