Catalysis News http://feed.informer.com/digests/KLQN7YPJZV/feeder Catalysis News Respective post owners and feed distributors Tue, 22 Nov 2016 12:42:09 -0600 Feed Informer http://feed.informer.com/ John Toussaint’s Monthly Reflections – Why Do We Practice Lean Thinking? https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-why-do-we-practice-lean-thinking/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:7ca9d079-ec0f-438b-b6b6-ca6d26732f71 Wed, 12 May 2021 10:41:06 -0500 <p>I have had to answer many people during my career why I should espouse this management philosophy that is so hard to learn. The reason is simple; it saves lives. This has never been more clearly demonstrated than the work we witnessed in Westrand and Johannesburg, South Africa. The results CEOs Gladys Bogoshi and Grey [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-why-do-we-practice-lean-thinking/">John Toussaint&#8217;s Monthly Reflections &#8211; Why Do We Practice Lean Thinking?</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <div>I have had to answer many people during my career why I should espouse this management philosophy that is so hard to learn. The reason is simple; it saves lives. This has never been more clearly demonstrated than the work we witnessed in Westrand and Johannesburg, South Africa. The results CEOs Gladys Bogoshi and Grey Dube achieved are stunning. Maternal mortality dropping 100% in the labor wand at Leratong Hospital. NICU infection rates dropped over 90%, meaning 72 babies were saved year over year from 2017 to 2018. This is in addition to many more lifesaving accomplishments. If you’d like to read more about this <a href="https://createvalue.org/wp-content/uploads/SA-White-Paper-Formatted.pdf" target="_blank" rel="noopener noreferrer">click here</a>.</div> <div> </div> <div>If it works in South Africa, it can work anywhere. Why? South Africa spends 8.2 % of its GDP (the US spends 18.5%) on healthcare, but only 4% on public healthcare. The public system covers some 50 million black South Africans while the other 4.2% of GDP is spent on private healthcare. The majority of the 8 million white South Africans have access to private insurance, private practice physicians and private for-profit hospitals. Most public hospitals are overcrowded, underfunded, and have difficulty serving the needs of the poor black populations. The result are long wait times to see physicians, huge lines to receive medicine, and in some cases very high hospital infection rates that often lead to death.</div> <div> </div> <div>Mr. Dube was tired of problems landing on his desk that he thought others could be solving. He had been in healthcare for 47 years but was burning out. As CEO of the 850-bed Leratong Public Hospital in Johannesburg he had to do something differently or he was going to quit. He was asked by the Member of Executive Council (MEC) in Gauteng in 2016 whether he would like to join the tour of a hospital practicing lean thinking. He had been recently introduced to the method by a professor from Cape Town University, Norman Faull, who headed up Lean Institute Africa. He jumped at the chance to come to Wisconsin to visit Kim Barnas and me because he was curious to see a different way of managing healthcare. Ms. Bogoshi, CEO of Charlotte Maxeke Johannesburg Hospital, one of the largest academic medical center in Johannesburg, was also struggling with problems. There were throughput issues in the AIDs clinic and soaring infections in the NICU. Staffing was thin and people were over-worked. She was also looking for a different way to address the seemingly endless list of problems landing on her desk at her 1200-bed public hospital. She was excited to come to Wisconsin.</div> <div> </div> <div>Both were forever impacted by their visit. They saw a lean management system in action and quickly understood how this could impact their operations in South Africa. Kim and I agreed to work with Norman Faull and the two CEOs virtually. Unbeknownst to us the virtual coaching we would do would be a precursor to how we would end up doing all of our work during the pandemic.</div> <div> </div> <div>We outlined a 13-month <a href="http://www.shingo.org/" target="_blank" rel="noopener noreferrer">Shingo principles-based</a> executive coaching process, which was designed for each of them to apply the learning of a new principle monthly and then practice a behavior related to that principle in their daily work. At the end of the month, they would report back what they were learning and ask us questions. Using a series of video learning materials and chapters in our books they persevered and almost immediately began seeing results.