It’s huddle time! No, I’m not joining a sports team. But along with my leadership team, we are taking the next step on our lean journey. In a few weeks we’ll be starting twice a week 30 minute leadership huddles. 
This is part of Lean in Daily Work which also includes key visual metrics, visual boards, Everyday Lean Ideas (ELI), and leadership walks.
In a post last summer, I talked about the lean journey. It is important for leadership to set common expectations throughout an organization. So if we’re going to practice lean thinking as a department, our leadership team has to set the example.
The goals of this lean experiment include the following:
- Create a common understanding of what our performance is compared to what we want it to be so that we can understand the gaps and improve
- Make our work visual and actionable
- Understand our business more deeply by asking questions and looking at trends
- Surface, track and trend problems
- Gain experience and practice with lean
Our visual board will be organized around the same balanced framework that our health system leadership is defining for setting goals, priorities and measures – safety, quality, timeliness, financial stewardship, and people. And a few words to help understand what this framework means:
Safety – To avoid harm to patients, employees, students and visitors.
Quality – Do the right work in the right way the first time to obtain the intended clinical and/or administrative outcome. Do not pass on a defect.
Timeliness – Timely execution.
Financial Stewardship – Resource stewardship.
People – Create optimal environment to engage and empower workers and leaders to improve performance.
At each huddle we will walk through a standard set of questions:
- Are there any Major Incidents or risks for Major Incidents that need executive escalation?
- Are there any staff we would like to recognize?
- Are there any incidents to report in regards to safety of our patients or staff?
- Are there any incidents to report that were the result of inadequate testing or quality controls?
- Are there any concerns regarding service level agreements, project deliverables, or service desk performance metrics?
- Are there any financial issues to report including potential budget variances or unplanned funding requests?
- Are there any resource management issues to discuss including key position vacancies, resource availability or any significant morale or engagement issues?
- Are there any Everyday Lean Ideas (ELI) to review and/or update?
- Are there any other announcements?
For anything that is raised requiring follow-up, we will determine the action needed and assign a lead.
An obvious question when we are all pressed for time is what the addition of these two 30 minute huddles each week offset in terms of other standing meetings. The answer is none, yet. The “yet” part is key. I believe that Lean in Daily Work practices can eventually reduce other standing meetings and change the way we use email. Two common complaints from leaders are too many meetings and too much email.
Will we get this right the first few huddles? Probably not. Will it feel awkward and different? Probably yes. But we’re agreeing to experiment and learn as we go. Lean Enterprise Institute CEO John Shook often says, “Learning how to improve is as important as the improvement itself.” Using PDCA (plan-do-check-act) we’ll make adjustments as needed.
I’d eventually like to see use of Lean in Daily work practices (huddles, visual management, ELI) implemented throughout my entire IT department at all levels. By leading the way and being willing to experiment as a leadership team, we will learn and refine our approach. As my lean coach, Margie Hagene from the Lean Enterprise Institute, would say, we’ll develop the muscle.
Resources
See the Michigan Quality System website to learn about our health system’s lean journey: http://www.med.umich.edu/mqs/
See the UM Virtual Lean Resource Center to learn more about lean: www.med.umich.edu/i/quality/tools/lean_assist.html
Visit the Lean Enterprise Institute for resources to transform your company: http://www.lean.org/
Rodney Nelson on said:
Thank you for sharing this information. The concept and questions make a great starting point for status meetings. Can you offer examples of metrics that can be used to measure the efficacy of day-today operations and reported upward and across the organization? What details would you like to see on a team’s visual board that would be meaningful to directors and excutive leadership?
Thanks!
Sue Schade on said:
Rodney, thanks for the feedback. We are still working through specific metrics within the framework. When we have some practice, will be ready to ask some teams to start doing similar huddles, visual boards and metrics. Stay tuned!
Andrew Gutting on said:
Wonderful!
I like your attitude about likely not getting it right the first time.There is no right starting place with lean, you just have to start, inevitably fail, learn, and try again.
I’d like to mention two powerful pieces of the Lean in Daily Work model from a front line staff perspective. First, that the metrics that teams should develop should be centered around what our customer’s value from the services that we provide, not we value. Doing this alone, realigns how teams think about the work they do, how they prioritize which tasks are most important and encourages teams to seek to understand their customers better.
Secondly, through shifting our paradigm that problems are bad to recognizing problems are an opportunity for improvement and from “problems occur because of bad people” to “problems occur because of bad process”, we can begin to remove fear in our workplace. Fear that causes staff to hide problems for fear of punishment. Fear that causes staff to blame each other when things go wrong. Fear that makes people unwilling to try and express new ideas to solve problems.
Lean is is just as much about people/culture as it is about the technical tools that are used and the Lean in Daily Work model is a great example of what can be achieved when those two things are in harmony.
Sue Schade on said:
Andrew, well said. Really appreciate your perspective and that you are willing to share here and in our recent CIO Breakfasts. Many thanks!
Jeanne Kin on said:
Look forward to hearing the results of your experiment!
Sue Schade on said:
Jeanne, and you certainly will!
Kyle on said:
Another great blog!! Keep um coming!
Sue Schade on said:
Thanks Kyle! You can assume there will be a part two on this one in few months once we get some experience.
Nicki Schmidt on said:
Great news Sue! I also look forward to hearing how your experiment evolves! Wishing you and your team continued learning and great success.
Nicki
Sue Schade on said:
Thanks Nicki! Will be posting more in future on our experience and experiment.
Devan Riley on said:
Hello Sue:
I am a grad student working with a hospital to improve their daily leadership huddles. I was wondering what metric you ended up using to track efficacy, and also how did you track accountability for issues raised during your huddles? I look forward to hearing more about your experience.
Thank you.
Sue Schade on said:
Devan, great question. At Michigan Medicine, we tracked follow-up as tasks in SharePoint and huddles were all by phone. At University Hospitals, we didn’t have specific issues tracking mechanism but we did huddle in person (with few exceptions for people who needed to call-in) and it was a more real-time, issue resolution right afterwards kind of dynamic.