Characteristics of a successful Leader in a condition Care Setting

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I want you to think about the term Leadership for a moment. If I asked several of you to give your definitions I bet there would be many distinct points of view, some similar, perhaps, but most quite different. Do you envision someone who is strong and demanding with rigid concepts about getting things done? Do you envision someone who is a good listener, who leads by example? I think there are many valid ideas about leadership, and each probably has its place depending on the situation. I want to focus on what kind of leadership is necessary for changing an society into a Lean society or maintaining a Lean organization. The presume I select to do so is that I am a member of a committee that is charged with developing a schedule to aid local physicians and physician organizations couple Lean healthcare with the Wagner lasting Care Model. One of the milestones is to make leadership locally; leadership in capability also came up as the customary identified need in a examine of the local physician organizations.

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When changing an society into a Lean one, the first thing I reconsider is the someone at the top and his characteristics. Without firm retain from this someone the transformation will not be successful and will not endure. In a hospital this would be the Ceo and in a customary care setting, the someone manufacture the major supervision decisions, either the office owner of a physician. One characteristic of this leader should be persistence. Why? Changing the way an society approaches capability requires a cultural change. Such turn will encounter resistance; people tend to resist turn because maintaining the status quo is comfortable. A leader at a hospital, for instance, might after much staff training in Lean tools consequent in getting the front line workers-the nurses, the aides and the doctors--to turn only to have middle supervision sabotage the efforts. Only with persistence can this roadblock be overcome. Persistence mixed with patience and high standards will be necessary because the changes will take a necessary whole of time too. One year for a customary care office to embrace continuous capability correction would not be unusual, either the leader starts small by changing one part of the office at a time or either the staff as a whole is trained and asked to change. By the way, in a November 19, 2007 record in the Wall road Journal persistence along with attention to detail, efficiency, and analytical skills were named as the most prominent skills of successful Ceos.

Attention to detail means recognizing and comprehension how the parts work together.  In order to lead turn successfully this would mean comprehension how distinct members of a capability correction team work together.  Do they complement each other?  Do they clash?  The leader is responsible for integrating such a team.  besides comprehension team dynamics, a leader must understand how the distinct parts of the healthcare site function.  Does the retain staff or supervision complement the clinical?  For instance, is billing efficient?  If not, this has negative consequences in providing clinical care.

Efficiency in capability correction cycles means comprehension where waste exits in an society and also comprehension how to utilize staff ideas to eliminate these wastes.  For example, in a customary care site a leader should have a clear picture of how to sacrifice the time spent seeing for misplaced patient histories, if paper histories are still being used.  Of course, if electronic health records are being used, this problem would be largely obviated.

A fourth skill very necessary for strong capability correction leadership is analytical skills.  A leader should be able to weigh the cost of a capability correction effort versus the return on investment.  Rarely are the success or failure of a capability correction effort tracked in terms of cost and savings.  Focusing only on patient health means that sustainability is ignored.  With the increase of competition in health care and the arrival of bundling of cost for services in Medicare the financial factor cannot be ignored.

Besides these four characteristics the leader guiding the Lean transformation must also understand some of the basic tools of Lean-process mapping, kaizen events, 5S and voice of the customer, among others. I don't think that the leader needs to be the master of these; rather she should be able to identify their spoton application and through her foresight of a capability society see that these tools are implemented and the results communicated throughout the organization. One situation, for instance, in which the leader makes sure the tools are implemented correctly is by appointing people with Lean skills to teams; this team might be defining new processes to deal with diabetes patients in a customary care setting. She should be able to go for an able leader for this team and see that the ideas generated are sorted and disseminated with the best ones implemented. Once the process is implemented the leader should have the impact measured and if the impact is unavoidable have the process maintained in spite of base roadblocks such as resistance from those who want to pronounce the status quo, as mentioned above.

In order for a leader to become familiar (not an master though) with these tools several approaches are possible. There are many conferences and trainings for lean supervision ready in healthcare. The American community of capability offers such. Another approach is to covenant with a advisor who is familiar with both healthcare and Lean techniques. Whatever the approach-workshops, conferences, online training or hiring of a consultant--I think it a good idea to consequent up these with a reference text such as A Lean Guide to Transforming Healthcare by Thomas Zidel.

Lest you think that I miss the mark with my characterization of a Lean leader, let me enumerate one last story. Jaimie Houghton was the Ceo of Corning Glass and implemented Total capability supervision in the early 90's to Corning. He spent a great deal of time traveling to Corning's units worldwide to drive his foresight of a capability organization. In 1995 one of Corning's units received the Malcolm Baldrige National capability Award. Mr. Houghton retired the next year after successfully imbedding Tqm in Corning. His successor, however, did not have the passion for capability that Mr. Houghton had. The programs were not abandoned but other priorities and visions preempted Mr. Houghton's legacy. The consequent was that sales dropped dramatically and the stock price fell from 3 to as low as .10. In 2002 Mr. Houghton was coaxed out of resignation to rescue this failing giant. This time, Mr. Houghton instituted capability using Lean and Six Sigma. He made sure that the programs would endure after he left again. Although the share price is considerably below the high of 3 of former years, the business leads its competitors considerably in market value. Much of this is attributable to the persistence of Mr. Houghton in ingraining recognized capability approaches into the company.

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