</div> <div> </div> <div>Both commented that the secret sauce was changing their own behavior. Mr. Dube and Ms. Bogoshi are excellent students. Culture is about behaviors and they took to heart our first teaching session regarding leadership behaviors. There are five behavioral traits important to building a culture of continuous improvement. Willingness to change is at the top. We observe whether an executive is willing to change if he/she is practicing the process of self-reflection. Is there a time in the day or week when the executive steps back to deeply understand how their behavior is impacting the staff? Some questions that can help guide this reflection are; what did I do this week that unleashed the creativity of my team or what did I do this week that shut them down? A second trait is humble leadership. This trait is practiced when leaders go to the gemba, whether this is in the emergency room, surgical suite, or anywhere else value is create for patients. Leaders carefully observe the work and ask open-ended questions to understand how the work is performed to understand the barriers staff face. The third trait is curiosity. This is practiced by listening carefully to staff. This must be done in an empathetic way to deeply understand what they are trying to tell you. Executives should never propose ideas until they have listened carefully and understand the current state of the existing work. The fourth trait is perseverance. This is manifested by anointing a “buddy,” someone you trust to give you direct feedback about your behavior. Both CEOs used a buddy every week. The buddy watched whether they were leading in a way that supported and celebrated the work of staff or conversely turned their brains off. Finally, the remaining trait is self-discipline. This is practiced by creating leader standard work, which is focused on creating better customer value. An example would be making sure you have gemba visits on your calendar each week.</div> <div> </div> <div>Ms. Bogoshi and Mr. Dube found leader standard work to be the biggest challenge. Going to the gemba became the mantra and they did that two or three times a week. They shared their <a href="https://createvalue.org/wp-content/uploads/Radar-Chart.pdf" target="_blank" rel="noopener noreferrer">behavioral trait radar chart</a> with their subordinates, and they created an expectation that all managers would focus on the same behaviors. They coached their subordinates on these behaviors and had them review the same video homework we had given them. Ms. Bogoshi said she viewed one of the videos nearly 20 times.</div> <div>The change in the leaders’ behavior led to soaring staff engagement. Most of the ideas that resulted in dramatically lower infection rates and reductions in mortality were proposed and implemented by frontline staff. In one case, a housekeeper became the teacher of the appropriate handwashing technique in the NICU. The doctors learned from a housekeeper. That would not have happened before lean.</div> <div> </div> <div>I am sure you have your own remarkable story about how lean thinking has changed your life and the lives of others. Share it with me at <a href="mailto:john.toussaint@createvalue.org" target="_blank" rel="noopener noreferrer">john.toussaint@createvalue.org</a></div> <div> </div> <h3><strong><a href="https://lp.constantcontactpages.com/su/dSydUhk" target="_blank" rel="noopener">Sign up to get John&#8217;s monthly reflections delivered to your inbox</a></strong></h3> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-why-do-we-practice-lean-thinking/">John Toussaint&#8217;s Monthly Reflections &#8211; Why Do We Practice Lean Thinking?</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> Better Care Teams: A Key Element Of Better Care Plans https://createvalue.org/articles_and_news/better-care-teams-key-element-better-care-plans/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:0e92b771-b118-ba4e-ba3d-cca803401181 Mon, 26 Apr 2021 14:19:18 -0500 <p>Why don’t more leaders embrace the organizational excellence transformation journey? We still live in a fee-for-service environment and there is little incentive for leaders to change their strategy. Team based care is critical to designing care models around patients but team based care is discouraged in the present insurance environment as well.  In this latest [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/better-care-teams-key-element-better-care-plans/">Better Care Teams: A Key Element Of Better Care Plans</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p>Why don’t more leaders embrace the organizational excellence transformation journey? We still live in a fee-for-service environment and there is little incentive for leaders to change their strategy. Team based care is critical to designing care models around patients but team based care is discouraged in the present insurance environment as well.  