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Lean Healthcare Review |
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Resources:
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Improving Quality, Time and Cost in Health Care: The Three Wins |
Barriers to Process Changes within Organizations:Considerations for Implementing Lean Healthcare |
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Organizations are often very good at planning strategy. The challenge comes in moving from strategy to execution. Execution involves a series of changes -- the result of people doing things differently over a period of time. How well an organization succeeds in implementing process changes depends on how effective it is in maneuvering through the resistance of its employees. Strategy is not something that can be cast over an organization like a big net. Strategy involves asking people to change in some way, and many times people will resist.
In the course of my work with different organizations over the years, I have seen a lot of strategies fail. People undertook very good planning, they had a good sense of direction, and they knew what needed to be done. But often they couldn’t move to sustained efficient and effective action. Since all of the strategies had improvement of performance as a goal, this meant employees had to change the way they worked. What I found as I revisited each of these organizations and studied why strategies failed was a simple fact: the same barriers stood in the way of implementing action.
These barriers are the emotional and social characteristics that exist in the workplace. If these barriers aren’t examined and new skills developed, most change initiatives will fail over the long haul. No matter how beautiful the strategy – Lean Healthcare, for example – unless people’s ‘guts’ are in alignment, nothing will be sustainable. This is what Howard Gardner in his book, Changing Minds, speaks of as “resonance.” (Harvard Business School Press, 2004) The basic barriers are pretty clear -personality and work habits; communication patterns; people’s approach to |
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conflict; lack of effective feedback skills; and fear of both data and the change involved.
Let’s look at Lean Healthcare as an example. Basically, Lean is a systematic approach to identifying and eliminating waste or non-value-added activities through continuous improvement. The key focus of Lean Thinking is identifying the value of any given process by distinguishing value-added steps from non-value-added steps, and eliminating waste so that eventually every step adds value to that process. In effect, Lean is a series of process changes.
When Lean implementation begins in healthcare, people say, “That’s for manufacturing, we don’t make widgets. We care for people.” Or they hear the word “Lean” and immediately think that employees will be laid off. Competitiveness between departments increases. This creates conflict which can bring out the worst in everyone. People stop talking to one another and stop sharing information. Employees don’t ask for constructive feedback about their work and they don’t make necessary improvements. The culture is fearful and the last thing people want is data about the results that they are getting. To avoid these scenarios, organizations need to pay attention to their employees’ social and emotional skills. There are a variety of tools available to help people develop the skills to productively manage these difficult transitions. For example, there are personality trait surveys, conflict management techniques, communication strategies, feedback process |
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team models and development exercises. People need education and training to use these tools to their best advantage.
They will then be able to :
· Apply group processing techniques to facilitate buy-in and change behaviors
· Leverage emotional intelligence to smooth change and transition
· Effectively handle difficult conversations in high stakes situations
· Deliver constructive feedback and improve organizational morale
All of this requires the appropriate education, training, time, and practice.
In order to change, employees need help getting unstuck. They need to move through the established norms and values to a new place where the motivation for change outweighs the fears. Removing the barriers improves the likelihood of a successful implementation.
Carol Buchdahl, RN, M.A. Manager: Organizational Learning and Leadership Development Technology Extension Division – Community College Vermont, 05154, USA |
