Lean classics worth a second look

I am a lean leader and always willing to share my learnings. I’ve written several blog posts chronicling my lean experience at different organizations. Some of them have been quite popular with readers. I’ll call them my canstockphoto19155139“lean classics”. Here’s a recap for your reference:

Huddles and Visual Management:

Leadership huddles: not just another meeting – describes my first IT leadership huddle launch back at University of Michigan Health System. As my lean coach said at the time, be willing to experiment, it doesn’t have to be perfect. We learned and tweaked it as we went through the PDCA cycle.

Making the invisible visible – describes the beginning stages of the visual board our IT leadership team created at University Hospitals in Cleveland.

Making the invisible visible – part 2 – describes that same effort several months after we launched it and how we used it as a team.

6 tips for successful huddle boards – based on experience, my advice to those considering their own huddle boards. Remember, you need to be willing to experiment.

Gemba Walks:

Importance of rounding or going to the “gemba” – describes early experience with clinical and operational rounding both at Brigham and Women’s Hospital and University of Michigan Health System. Continue reading

The power of co-location

There continues to be a lot of focus on telecommuting and open office space for knowledge workers in large organizations. Both are important yet not everyone agrees they are good – a lot depends on the canstockphoto12582566 for colocationorganization and the culture.

But I want to focus on another “space planning” topic, co-location. As health care organizations grow, administrative departments including IT often end up being spread out in many office buildings, sometimes at great distances from the hospital with a lot of traffic in between.

The investment needed to centralize all the administrative functions in one building often takes backseat to investing capital in clinical space. No surprise. Video conferencing is always an option for bridging the miles. This technology continues to advance and become more of a commodity. National and global companies must leverage technology but health care systems are mostly local or regional.

In my many years of health IT management, I’ve experienced a variety of space situations: Continue reading

One of those weeks…

People often ask me how I find time to write a weekly blog with a big, busy CIO job. I tell them all the same thing – it’s a discipline. I try to start early in the week with an idea, draft it one night, come back to itcanstockphoto6248723 the next night to finalize and then post it on Thursday or Friday morning. Topics are often timely; something strikes me and I tell myself “that will blog”. I add the idea to my running list. This week it included tips on doing presentations for executive groups, personal organization challenges and tips, and what’s possible to accomplish as an interim leader in just 6 months.

But this week I had as many as five new ideas but no time to start writing any of them. By Thursday night if I haven’t settled on a topic and started, I’m in trouble. Taking time to write may compete with critical work I need to finish up by the end of the week. This week was one of those weeks.

This week started out with a bang.  By 9AM Monday, I was juggling 4 different issues. Continue reading

Teamwork at its best

If you are an IT professional supporting major production environments and applications, you have most likely experienced a significant system outage at some point. We had one of those events thiscanstockphoto16328410 week. As in previous experiences in other organizations, I saw people at their best come together as a team working diligently to restore systems. This team included IT, clinical and operations staff.

I know CIO colleagues who recently managed through a week long outage of their business systems in one case and a multiple day outage of their electronic health record in another. They could probably share similar lessons following those experiences. 

In the spirit of teaching and learning from one another, I offer these key points if you have a significant event: Continue reading

What upgrade?

This past weekend we did another major upgrade – this time the ambulatory EMR. It went extremely well and was met with smiles and kudos from our senior executives. While we’ve done several major upgrades canstockphoto13469755recently including revenue cycle and acute EMR, this one had a lot of eyes on it. Those same senior executives have been rightly concerned about the performance of our ambulatory EMR while we worked through some significant issues during the past several months, including software, hardware and infrastructure. So, kudos to the team that turned the corner on those issues and pulled off a very successful upgrade with minimal issues and disruption to our physician providers and operational practice teams.

We called our 200+ physician practices before the upgrade to make sure they felt prepared.  A few actually said “what upgrade?”. Apparently they had not read the any of the advance communications. So we worked with each of them to make sure they were ready.

The command center was open all week and will close early today as we have fewer and fewer calls.  Over 62% of the reported issues had been resolved as of late yesterday. Our users gained a lot of new functions and features which has made everyone happy.

In addition to a strong and collaborative relationship with your vendor, here are some critical success factors for any major software upgrade: Continue reading

Who’s on first?

Picture this. One of your IT leaders tells you they have been pulled into a project by a senior executive; they are trying to figure out who in IT owns it. You tell them that another of your leaders owns it. They arecanstockphoto2538045 working out the specific issues with yet another leader. The first person says it’s still not clear. So you pull all three of them together for 15 minutes and try to sort it out.

With a collaborative team that works well together, that 15 minutes is relatively easy. Your first question is who’s on first? You want to know who owns it and what’s going on.