In this latest Health Affairs article my colleagues and I are proposing a different insurance coverage system. One that supports better care by assuring team based care is both incentivized and required for participation in a new type of insurance plan we describe as the Better Care Plan. </p> <p><a href="https://www.healthaffairs.org/do/10.1377/hblog20210419.485823/full/?utm_medium=email&amp;utm_source=hat&amp;utm_campaign=blog&amp;utm_content=toussaint&amp;utm_source=Newsletter&amp;utm_medium=email&amp;utm_content=A+Key+To+Promoting+Health+Equity+When+Measuring+Care+Quality&amp;utm_campaign=HAT%3A+4-22-21&amp;vgo_ee=Uo6%2Bz%2FB8F%2FYpgIYghJn7Vw1%2FPXNjtJCFRFzm%2B1%2Bm1gg%3D" target="_blank" rel="noopener">Read full article</a></p> <p>&nbsp;</p> <p>&nbsp;</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/better-care-teams-key-element-better-care-plans/">Better Care Teams: A Key Element Of Better Care Plans</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> Podcast, the Lens – 29. Increasing Patient Value by Developing New Care Models https://createvalue.org/articles_and_news/podcast-lens-29-increasing-patient-value-developing-new-care-models/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:342bbb5a-f3ee-68d9-3ebe-2d551d38a408 Wed, 21 Apr 2021 11:43:23 -0500 <p>            On this episode, we are joined by Ted Toussaint, who teaches, writes, and consults on healthcare innovation both independently and with Catalysis. We discuss new care model development. Related Items Pre-Summit workshop Techniques for Patient Discovery: Creating Knowledge that Drives Results Lean Healthcare Transformation Summit White Paper: Designing the Future [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-lens-29-increasing-patient-value-developing-new-care-models/">Podcast, the Lens &#8211; 29. Increasing Patient Value by Developing New Care Models</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p><iframe src="https://anchor.fm/the-lens-by-catalysis/embed/episodes/29--Increasing-Patient-Value-by-Developing-New-Care-Models-ebdmtd" width="400px" height="102px" frameborder="0" scrolling="no"></iframe></p> <div><a href="https://podcasts.apple.com/us/podcast/the-lens/id1498519918?uo=4"><img loading="lazy" class=" wp-image-15447 alignnone" src="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg" alt="" width="253" height="76" srcset="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg 300w, https://createvalue.org/wp-content/uploads/apple-podcasts-1024x308.jpg 1024w, https://createvalue.org/wp-content/uploads/apple-podcasts-768x231.jpg 768w, https://createvalue.org/wp-content/uploads/apple-podcasts-90x27.jpg 90w, https://createvalue.org/wp-content/uploads/apple-podcasts-150x45.jpg 150w, https://createvalue.org/wp-content/uploads/apple-podcasts-250x75.jpg 250w, https://createvalue.org/wp-content/uploads/apple-podcasts.jpg 1129w" sizes="(max-width: 253px) 100vw, 253px" /></a>             <a href="https://open.spotify.com/show/5X3IctwRvIYFKgHCPzGB6f" target="_blank" rel="noopener noreferrer"><img loading="lazy" class=" wp-image-15448 alignnone" src="https://createvalue.org/wp-content/uploads/images-300x83.png" alt="" width="246" height="68" srcset="https://createvalue.org/wp-content/uploads/images-300x83.png 300w, https://createvalue.org/wp-content/uploads/images-90x25.png 90w, https://createvalue.org/wp-content/uploads/images-150x41.png 150w, https://createvalue.org/wp-content/uploads/images-250x69.png 250w, https://createvalue.org/wp-content/uploads/images.png 428w" sizes="(max-width: 246px) 100vw, 246px" /></a></div> <p>On this episode, we are joined by Ted Toussaint, who teaches, writes, and consults on healthcare innovation both independently and with Catalysis. We discuss new care model development.</p> <h3><strong>Related Items</strong></h3> <p>Pre-Summit workshop <a href="https://na.eventscloud.com/website/22834/pre-summit-workshops/#Innovation" target="_blank" rel="noopener">Techniques for Patient Discovery: Creating Knowledge that Drives Results</a></p> <p><a href="https://createvalue.org/summit-usa/" target="_blank" rel="noopener">Lean Healthcare Transformation Summit</a></p> <p>White Paper: <a href="https://createvalue.org/designing-the-future-of-healthcare/" target="_blank" rel="noopener">Designing the Future of Healthcare: A System for New Care Model Development to Drive Breakthrough Results</a></p> <p>Customized <a href="https://createvalue.org/transformation-roadmap/" target="_blank" rel="noopener">Transformation Roadmap</a> Services</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-lens-29-increasing-patient-value-developing-new-care-models/">Podcast, the Lens &#8211; 29. Increasing Patient Value by Developing New Care Models</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> Podcast, The Lens – 28. How Process Improvement Supports Organization Strategy https://createvalue.org/articles_and_news/podcast-the-lens-28-how-process-improvement-supports-organization-strategy/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:a60069ae-e584-b78f-6eae-129ba98b464c Mon, 19 Apr 2021 07:00:02 -0500 <p>            Colby Parrott, Director of Organizational Effectiveness at Vancouver Clinic, joins us to discuss how process improvement supports the strategy of the organization. Aligning the work of the organization with strategy is an integral step in achieving success. Related Items Lean Healthcare Transformation Summit Catalysis Healthcare Value Network Customized Transformation Roadmap Services</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-the-lens-28-how-process-improvement-supports-organization-strategy/">Podcast, The Lens &#8211; 28. How Process Improvement Supports Organization