On Leadership

Making the invisible visible – part 2

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It’s been 3 months since the IT leadership team here launched a visual management board and started a thrice-weekly huddle. Since then, we have made numerous adjustments to improve our process.visual management board

Initially, the board was in a conference room; we sat around the table for the 15 minute huddles on Monday, Wednesday and Friday mornings. While it was not the ideal setup, it was the way to deal with a distributed leadership team. A few weeks ago, we moved the board out into an open area where everyone walks by and started doing the huddle standing up. We installed a speaker phone next to the board. It’s not a perfect arrangement but it works.

No surprise that it is very different when the group is standing in an open area: more transparency and visibility. We can invite people to observe our huddle and show the board to others who want to learn about it.

Working with the leadership team, we refined our goals to be:

  • Reduce cycle time – “get things unstuck”
  • Reduce preventable incidents
  • Ensure ownership and accountability
  • Reduce variation
  • Increase coordination and communication between teams
  • Ensure we deliver on top priorities
  • Focus constantly on customer satisfaction and provide superior service to end users

The sections of the board are the same ones we started with:

  • Production environment – To track major incidents and any open tickets that need escalation. We display the number of open tickets by system, critical open tickets, and approved system changes for the week.
  • Top priority initiatives – To confirm our highest priorities and review issues that need to be addressed. We display the go live calendar, project successes from the previous week, and the dashboard from the Project Management Office.
  • Metrics – To track key department wide metrics. We display metrics including key infrastructure stats, and operating budget vs plan.
  • People – To highlight new hires, recognize staff, and raise awareness on recruitment efforts. We list open positions, pictures of new hires, and employee appreciation awards.
  • Everyday Lean Ideas (ELI) – To provide a central place for staff to suggest improvements.

We have a standard script for our huddles. Continue reading →

Teamwork at its best

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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 →

Who do we want to be?

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While I try to stick to the topics you would expect in a professional blog, there are times when I can’t ignore the events we all witness. Whether they are joyous or tragic, they all leave a mark on us. Last July Icanstockphoto6283939 wrote about marriage equality sharing the story of my Aunt Dorothy.

During the fall as a US presidential candidate repeatedly talked about building a wall along the Mexican border, my post “Build bridges, not walls” was a message about the importance of embracing diversity. In that post, I quoted a church hymn that really struck home for me. “Our World is One World” by Cecily Taylor included this verse:

Our world is one world, the thoughts we think affect us all. The way we build our attitudes, with love or hate, we make a bridge or wall.

I closed that post with this statement: “Let’s continue to work together to build the kind of world we want for our children and grandchildren and generations to come.”

My fourth grandchild is due next week. I look forward to holding this new baby and welcoming him into our family. I am busily crocheting his baby blanket trying to get it done in time. While I crochet at night, I watch hours of television news about the worst mass shooting in US history – 49 people were killed in a gay nightclub, a place they considered safe and welcoming.

My maternal grandparents were born in Slovenia and came to the United States as immigrants in the early 1900’s. My grandfather was one of 11 children. One of his sisters had 10 children; two of her sons and one of her son-in-laws were rounded up and executed along with 30 others in their Slovenian village by the Fascists in 1942. They were my mother’s cousins. Continue reading →

IT governance – basic but critical

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The first three months of my interim CIO engagement at University Hospitals has flown by. I’m fortunate to be working with a very talented IT team and we recognize there is always room for improvement. We canstockphoto22767750have already made some very positive changes and improvements. We are tightening up how we manage and monitor the production environment to reduce preventable incidents. We do a root cause analysis on every major incident and review them as a team at our bi-weekly leadership meeting, tracking all subsequent action items. We are making progress on numerous major priority projects and there have been several system upgrades and go lives during this period. We are doing detailed planning for our new hospital integration efforts. We are launching our visual management board and leadership huddle next week as part of our lean efforts. And we have re-established an executive level IT steering committee addressing the critical need for IT governance.

Our third IT steering committee will be Monday evening. Our CEO and other senior executives are engaged – exactly what we needed. They are developing a deeper understanding of our current work and the many new requests we have received since this year’s budget was approved. We have reviewed with Continue reading →

Making the invisible visible

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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

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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 →

Innovation – who owns it?

