Tag Archives: lean

Unlocking the power of time: insights from an inspiring leader

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Today is the longest day of the year and the official start of summer. This longest day leads me to reflect on how we spend our time.

I recently had the pleasure of interviewing Saad Chaudhry, Chief Digital and Information Officer at Luminis Health, for a Townhall episode on This Week Health. Saad is an inspiring leader on so many levels so preparing interview questions was easy. I had heard Saad talk in the past about what he calls his Manifesto of Time, so I wanted to make sure we discussed it in the interview. For Saad, looking at the number of hours the average person has in their lifetime means looking at how we choose to spend it and whether we give or take time from others.

As a health IT leader, he says we are in the business of time. He is committed to giving time back to staff and patients. He asks in his manifesto – “Does a process/technology/policy steal time from a fellow human? Is there a better alternative to simplify the experience?” He challenges us to make systems and processes easier for patients and staff, giving time back rather than taking more time from them.

I can’t say it nearly as well as Saad, so I encourage you to read The Manifesto of Time and listen to the short clip on time from our interview – Spending Time: Why It’s Important to Maximize Giving Back Our Most Valuable Commodity. We covered much more in the full interview if you are interested and willing to spend 30 minutes of your time listening – A Realigned Role, Generational Diversity, and Giving Back Time.

I know your time is precious – thanks for reading and listening!

Rounding in a virtual world

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If you are a regular reader of this blog, you know I am a fan of lean concepts and practices. In fact, my posts on lean have been some of the most popular ones over the years. So, it is no surprise that I have embraced a form of rounding or “gemba” now that I am serving as interim CIO at Boston Children’s Hospital.

As part of our commitment to being a High Reliability Organization (HRO), Boston Children’s Hospital has a program called “Rounding to Influence” (RTI). With this program, senior leaders meet with staff in their areas to discuss a specific topic and solicit input. The Rounding to Influence program is facilitated by David Davis, Vice President, Patient Safety, Quality and Regulatory Affairs. When I learned about the RTI program several weeks into my interim engagement, I was quick to start participating.

My first experience was tagging along virtually with Laura Wood, EVP Patient Care Operations / System CNO, on her rounds with clinical staff along with a few of my IT leaders. Given the topic for that session was about having the right information to perform your work, it was a great place to start and hear from our clinicians and support staff. Here were the questions:

Having the right information and data is important to everyone in order to perform their roles effectively.  Depending on your role, do you have trouble finding the information or data you need to do your job?  Do you know how and where to get the information/data you need?  Do you have concerns you are seeing incomplete or unreliable data?  How would you know?  How can we be more reliable in our information and data sharing?

The obvious next step was to start virtual rounds with our own IT staff. Here is how it works. Continue reading →

Systems at scale and optimized workflow

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IT teams work at scale all the time supporting thousands of users. Workflow optimization is often a goal for new systems. The mass vaccination sites and events are at scale and depend on an optimized, efficient workflow. With over 2 million doses a day being administered now in the U.S., these sites and events are becoming more prevalent and will continue over the next several months. While there was much publicity of the problems in the vaccine rollout early on, there have been many improvements in the tools to find vaccine locations and schedule appointments, and the administering of shots. In part that has been due to improved technology and better workflow design.

Two health systems doing mass vaccination sites/events have shared their playbooks in recent weeks for others to learn from. UCHealth in Denver is offering a playbook, “COVID-19 Mass Vaccination Drive-Through Playbook”. It is a 59 page comprehensive and very detailed playbook covering organizational structure and partner involvement, pre-event planning, contingency planning, patient communication, staff, provider and agency recruitment, vaccine storage and handling, and media communications. The Atrium Health playbook is a higher-level guide for leaders – “A Leader’s Guide to Safer, Faster and More Equitable Community Vaccination Events”. Both are valuable tools whether you are in the planning stage or tweaking your current operation.

To build on these tools, I recommend checking out two recent interviews that Bill Russell did at This Week in Health IT.

Continue reading →

What organization can’t benefit from lean?

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As I start my interim management role at a new organization, I’m learning about pockets of best practices throughout the health network for daily huddles and other lean methods. I’m learning from my team that canstockphoto67324721 lean thinkingidentifying the right metrics to measure in IT is a challenge.

And of course, I’m getting a lot of standing meetings added to my calendar while trying to understand what each group’s unique purpose is and where specific type decisions are made. These are important questions given most organizations have too many meetings and people often say they spend too much time in meetings.

One of my first observations week one as I listened to colleagues is that there is potential for lean methods such as a daily management system, huddles, and visual boards.

I’ve learned a lot about lean and what it takes to introduce new concepts into organizations in recent years. One of the most important lessons I’ve learned is to listen and get to know an organization before making any assumptions.

I will be doing a lot of listening and learning in the coming weeks. When it comes to lean methods, I will share my experiences in previous organizations as it makes sense with my new colleagues and teams.

If you share my passion for lean thinking or are interested in learning more, check out my post “Lean classics worth a second look”. It’s a recap of previous posts covering huddles, visual boards, and gemba walks from my journey as a lean leader in different organizations. And if you have a story on how you have applied lean thinking in your organization, I would love to hear it.

Related Posts:

6 tips for successful huddle boards

Leadership huddles: not just another meeting

Making the invisible visible

Making the invisible visible – part 2

Importance of rounding or going to the “gemba”

Go to the gemba, seek to learn

Tune in: recommendations for IT podcasts

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How do you keep up with industry news? Do you have a favorite online publication? Are you a reader or a listener? I find myself struggling to keep up with everything I want to read. But I’m doing better, now, with canstockphoto33796857 podcastat least tracking on the headlines and top industry news stories.

For all you busy multi-taskers who may be looking for an alternate way to educate yourself and stay current, 20-30 minute podcasts are a great option. Whether you’ve got a long daily commute, need something to listen to while working out at the gym or while walking the dog, consider listening to podcasts.

Here are some podcast series worth checking out:

This Week in Health IT – This is a new program launched by Bill Russell, CEO at Health Lyrics, focusing on news of the week and a topic of interest. He publishes online every Friday afternoon. I was honored to be on the program last week. We covered the Amazon, JP Morgan, Berkshire Hathaway announcement and the Apple health records app story. Both are examples of the disruptive forces we are seeing in healthcare. Bill and I also talked about the evolving role of the CIO and shared our favorite social media posts of the week.

HealthSystemCIO.com – Anthony Guerra and Kate Gamble have been conducting extensive one-on-one interviews with CIOs for several years. They publish them online as multi-chapter series. These interviews provide insight and experiences for everyone in health IT.  And if you’d rather read the interviews, they are also available as full transcripts. Continue reading →

Lean classics worth a second look

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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 →

6 tips for successful huddle boards

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I recently had an opportunity to advise an IT department on their overall lean initiative. While no two organizations have the same lean journey, there are common challenges. Visual management and huddlecanstockphoto19155139 boards are components of a lean management system. Here are some of the common challenges you can expect to encounter and tips for success:

“Perfect is the enemy of good” – You must be willing to experiment and get messy. Visual boards take many shapes and forms. Do they help you focus on the right work and metrics as a team?  It’s less important that they look pretty to the outside observer.

Standard framework with room for variation – Even if there is a standard for what all huddle boards in your organization should look like and include, there must still be room for variation by unit or team. What’s important to one team may not be important to another. If you’re ready to get started and wonder if there will be an organization standard at some point, don’t wait for it. Just get going and adapt later if a standard appears. Continue reading →

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 →

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 →