Strategy</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p><iframe src="https://anchor.fm/the-lens-by-catalysis/embed/episodes/28--How-Process-Improvement-Supports-Organization-Strategy-euogmc" width="400px" height="102px" frameborder="0" scrolling="no"></iframe></p> <div><a href="https://podcasts.apple.com/us/podcast/the-lens/id1498519918?uo=4"><img loading="lazy" class=" wp-image-15447 alignnone" src="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg" alt="" width="253" height="76" srcset="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg 300w, https://createvalue.org/wp-content/uploads/apple-podcasts-1024x308.jpg 1024w, https://createvalue.org/wp-content/uploads/apple-podcasts-768x231.jpg 768w, https://createvalue.org/wp-content/uploads/apple-podcasts-90x27.jpg 90w, https://createvalue.org/wp-content/uploads/apple-podcasts-150x45.jpg 150w, https://createvalue.org/wp-content/uploads/apple-podcasts-250x75.jpg 250w, https://createvalue.org/wp-content/uploads/apple-podcasts.jpg 1129w" sizes="(max-width: 253px) 100vw, 253px" /></a>             <a href="https://open.spotify.com/show/5X3IctwRvIYFKgHCPzGB6f" target="_blank" rel="noopener noreferrer"><img loading="lazy" class=" wp-image-15448 alignnone" src="https://createvalue.org/wp-content/uploads/images-300x83.png" alt="" width="246" height="68" srcset="https://createvalue.org/wp-content/uploads/images-300x83.png 300w, https://createvalue.org/wp-content/uploads/images-90x25.png 90w, https://createvalue.org/wp-content/uploads/images-150x41.png 150w, https://createvalue.org/wp-content/uploads/images-250x69.png 250w, https://createvalue.org/wp-content/uploads/images.png 428w" sizes="(max-width: 246px) 100vw, 246px" /></a></div> <p>Colby Parrott, Director of Organizational Effectiveness at Vancouver Clinic, joins us to discuss how process improvement supports the strategy of the organization. Aligning the work of the organization with strategy is an integral step in achieving success.</p> <h3><strong>Related Items</strong></h3> <p><a href="https://createvalue.org/summit-usa/" target="_blank" rel="noopener">Lean Healthcare Transformation Summit</a></p> <p><a href="https://createvalue.org/networks/healthcare-value-network/" target="_blank" rel="noopener">Catalysis Healthcare Value Network</a></p> <p>Customized <a href="https://createvalue.org/transformation-roadmap/" target="_blank" rel="noopener">Transformation Roadmap</a> Services</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-the-lens-28-how-process-improvement-supports-organization-strategy/">Podcast, The Lens &#8211; 28. How Process Improvement Supports Organization Strategy</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> John Toussaint’s Monthly Reflections – If I Were to Lead Another Lean Transformation https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-lead-another-lean-transformation/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:961a48fe-40fd-407b-3938-a0a11058d7dc Wed, 14 Apr 2021 12:10:01 -0500 <p>Over the years I have often been asked what I would do differently if I were to lead another lean transformation. The list is too long to cover in this monthly letter, but I would like to highlight two important learnings that would shape the transformation differently. View this message on Youtube. I would be [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-lead-another-lean-transformation/">John Toussaint&#8217;s Monthly Reflections &#8211; If I Were to Lead Another Lean Transformation</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p>Over the years I have often been asked what I would do differently if I were to lead another lean transformation. The list is too long to cover in this monthly letter, but I would like to highlight two important learnings that would shape the transformation differently. <a href="https://www.youtube.com/watch?v=L8MRT5URA9c&amp;t=3s" target="_blank" rel="noopener">View this message on Youtube</a>.</p> <p>I would be more explicit about what behaviors were expected of me and the executive team. As a team we did not develop the specific behaviors we could all agree to embrace and practice. That was true for the Board of Trustees as well. Behaviors are the glue that holds the culture together. Just as key performance indicators are deployed throughout the organization to measure whether you are winning or losing, key behavioral indicators must also be deployed, and the senior team and board must model those behaviors for the culture to sustain.</p> <p>Deployment has multiple channels. The most powerful is, of course, modeling the way at the Gemba. Leaders leading with humility by asking open-ended questions, listening with empathy, staying on the left side of the A3, and following leader standard work set the stage for sure. But what I have learned is that modeling the way does not go far enough. Leaders also must learn to be coaches. As CEO, I modeled the behavior I was seeking but did not effectively coach my team. This is a gap I see with many senior leaders today. I expected my senior leaders to just “get it” without my help. But if we do not do the hard work of developing our team members it will not happen. The key to success is developing people and leaving capability behind so the culture sustains without you.