Business Management

As manager of Performance Improvement for a 400 bed hospital, I had ten years to focus on pulling the organization together as a team. It was almost a dream world for operational excellence, with an executive staff that was behind the improvement process, the finances to support improvement efforts, and hospital managers and staff who were willing to work hard to learn and apply the right tools. In 1992 the hospital brought in Florida Power and Light's training team to help us build the process, using FP&L staff who had been instrumental in leading that organization to the first Deming Award earned by a U.S. corporation.

Those trainers brought serious tools, including everything from statistical process control to facilitator and team leader skills training. Besides learning these tools myself, 100 of my management colleagues spent close to 30 classroom hours - and countless hours of practical application - developing skills to lead this sort of process. One of our first efforts was to train 35 facilitators to work with the various teams throughout this medical organization. And we followed that by training 1200 staff members in the basics of effective team membership to support the efforts that we expected to grow from this organized approach.

A DESIGN FOR THE PROCESS

At the start, a Design Team was chartered, which included executive and director level staff, as well as hand-picked front line people who were committed to making the whole process work. Every bit of the process was carefully planned, because this was one effort we intended to make successful. Budgets, time allowances, purchase of materials, and even chartering of an oversight department (Performance Improvement) were detailed out, and the likely areas of need were identified for initial efforts. Even a performance-based incentive plan was established, one in which all full-time staff could share the monetary results that we hoped would result from this sort of all-out approach to improving

BUILDING TEAMS TO BUILD SUCCESS

Over the course of those ten years my department saw over 200 teams formed, and conducted an annual PI Olympics which showcased the efforts - and the outcomes - of each of those teams. Those team efforts were broad! We saw functional teams that evaluated the billing and accounting processes, management teams that took on leadership approaches, and dozens of cross-functional clinical teams improving everything from surgical cycle time to patient scheduling and transport. It was an eye-opening experience, and one that resulted not only in many improvements, but also saw employee morale soar, with turnover dropping to match the best in the state. Why was that? Because people love to be involved in a process that is obviously making a difference.

WHY IS SUCH AN APPROACH EFFECTIVE?

Operational excellence, continuous improvement, lean, six sigma, and performance improvement: all have evolved from the same basic approach, starting with the assumption that people working together will accomplish more than any single leader can ever hope to do. To be effective, the approach has to include common goals, goals that leadership has identified as being basic to the success of the organization. The goals have to be obvious to all players, and must emanate from a solid understanding of the needs of the external customers purchasing the services and products of the company.

LEADERSHIP HAS A CRITICAL ROLE

Management must agree to work with one mind toward those goals, and this is more difficult in larger organizations, because it's easy for large departmental or divisional goals to take the place of the highest level goals - those that insure the longevity and success of the organization itself.

Because of this issue, executive leaders have to take the time not only to develop the highest level goals, but also - and most importantly - to "make the connections" between those highest level goals and the activities that produce the supporting results in the various parts of the company. What does this mean? It means thinking through the contribution each department makes to the overall success of the corporate goals. Company staff, even the "lowest level" staff, are intelligent enough to re-aim their efforts for significant improvements IF they understand how their part contributes to the overall success of the corporate goals. Is that connection-planning too much to ask of executives? Believe me, such planning will provide results wildly out of proportion to the time taken for the effort.

RESULTS HAVE TO BE MEASURABLE

Finally, it's relatively easy to build momentum at the front end of an improvement initiative if there is common purpose among leadership and staff. But the process is doomed to failure if the measures for successful results have not been defined. That starts at the highest level, and is followed with careful development of supporting measures down through the whole organization. This isn't rocket science, but it does mean analyzing lower level measures to find which will drive reliable, repeatable improvement of those at the higher, organizational level. Again, why is this so important? Because it connects the efforts of staff to visible improvement - people need to know that their work is making a difference.