My team has learned that one of my questions about problems is “who wakes up in the morning worried about it?”  Not that I want people worrying and losing sleep. But, it’s a way to identify who owns something and is accountable for it. “Who’s on first?” is another one of those questions. It may be a messy, complex project. It may be off to the side or on the fringe but it still needs a clear owner.

After just 15 minutes, my three leaders and I confirmed the right roles for each of them, and next steps. And of course we talked about lessons learned. So what did we learn again in this situation?

Role clarification – this is critical for all projects, small or large, high priority or not. Clarifying and communicating sponsor, business owner, project manager, and decision makers is key.

Communication – proactive communication throughout the life of a project to all members of the core team and the stakeholders is another key.

Setting and managing expectations – this is especially true when dealing with many concurrent efforts with the same set of users and stakeholders. It’s also important when a project that seems simple actually has a lot of complex issues:  technical, operational, legal or something else.

I’ll bet you can think of a messy project in your experience that swirled or stalled. You might have some bad memories. Most likely, what went wrong ties back to one of these basics. So clarify roles, communicate, and manage expectations, but make sure you know who’s on first.

Making the invisible visible

The whiteboard in my office has become a working draft for our IT leadership visual management board. And it’s become a focal point of discussion as I socialize the idea with our IT VPs, directors and canstockphoto26356044managers. I’m encouraged that everyone who gets the walkthrough supports the idea and sees the value in it. They see the potential it has to address some fundamental problems in how we work as a department.

Ownership of the board is shifting to the team. I’m using color coded sticky notes to add ideas and pose questions. I’ve encouraged IT leaders to stop by and put their own sticky notes up as we develop it together.

Some have asked if they should do something similar with their own team. The answer is yes! We need to commit at the leadership level and model behaviors. But to truly be effective, each team should have some kind of visual management and huddle that rolls up to the leadership huddle. Continue reading

Lessons from an aspiring lean leader

This week I will be sharing lessons I’ve learned as a lean leader and champion – in particular around visual management. The Lean Enterprise Institute (LEI) holds an annual Lean Transformation Summit canstockphoto16267629where experts and practitioners come together from all industries to learn from one another.

My talk will cover a multi-year journey that has involved learning from others both in and out of healthcare, site visits, training classes, lots of reading, and experiments with my leadership team. Most of my talk is based on my experience and lessons learned at the University of Michigan Health System.

I was delighted to see that University Hospitals where I’m currently the interim CIO has been on their own lean journey since 2011. At our hospitals you will see huddles and visual boards throughout. Thousands of staff have been trained in lean concepts and methods. In contrast, there have been limited experiments with lean at the corporate office. I have a few allies in my IT leadership team who have experience with lean in other organizations. A good start!

I would have been making a mistake to arrive at UH as the interim CIO and start introducing lean methods week one. I needed to see and hear the problems that need to be addressed. Continue reading

7 tips for managing in the fast lane

It’s generally a bad sign when the seat belt warning light for the passenger seat comes on but you are the only one in the car. You’ve got too much weight on that seat and the car thinks it’s a person who needs to fasten their seat belt.

This has happened for me a few times lately.  It’s when I have thrown my briefcase and stacks of work for the weekend or the evenings on the seat.  Or I’m out of my office at hospital meetings for several days in a row and need various files with me.  The passenger seat becomes my file cabinet until I’m back in my office.

If I’ve been out of town to visit family or on business, it gets even harder to manage the volume.

People say they don’t know how I do it….how do I keep on top of everything. I respond, typically, “I don’t do it that well.” I’m my own worst critic. But I try my best.

So how do you survive and be your best at times like this?

Triage skills – Review your email inbox and make sure that the time sensitive ones are answered. Look for emails from your direct reports, boss, peers and customers to handle. Continue reading

So you didn’t get the job

Last week I wrote about how to stand out in the interview for a new job. I promised that I would write about what to do when you don’t get the job.  I’ve been there before and it’s not easy.

You think you’ve nailed the interview. You’ve met with lots of people. You like them and your potential new boss. You think it’s a great opportunity and you are excited about the prospects. You anxiously wait for “the call”. And then it comes. The hiring manager, HR person, or recruiter says “we’re going in another direction” – that common euphemism to say that someone else is getting the job.  They go on to say some nice things about you and that you interviewed well but all you hear is that you didn’t get the job.

Your friends and family are supportive. They may say “it wasn’t the right one anyway”. Or “something better will come along”. They tell you how to feel but what you want to say is what my youngest daughter would say to me – “you can’t tell me how to feel, you’re not inside my body!” Continue reading