</p> <p>Coaching is not easy. My colleague and Catalysis board member Kevin McNamara, CEO of TIDI Products LLC, a medical device manufacturer, believes coaching his team is his most important responsibility. The purpose statement of his leader standard work is “to support and equip his leaders.” His management system includes standard work for coaching his executives. This coaching occurs in multiple ways; during catchball sessions of strategy deployment, during recurring weekly one-on-ones specifically designed for personal development, at the Gemba, or during executive leadership meetings. He has developed standard work for Gemba, reflection, and coaching that is transparent to everyone through shared access to OneNote, a virtual Microsoft tool. He and his executives also share their personal development plans in OneNote. Upcoming experiments and commitments from these discussions are captured for review at the next check-in. There is color coding of his week of work in his Outlook calendar which indicates the purpose of each of his interactions. Purple indicates coaching opportunities, and the goal is upwards of 40% of his time should be spent in the purple meetings coaching. This includes planning, preparation, and follow up for these interactions. If the week does not have enough purple, he must study and adjust for the next week.</p> <p>The other important learning that would guide my thinking about transformation is a different focus on customers. We should be delivering the care people really want, not what <u>we</u> think they want. We know too well all the barriers to care people face today. That is why we are trying to address the massive waste with lean thinking. But as the famous system’s thinker Russell Ackoff once opined, “The more efficient you are at doing the wrong thing, the wronger you become. It is much better to do the right thing wronger than the wrong thing righter. If you do the right thing wrong and correct it, you get better.”</p> <p>So how do we know we are doing the right things wrong rather than the wrong things right? We must ask the question; how do we know what our customers’ needs are? The delivery and practice of clinical care has seen many changes related to the pandemic. A physician executive in California said to me “it took us 10 years to get to 10% virtual visits and 10 days to get to 90%.” But then he said, “how are we going to maintain that level and is that what our patients really want?” So how might we figure that out?</p> <p>This is where I made another mistake as CEO. To get feedback we used what I will call gimmicks, such as focus groups. We would invite 30 women to a hosted dinner to tell us what we wanted to hear. We never really got much new knowledge because they all nodded yes when we presented our fully baked solutions. We got closer to the truth when we invited customers to join a value stream analysis or an improvement event but even then, it was thin evidence and not representative of true customer wants.</p> <p>Taking the time to research customer needs in a deep way is really the only way to find out needs. The innovation team at Legacy Health in Portland spent months on face-to-face interviews to understand what people saw as missing from their healthcare experience. Using this information, which included many direct quotes from potential members, they set up some quick experiments to test which new care model concepts people wanted. They will fail quickly and move to the next prototype as learning proceeds. <a href="https://createvalue.org/wp-content/uploads/Designing-the-Future-of-Healthcare-Whitepaper.pdf" target="_blank" rel="noopener">Click here</a> to read our white paper about using customer needs’ research to design new care models.</p> <p>My son Ted did similar research when he worked at Atrius in Boston. He visited frail patients in their homes and heard “I would rather die than go back to the hospital.” That one reflection drove the innovation team to develop a remarkable program, <a href="https://hbr.org/2016/12/how-atrius-health-is-making-the-shift-from-volume-to-value" target="_blank" rel="noopener">Care in Place</a>.</p> <p>My questions for you this week are: What behaviors have you established at the senior leader level to build a culture of continuous improvement? And how do you know what your customers’ (patients, members) needs are? Share your thoughts with me at<strong> </strong><a href="mailto:john.toussaint@createvalue.org" target="_blank" rel="noopener">john.toussaint@createvalue.org</a>. </p> <h3><a href="https://lp.constantcontactpages.com/su/dSydUhk" target="_blank" rel="noopener">Sign up to get John Toussaint&#8217;s Monthly Reflections delivered to your inbox</a></h3> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-lead-another-lean-transformation/">John Toussaint&#8217;s Monthly Reflections &#8211; If I Were to Lead Another Lean Transformation</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p>