Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement

Here's another video in the series that Joe Swartz and I shot at Franciscan St. Francis Health back in October. See them all here or via a YouTube playlist.You might remember pharmacy manager Ronda Freije from two previous videos.

Here, she talks about a concept called "Seven Days' Grace." It's a concept that Joe Swartz and I wrote about in Healthcare Kaizen using stories from Franciscan (see excerpts via Google Books).

Today's post is hosted over at LinkedIn, as part of my participation in the LinkedIn Influencers series.The post is titled: "The One Thing Google Should Show When You Search for a Hospital."

It's not about Lean per se, but it's about topics that I hope we'd agree are relevant:

Transparency of quality and patient safety data

Making that data easily available and understandable by patients

Using that data to hopefully make better decisions about where we get care

Hoping that data, transparency, and choice puts positive pressure on every health system to get better.

http://leanblog.org/audio25

In yesterday's blog post ("Safety is always our top priority" - From lip service to daily practice?"), I challenged hospital leaders to back up the "happy talk" with real action and stories about putting safety first. It's easier said than done.I wanted to share a story from Karen Kiel-Rosser, Vice President/Quality Improvement Officer, at Mary Greeley Medical Center in Iowa. MGMC is a KaiNexus customer, they've recently received the "Gold" level recognition in the state Baldrige process, and she's an upcoming podcast guest (to talk about Baldrige).

http://leanblog.org/audio24

It's really easy to make statements like "patient safety is our top priority." That same statement can be applied to hospital staff, as well.Or, it should.

But the "happy talk" (as Pascal Dennis calls it) isn't always followed up by action.

When a hospital executive makes the "safety is always our top priority" statement, is it REALLY true? Is that statement backed up by action and integrity or does it just sound good?

"Accountability" is a word that's easy to throw around in an organization. It's often pretty meaningless (or not well understood). What does it really mean?

http://leanblog.org/audio23

Recently, I've seen many examples where businesses don't pay attention to little details. When you see little things going wrong, it makes you wonder about the more important stuff. One example from healthcare might be this story from the Cleveland Clinic, where patients told the CEO that there were dust balls under the beds in patient rooms. Why don't staff notice these things? Why don't they have better standardized work for cleaning the patient rooms?What are some of the other problems that I've seen just in the past two weeks?

It's a pretty common facilitation technique to do a "plus / delta" discussion at the end of a meeting, exercise, etc.In the plus column go the things that went well, were enjoyable, were helpful, and should repeated.

The "deltas" (which is meant to seem more positive than saying "minuses," I guess) are the things that could be improved upon. A "delta" is a gap between where you are and where you want to be.

After being in the doctor's office for just over an hour, nobody said "let's plus / delta your visit before you go." That never happens in a clinic setting. At best, you might get some sort of survey after the fact. But, the point of a good constructive "plus / delta" discussion is to give immediate feedback to those who might be able to make some improvements.

http://leanblog.org/audio19

This article caught my attention the other day: "Philly VA employees ask for golf shirts in suggestion box for improving veteran care." I hesitate to throw stones, but there are some very predictable dynamics involved here... and I will provide some ideas about a better approach and not just criticize.

I'm planning two different workshops in the coming months:Boston 3/31: "Successful Lean Teams" - Personal Kanban (with Jim Benson) and Kaizen

Indianapolis 4/22-23: On-site Kaizen Workshop at Franciscan St. Francis Health System

It's easy to point fingers at others who don't do what they know they're supposed to do. It's sometimes helpful to be reflective and introspective instead of just trying to figure others out...