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How Lean management dies at a hospital

Without top leadership encouragement and engagement, the Lean process improvement approach can gradually fall into disuse

This story was recently related to me about a hospital in which the Lean process improvement philosophy was adopted, with strong support and encouragement by the CEO. Over several years, it resulted in a significant cultural change in the organization, with resultant improvements in clinical care, employee satisfaction and morale, and finances.

After the CEO left, the board's search consultant interviewed senior clinical leaders and administrators to learn of their hopes with regard to candidates who might serve as the hospital's new leader. The consistent theme from the senior team was to recruit someone who had a strong commitment to Lean, so the philosophy would continue and be enhanced for the future.

It soon became evident that the search firm had no idea what was being discussed, could not pass along the proper message to the board of trustees search committee, and over time watered down the job description to include typical general language about managing improvement.

As the search continued, the hopes of the senior team were left in abeyance, and a new CEO was brought in with minimal commitment to the Lean philosophy.  While the philosophy stayed in place for a while, without top leadership encouragement and engagement it gradually fell into disuse. Undoing years of progress, Lean remained mainly in the memories of those who had enjoyed the benefits it had brought for the community.

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