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I’m back from HIMSS16 and the sensory overload of Vegas. Like every year, the conference and exhibit hall was filled with new vendors and products. Trying to find the really new, new that is a breakout canstockphoto19831405innovation can be a challenge with thousands of exhibitors. I expect to soon read many post HIMSS articles that will highlight the new innovations and the promising start-ups there.

The HX360 program was co-developed by HIMSS and AVIA, an innovation partner for more than 20 forward-leaning health systems. The program is an attempt to carve out during HIMSS an innovation focus for senior leaders. This year I attended the one-day HX360 Executive Program.

The highlight for me was a panel of CEOs and Chief Innovation Officers from leading health care organizations – Providence Health and Services, Dignity Health, Christiana Care and University Health Network in Canada. The panelists were forward thinking health care leaders and organizations. Continue reading →

Shattering the glass ceiling

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No more hitting it, or even breaking it – let’s shatter it!

I’ve been vocal in urging more women to pursue technology careers and in supporting women as they face challenges moving up the ladder.canstockphoto28787142

HIMSS16 attendees can focus on many topics this year. I will be pursuing my passion for developing the next generation of leaders, especially helping women deal with barriers they face as we try to level the playing field.

I’m happy to be a voice for women – but I’m not alone.

  • On Tuesday at 10AM at the HIMSS Spot, the annual #healthITchicks meetup is happening. I’ll be one of the guest speakers along with Rebecca Freeman, Chief Nursing Officer at ONC and Dana Sellers, CEO at Encore. Jennifer Dennard, #healthITchicks founder, organizes monthly TweetChats on a range of topics as well as this annual meetup at HIMSS.  Join us for some interesting Q&A and networking!
  • On Wednesday at 2PM, I will be one of two female executives speaking at the Views from the Top Session – “Shattering the Glass Ceiling – Lessons Learned for Aspiring Female Executives”. I’ll be joined by Deanna Wise, Chief Information Officer at Dignity Health. Carla Smith, EVP at HIMSS will be the moderator. A similar session last year was a big hit with a large crowd so let’s make this year even bigger and better! Kate Gamble with HealthSystemCIO.com wrote an excellent preview of the session this week.
  • And in a two hour closed session on Monday morning, I will be one of six executive women that Carla has pulled together for a Women in HIT roundtable session. More than 900 women responded to a recent HIMSS / Healthcare IT News survey on the women’s professional needs in the health IT field.  According to Carla, those responding overwhelmingly wanted more recognition of female leaders, and more gender-focused resources that support networking, mentoring, and educational and career opportunities. She hopes that the roundtable will give HIMSS valuable input towards developing a year-round, comprehensive, and meaningful program to empower women, and to nurture the next generation of women leaders.

Continue reading →

Get started by asking the right questions

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If you are drinking from a fire hose, you need to focus or you will drown. When so much new info is coming your way every day, you need a framework.  When I started my present interim CIO engagement, canstockphoto16518323I knew I needed to understand some key areas right away. They included strength of the leadership team, staffing, system performance, user satisfaction, budget, vendor relations, security, and IT governance.

Issues with system performance and dissatisfied users will find you even if you don’t go looking. Without solid system performance for your production environment, it’s hard to discuss anything else with your executives. If the issue affects your clinicians and their ability to see patients and manage their workload, you need to pay close attention. And you need to work with your team to figure out what’s going on and resolve it. System performance affects user satisfaction.  Whether users love or hate a system they depend on, it has to be fast and reliable.

To quickly assess the IT leadership team, you need to understand their background and experience, their current scope of responsibility and their primary concerns. What are they struggling with?  What help is Continue reading →

Interim management is different

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I am wrapping up week 3 as the interim CIO at University Hospitals in Cleveland, Ohio and I’m drinking from the fire hose. I have to learn a new organization, a new team, a new set of projects and priorities, canstockphoto3961050 (1)and a new set of tools. This much change takes patience – first with myself. I realize I can’t learn it all in one day or one week.

The good news is that there are many common themes and issues between health care organizations. With so many years of experience in health IT and leadership roles, I can jump right in. Imagine trying to learn this industry for the first time at this level!

I meet with other executives for the first time in “meet and greet” sessions. I want to get to know them and understand what they need from IT.  So, I’m asking each of them 4 key questions:

  1. What’s working well?
  2. What’s working not so well?
  3. Considering I’m interim, how can I have the greatest impact?
  4. What are the key requirements for the next CIO?

I’ve asked all of my management team in IT to consider these same questions. More good news, Continue reading →