Monday, January 27, 2014

Become a Leader Without Knowing It All: How to Improve Employee Engagement Through Leadership Standard Work

by Bill Kirkwood | January 23, 2014 11:29 am
Lean Healthcare Leadership Standard WorkHow many years have we been hearing and reading about the decline in employee engagement?  If the research and surveys are to be believed, close to half of employees are unengaged in both their work and their employer.  There are countless solutions out there, yet the employee engagement numbers are holding steady. What can we do to get our employees on board?
Leadership standard work (LSW) can be a powerful response. It is a cornerstone to a Lean management system.  LSW specifies a leader’s daily, weekly and monthly practices that bring a disciplined focus to process, improvement opportunities and measurable outcomes of processes. This standard work is not ad hoc but rather documented with defined frequency of practice or, should I say engagement.  Importantly, these practices, which include a formal review of active performance improvement efforts and current performance against agreed to targets, takes place at the workplace—at the gemba.  Why at the gemba and not the traditional conference table preferred by many leaders?  Because that is where the work takes place by those unengaged employees.
A core element of LSW is coaching and teaching.  It is within the coaching process that leaders change the organizational conversation by engaging employees in the process of continual improvement. Think of what is being communicated when a leader shows-up in the workplace to conduct a review and coaching session.  In many cases this conveys the message “we are no longer in Kansas,” the past approach to work is no longer sufficient to assure success and conveys you and I are in this together.”  It affords a larger number of employees the ability to actively participate in a new way of talking with the leader about the problems they are confronted with and to share their ideas for continual improvement.  When done well, coaching in the gemba:
  • Provides employees an opportunity to contribute their ideas for improvement
  • Clarifies what is expected of them
  • Takes on real-time development opportunities with employees engaging in small tests of change
  • Provides recognition for work well done
  • Demonstrates a sense of genuine caring from the leader.
How many approaches to rounding have you initiated in your organization?  LSW provides a very important ingredient to overcoming leader reluctance to rounding.  Speaking from personal experience, rounding was intimidating because I thought I had to be all knowing and going to the workplace could expose my ignorance.  Many leaders having earned their stripes by being  perceived experts and giving orders from a distance. It worked, or so they and I thought. Going to the gemba violates that comfort zone.
LSW, with its coaching approach, allows leaders to mentor and teach using the Socratic method. It removes the responsibility of being all-knowing.  Coaching shifts from one way “communication” to active inquiry and teaching.  The many leaders I have worked with over the years find this a positive challenge and not an onerous task, once they know there is someone to coach and guide them.  It is our role as Lean coaches and advocates to coach and mentor leaders; to make it acceptable not to know everything; and to coach and teach them on understanding the PDSA cycle, quality and Lean tools.  The return for these efforts are engaged leaders and employees.

Today’s post was written by Bill Kirkwood, Ph.D., Director at HPP.
Bill has 30 years healthcare leadership experience in both system and individual hospital settings in the Mid-West and North-East, and oversight of change management activities and Lean Transformation engagements.  This experience includes serving in an executive capacity in Quality, Operations and Human Resources. 

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Healthcare software innovation: Why in-house accelerators are better

Considering that Boston is home to some of the country’s best medical, scientific and technological minds, it is little surprise that the city has a vibrant startup ecosystem. That ecosystem lowers barriers to creating groundbreaking innovations, connecting innovators to funding, mentorship and human capital. Yet, it isn’t very well-suited to help health care software innovators, who face a unique set of challenges.
The unique and increasingly complex IT environment within health care institutions is one of the biggest barriers to the development of novel clinical software solutions. To start with, health care delivery IT environments boast complicated safeguards to keep medical information secure. In addition, as these environments grow in scope and complexity, keeping pace with advances in clinical technology, it becomes harder to incorporate new software. Breakthroughs that enable Boston Children’s Hospital to be a leader in robotic surgery, for example, also make it harder to design technologies that can easily integrate with a hospital’s IT system.
The clinical IT environment is further complicated by a myriad of regulatory requirements. Plotting a course through the IT complexity, while complying with stringent security and HIPAA requirements, can be daunting. Furthermore, the FDA may soon be regulating clinical mobile apps and novel software as it does medical devices and pharmaceuticals. With regulatory concerns and complexity, it’s not difficult to see why many potential health care software innovators can get stuck in the early stages of the innovation lifecycle.
And the IT environment is not the only challenge for innovators wanting to develop new clinical solutions. Innovators need not only time and resources, but also highly specialized technical skills. Typically, innovators will reach out to their institution’s IT developers for help—only to discover that those developers have limited bandwidth and are busy working on higher priority projects.
As a result, innovators may seek an external software development vendor to build the solution they have in mind. But finding the right vendor is not easy. And even when there is a good health care software developer with which to partner, there are hurdles to negotiating contracts—and that is assuming there is money available to pay for the work.

Looking inward for answers

At Boston Children’s Hospital, we have built a unique program to help free aspiring innovators from many of the traditional challenges in building new clinical IT software. Known as FastTrack Innovation in Technology (FIT), part of the hospital’s Innovation Acceleration Program, it offers annual software development awards in the form of time with a special team of Boston Children’s project managers, business analysts and software developers.
The FIT team can rapidly translate a clinician’s idea into functional software that can be piloted in the hospital setting—and generally does so more efficiently and at a lower cost than most traditional software development vendors. FIT solutions have ranged from clinical software to mobile apps, and from clinician to patient-oriented solutions. Here are three examples:
• A Twitter-inspired app, called BEAPPER, allows emergency department staff to easily share and update information about their patients in real time and to get lab results on their mobile device.
• Another mobile app, MyPassport, helps inpatients communicate with their clinicians, access their care plan and track their progress toward discharge.
• ALICE, a digital “smart board,” has replaced the white boards and hand notations Boston Children’s clinicians used to keep track of patients in each unit.

A harvest of solutions

Having an in-house incubator has allowed Boston Children’s to rapidly create and test novel software solutions. Because our FIT developers understand the hospital’s IT environment, their technologies integrate far more smoothly than most vendors’ solutions to the same problem.
Innovating around clinical software solutions has traditionally been difficult. Because we can provide dedicated healthcare software development resources, our staff’s ideas are bearing fruit and helping us to enhance the delivery of pediatric care. To see so many innovators embrace these resources is not only gratifying to all of us in the IAP, it is also tremendously beneficial to the people who matter most—our patients.

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Join Dr. D. and Natalie for ICD-10-CM SHOOT OUT

Score a goal for QUALITY with Dr. D and Natalie in ICD-10-CM SHOOT OUT!!!

This game covers chapters 18-21 of ICD-10-CM..

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