9 Points (continued)

J. Michael Rona
Principal, Rona Consulting Group
Mercer Island, Washington

This is the second in a series of posts about 9 Points that define the lean heatlh care enterprise:

1. A Compelling Vision
2. Enlightened and Fearless Leadership
3. Values Driven
4. Respect for the Customer and Customer Driven
5. Quality Driven
6. Obsessed with Safety
7. Respect for Staff
8. Continuous Improvement
9. Generate Higher Margins or Create Greater Capability

These nine points help characterize a lean health care organization. When implemented and fully engrained, the organization is transformed. Then it lives the principles of the Toyota Management System and produces perfect products, one at a time, in flow synchronized to the demand of the customer. This is what a lean health care organization looks like and how it behaves.

In the first post in this series, I covered Points 1 and 2. In this post, I cover Point 3 and discuss the value that drive the lean healthcare enterprise.


3. Values Driven

The lean health care enterprise is guided by its values. They are living foundational beliefs, which drive all behavior and become the yardsticks by which the day-to-day conduct of the organization is measured. The primary value is service to the customer. If service to the customer is flagging, then nothing else matters. It is this priority which is essential in understanding the failings of the current state and which drive priorities for improvement.

The second value is teamwork. Lean health care enterprises understand the different value which the broad range of workers in health care bring to the processes of health care but do not let this create a hierarchy of power. It is this hierarchy of power which inhibits freedom by all to work together in a fear free environment and which then diminishes the product for the customer. These organizations recognize the interdependency of all members of the organization and the importance of minimizing traditional power relationships.

The third value is continuous improvement. Lean health care enterprises are never satisfied with the current state. They believe that things can and must improve all the time. They believe in teaching and learning and becoming excellent at every position in the organization. They invest significant resources in training and giving time to their workers to improve processes. They insist on each worker participating in improvement and at least monthly improvement suggestions implemented by each worker for their own processes.

The final value of lean health care enterprises is integrity. These kinds of organizations conduct themselves with the highest level of integrity, which is modeled by the leadership. This principle starts with always doing things that are right from the customer’s perspective and is linked to a commitment to requiring the unvarnished truth about the current state to be publicly stated within the organization and with the organization’s customers. This truth telling is the key to enabling improvement. Without it, the real story is never surfaced, customers are harmed and the workers are burdened with truths that cannot be told. Organizations, which hold integrity as a foundational value, have no fear of public disclosure since they see such things as the truth about the current state and a driver of even more rapid improvement. Truly enlightened lean enterprises willingly “put their defects at the front door” for customers and workers to see to drive improvement and trust.