A sustained lean transformation depends on developing key leadership behaviors
Understand that a lean transformation starts at the top; what it means to be an engaged lean leader; understand the ascension paradox of the lean operating system; learn ways to support lean leadership development.
Changing the behaviors of the executive team is one of the most challenging aspects of a lean transformation. This is a paradox as the executive team likely decided to pursue lean in the first place. The challenge is lean management systems require a mindset different from the traditional management by objective system most executives practice. Important strategies are achieved only through understanding capabilities at the frontlines. The executive team needs to show its commitment to the coaching required to change from a more traditional, top-down model to one that emphasizes ‘servant leadership.’ Leaders develop themselves and their workers by humble inquiry: “What problem are we trying to solve?”, “What is the current state of the process leading to this problem?”, “What is your desired future state?”, “How can the organization best help you and your colleagues reach this state?” The other paradox is that leaders desire rapid ascension to higher levels of lean practice. This is a latent problem since the real work is foundational (lean alignment and understanding) which takes time and patience. We have used a variety of means to develop lean leaders: lean pedagogy and learning trips, gemba walks, improvement event participation/sponsorship, working the line, creation of standardized work, goal deployment methods, standardized calendars, use of problem solving and strategic goal A3s and weekly all-hands improvement reports.
Lucile Packard Children’s Hospital is a free-standing 302-bed quaternary teaching hospital owned by Stanford University in Palo Alto, California. It consists of over 3,400 employees and over 1,100 physicians. It is an enterprise that consists of a children’s hospital, multiple outpatient clinics, a primary care and specialty network throughout Northern California, a research institute and affiliations and joint ventures with multiple nearby hospitals. As such, the enterprise is termed Stanford Children’s Health. Patients have come from 48 different states and 20 different countries beyond the United States. The case mix (a marker of severity of illness and complexity) of its patients is the highest in the United States, with over 60 percent of patients visiting one of three intensive care units. The organization has been on a lean journey for 4 years. www.stanfordchildrens.org
Craig T. Albanese, MD, MBA, is vice president of quality and performance improvement at Lucile Packard Children’s Hospital at Stanford University Medical Center. He is responsible for overseeing the children hospital’s lean and quality transformation. Albanese is also a pediatric general surgeon, professor of surgery, and holds the John A. and Cynthia Fry Gunn Directorship of Surgical Services at Lucile Packard Children’s Hospital. He obtained his BS in natural sciences and mathematics from Washington and Lee University. He earned his MD at Downstate Medical Center, subsequently completing his general surgery training at The Mount Sinai Hospital in New York and his pediatric surgery fellowship at the Children’s Hospital of Pittsburgh. Albanese was on the faculty at the University of Pittsburgh followed by the University of California, San Francisco before joining the faculty at Stanford in 2002. In 2008 he earned an MBA from Santa Clara University’s Leavey School of Business. His recently published book, Advanced Lean in Healthcare, earned bestseller status on Amazon.com.
