9 Points

J. Michael Rona
Principal, Rona Consulting Group
Mercer Island, Washington U.S.A.

The definition of a lean health care enterprise would be a health care system, which had in every manner patterned its management philosophy and system after the Toyota Management System. It would have the following characteristics upon close examination:

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.

Below I describe each of the 9 Points in detail:

1. A Compelling Vision

A clear and compelling vision is the critical starting point for any organization, but in particular for an organization that is pursuing a transformation. The question is transformation to what and why? The vision is a short and concise statement of what it is that the organization strives to be. By definition it declares a gap between the current state of the organization and its desired future state. The vision must be inspirational and a statement of aspiration. It must be a long view that would be welcomed by its customers and embraced by its people. It is a statement of quantum change and one that when achieved creates a major point of differentiation in the marketplace and pride for the organization’s workers.

2. Enlightened and Fearless Leadership

The lean healthcare enterprise is led by leaders who think very differently from the mainstream of health care leaders. They think first of the vision and have a clear sense of the future state. They understand that the key to transformation is a change in the management philosophy of the organization. They are unafraid of abandoning the current management paradigm and are comfortable with the uncertainty and ambiguity that exists in the transition from the current ways to the future way. They change themselves first and demonstrate the new way and are absolutely understanding but rigorously intolerant of individual managers defaulting to old ways. These leaders understand the changing of the mind of management that is occurring and help the transition by connecting the turmoil of change to the possibilities of the new way.

These leaders are passionate for the customers and constantly bring the voice and mind of the customer into the daily management of the organization. They are impatient with the traditional pace of management and relentlessly push for improvement. They are constant on the themes of change and what the new paradigm will bring. They have a deep knowledge and understanding of the new management process and philosophy. They have a constant view on the long term. They are unyielding in their belief in zero defects and the elimination of waste. They leave their offices and go to the “shop floor” to see with their own eyes the state of processes that are burdening their workers. And, they change things quickly.

I will describe Points 3 through 9 in posts to follow....