One of the greatest dangers when implementing Lean is a loss of momentum. There are times when healthcare workers express concern about being able to sustain the transformation. Achieving and publicizing early successes can help boost morale and enthusiasm, but, typically, people still must endure weeks, months, or longer doing the same amount of work the old way while also learning and implementing the new way. This transitional period means extra hours and, often, frustration. The critical metric for long-term sustainability of the transformation (and the toughest metric to ace) is establishing the organizational infrastructure. However, quality improvement happens not as intense bursts, but with consistent, daily management systems. Strong leaders ensure that the small systems are running efficiently to keep the entire Lean operation moving forward with momentum. An example of one of the important tools of infrastructure is the Healthcare Production Board where daily schedules and status provide visibility to all team members.
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