Today on the blog, I’m going to lay out a vision for elevating your organization to a world-class level so you can achieve excellent, effective patient care on time and on budget.
 
There’s two keys to becoming the best in the business: your people’s passion and your commitment to continuous improvement.
 
World-class organizations know how to harness these keys to success—world-class organizations know how to aggressively focus human potential to excel far beyond all known or imagined standards of performance.
 
Let’s break down that statement. 

​Focusing human potential
 
People are your most potent resource. No machine can match the human mind’s ability to innovate. No machine can match the compassion your people bring to patient care.

​World-class companies really go after all that their people have to offer. They tap into the intellectual, physical, spiritual and emotional strengths of their employees. They consciously and energetically depend on their nurses and doctors to innovate the best care delivery possible. They understand and believe absolutely in the value of their people.
 
Your staff chose healthcare because they are deeply committed to serving others. World-class organizations amplify their employees’ passion for patient care by investing back into their people. Education and training levels are kept high—they are a planned, significant part of each worker's year.  Actions and policies—not just talk—reflect the value placed on people by world-class companies.
 
 
Excelling beyond known or imagined standards
 
To excel far beyond all known or imagined standards of performance.  This statement has two parts. First: “to excel far beyond.” Not just meet, exceed, or improve upon—but to completely and emphatically surpass those standards. This means committing to continuously improve, even after you’ve met your original goals.

Second: “all known or imagined standards.”  World-class organizations don't just excel relative to established standards.  They defy our imaginations with their performance.  They don't just perform far better than what we know. They outperform the best we've imagined!
 
That means quality increases by factors of 100—or 1000. Cutting costs in half.  Five times as many patients seen in the same facility—or ten times as many!  Reducing supplies inventory by 90%. Doubling productivity—then doubling it again!  Lead times reduced by a factor of 5 to 10. Cutting new product, service, and process design lead times in half.
 
Amazing, dramatic, impressive improvements—completely shattering all previous, current, or imagined standards. Again, this means supporting innovative improvements even after you achieve your original goal. Stagnancy leads to financial instability and under-performance in care quality. Don’t stop, keeping evolving. Your results will keep evolving, too.
 
Finally, world-class organizations excel in all aspects of performance. This means all aspects—patient satisfaction, inventory management, care innovations, staff management—you name it.  World-class leaders continuously improve their whole system, never leaving a division behind.
 
Be sure to look out for upcoming posts on the blog. My next series will take a take a closer look at five world-class aspects of performance: customer focus, operations, product deployment, organizational design, and leadership.
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For example, head physicians in the U.S. military during WWII chose to ignore their colleagues’ calls from the frontlines to transition from plasma-only to whole blood transfusions. War is hell. It’s not easy to lead during a war. But had the management culture been more receptive to continuous improvement, battlefield physicians wouldn’t have had to fight so hard to implement life-saving technology.
 
There were several factors that contributed to the use of plasma rather than whole blood for transfusions at the outset of WWII. In the North Africa campaign there was no such thing as a blood bank where whole blood could be refrigerated and stored until it was needed. Then, no one had developed the means to send refrigerated blood to the battlefronts where it was needed. Lastly, physicians believed that plasma was better than whole blood.
 
However, as the war progressed it became clearer to frontline physicians and surgeons that there was a better outcome for severely wounded patients when whole blood was used. In this case the change agent was a physician, Colonel Edward D. Churchill, surgical consultant to the U.S. Army in the Mediterranean theater. The Colonel presented a new medical concept for the treatment of hemorrhage and shock: whole blood.
 
He started lobbying for change and hit several brick walls. He was swimming upstream against a long held notion that plasma was better, contrary to the evidence from battlefield physicians and surgeons. He quickly realized change could not come from within the military system. Even after a U.S. Navy Surgeon (Lieutenant Henry S. Blake) invented a special box to hold and transport refrigerated containers of blood, the Navy’s Surgeon General didn’t think it was that great an idea and refused to have the box used regularly in navy medicine.
 
Blake didn’t give up on his invention, and Churchill took the case for military use of whole blood to the New York Times. The Times wrote an article on August 26, 1943 titled, “Plasma Alone Not Sufficient.” The American public was upset when they read the article, fearful for the lives of its sons at the front. Finally, the U.S. Army Surgeon General felt pressured enough to quickly accept whole blood for Army use on the battlefield.
 
Look, I’ve seen firsthand how well the medical system works and how thousands of soldiers lived because of the expert care and miracles performed by surgeons, physicians and nurses on the battlefield. During my second tour in Vietnam, I was medevac’d back to the states. I was loaded on a string of medevac’d flights starting in Saigon, from Saigon to Guam, overnight then to Hickam Field, Hawaii, five hours parked in the heat on the tarmac because we were all infected, then to San Francisco, VA Medical Center, overnight, then to Madigan General in Tacoma, WA, and hospitalized for 30 days.

​Change can be difficult for some, not for others. It can be a mixed bag of attitudes, opinions, resistance, support when you start talking about the Toyota Production System (TPS) among healthcare leaders at all levels. I’ve gotten comments like, “What do you mean TPS, we care for patients, not cars – or at Boeing when we first started, “What do you mean TPS, we build airplanes.”
 
I’ve been told, “If we bring you in don't use Japanese words or terms, don’t bring in Japanese consultants, don’t start telling us about Toyota, we serve patients, not cars – don't talk about the Toyota Production System.” My comment usually is, “what do you want me to talk about, what do you want?”

I didn’t hear those words from Dr. Gary Kaplan and Mike Rona, when they brought me in for a one-on-one meeting fifteen years ago in Seattle. What I remember was, “Black, we’ve got a problem around quality and safety issues at Virginia Mason – we care deeply about our patients and it is obvious we can do much better.” They were very open to blowing up their mission statement and vision. Also, they weren’t a least bit arrogant. They said, “John Black, we don’t have a method, a management system, to make happen what your talking about.”
 
So, what about results? Rona and Kaplan, with coaching from John Black and Associates, led the adaptation of the Toyota Production System into the Virginia Mason Production System (VMPS). With VMPS methods, the team has achieved increases in patient and staff satisfaction, huge reductions in patient wait time and medical errors, stable economic performance.
 
Rona, now CEO of Rona Consulting, explains the promise of the Toyota Production System best: “What was such an eye opener for us was that this was exactly what we were seeking in healthcare: A zero defect product that exceeded the expectations of its customers, the highest quality, the highest staff satisfaction, the lowest possible cost and reasonable economic performance.”
 
Lean leadership is an immersive experience, a total transformation. The Toyota Production System is a universal process that translates to all industries and will revolutionize your organization’s ability to harness its human capital.
 
Ready to start your Lean transformation? Check out my book here, or contact me with questions.