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World Class Team Structures

1/6/2017

 
​World-class healthcare organizations are structured differently from the rest.  They have a "high performance organizational design." 
 
Traditional organizational designs don't allow employees to make nimble changes to the process of care delivery.  Traditional designs don't allow staff to be as patient-focused as they need to be. And traditional designs don't permit the kind of rapid, successful deployment of excellent patient care that typifies world-class organizations.
         
A "high performance organizational design" is different from traditional hierarchical structures.
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This chart illustrates how traditional organizational designs change to become high performance.  The traditional structure in Stage 1 is a hierarchy.  Obviously, top executives are at the top, workers at the bottom. A pyramid structure.  Not much direct communication.  Not much teamwork. Not much responsiveness to problems. Not much flexibility. Lots of rigid, formal structure. Plenty of work for producers of organization charts.
 
Stage 2 on the chart shows how the pyramid begins to flatten out on the top.  Less distance between top management and the workers, fewer layers of management, more teamwork.  Companies that aspire to become World-class are often in this phase. 
 
Stage 3 illustrates a World-class structure. A team structure. There is no long chain of command.  There are minimal layers of management. There are fewer structural barriers to communication. 
 
The advantages of team-centered organizational designs are many.  Communication is incredibly direct.  All functions needed for a project are present on the team.  New knowledge is created and integrated at a level far beyond what a traditional structure can achieve.
 
People and processes can be shifted to meet new innovations in patient care, and new requests from patients.  There is much more flexibility and responsiveness.  Responses are more focused and efficient.
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​Perhaps the most dramatic advantage is that frontline staff are empowered and rewarded.  They are no longer at the bottom of the pyramid following instructions. Processes established by managers are no longer far removed from the hospital floor and the patient.  Processes get improved by the ones who know best how to make them better—the doctors, the front desk, the nurses, everyone who makes the hospital hum.
 
World-class Lean leaders know how to step back and restructure to capitalize on their human potential. Most importantly, world-class organizations aren’t afraid to re-organize until they get it right.
 
Be sure to check out my other posts on world-class organizations. And as always, feel free to reach out to me for more ideas about how to make the transformations in quality patient care that will set your organization apart.

Achieving World-class Healthcare

11/25/2016

 
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.
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During this 3P event in the Five Hills Health region in Saskatchewan, JBA galvanized key stakeholders to achieve a 40% more efficient flow than current best practices, showcasing the dramatic effects of focusing brainpower to find innovative solutions.
​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.
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Mike Rona, President of Virginia Mason Medical Center, and I present certificates to the first group of Lean leaders at VMMC. Implementing the Toyota Production System shattered known standards of excellence at VMMC and ushered in a new era of quality care.
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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    About the author
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    John Black, President and CEO of JBA, has implemented Lean improvements for four decades, first with the Boeing Company and later as a leading consultant in the healthcare industry.


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