When I’m speaking with central improvement office teams about Patient-Centered Strategy: A Learning System for Better Care I’m often asked, “This makes so much sense to me, but how do I get the senior leadership team to do this?” This captures a common frustration among improvement professionals Many tell me things like “my senior leaders say they support lean, but they don’t model the principles and behaviors that embed lean thinking in the organization.”
I feel their pain because I was a poster child as a senior leader who thought he supported lean, but my actions did not encourage lean thinking in the functions that I was responsible for. It wasn’t until my colleague and organizational lean leader, John Poole, helped me take the leap of faith that thinking and acting differently would make my teammates more effective, create capacity for me to do more important work, and become a better leader. And he started with something near and dear to my heart, the strategic management process.
I’m a believer that there is no better place to teach senior leaders how to model the principles and behaviors of lean thinking than the strategic management process. It connects them to caregivers through the common language of scientific problem-solving; Plan-Do-Study-Adjust. Strategic planning and deployment are a connected, continuous process where your leadership collectively understands the organization’s current market position compared to the vision (or ideal state), identifies why it thinks the gap exists and what strategies might close the gap. There is no such thing as perfect information, so the outcome of those strategies is uncertain. Therefore, the deployment of those strategies is accomplished through a series of rapid learning loops; winning with customers results from focus and speed of learning. This is pure PDSA thinking, applied to the most important strategic issues facing the organization.
Empathize with the senior leader
So why is it so hard to convince people like me that this new way of thinking is better than my old mental model and the system that it created? Let’s take our own medicine and apply some PDSA thinking to this problem!
Remember that senior leaders in healthcare systems are, in the words of our lay board members, running the most complex organizations in the most complex industry they have ever seen. There are many stakeholders presenting different expectations to the CEO; and asking the CEO to solve these problems immediately. Those who solve the most problems and the biggest problems become the heroes. This is the mental model that most leaders were trained in is still the one predominately rewarded. Unfortunately, these leaders are finding out that the old way of thinking and acting isn’t working anymore. And therein lies the opportunity and the pull for you, the improvement leader, to help.
Start small while thinking big
Our hypothesis is that applying PDSA thinking to strategic management will provide focus and accelerate learning, creating greater customer value and better organizational performance. What must be true for our hypothesis to be proven correct is that senior leaders will believe that these principles, behaviors, systems, and tools will that we learn from other industries will work in healthcare better than what they have been using.
This is where the experimentation comes in. Start with a minimum viable solution and run small experiments, building out your strategic management system using rapid learning loops. Start with a service line or operating unit that needs breakthrough performance. Introduce visual management and leader standard work that enables the leader to experience strategic agility through increased focus. Figure out what works and what doesn’t so you can spread to other operations as you learn.
Stay focused on the end game
One of the best examples I’ve seen of “what good looks like” was on a recent visit to New Hanover Regional Medical Center, a Catalysis Healthcare Value Network member based in Wilmington, NC. The senior leadership team showed us their visual management system and leader standard work for developing, deploying, and managing strategy. More important, the senior leaders talked about their personal journey; the emotional challenge of believing that changing how they did their work would inspire the rest of the organization to change how they did theirs. Their humility and candor left a deep impression on me. When my son who lives in Wilmington required emergency surgery, I had complete confidence in their care. When Hurricane Florence was bearing down on Wilmington in September, I followed their website because I knew they would help the community prepare.
How do you help senior leaders like me who think they get it, but don’t get it? Start small with a senior leader who has a big problem or opportunity to solve. Help them see that this way to managing strategy is superior to their old way because it creates focus and accelerates learning, resulting in more capacity for that senior leader to tackle more strategic issues. They will learn, as I did, that modeling these behaviors creates trust with their direct reports that they will have the freedom to create customer value through patient-centered strategy!
Jeff Hunter, Faculty
Learn more about Jeff Hunter’s work at: jeffhunterstrategy.com
Patient-Centered Strategy, by Jeff Hunter
White paper: Where’s the Strategy in Strategy Deployment?