Posted by: Knightbird | January 3, 2015

Lack of Recent Posts

I have been noticeably absent from my blogs over the past year. A little over a year ago, I was excited to start a new Lean Adventure. After interviewing, where I disclosed both my Lean Management philosophy and experience in tribal health systems, I was hired to run a large rural Alaska health care system. 4 months after I started, I left that job having learned some valuable lessons. The best lesson was that the Lean Thinking philosophy works, and can inspire employees working in dysfunctional systems. The second lesson is that politics still prevails over results.

The month I arrived on the new job was exciting and challenging. The company was projecting a large loss or about 5% of total expenditures. 3 months later, the loss estimate increased to over 10%. A budget prepared by the prior chief executive contained a 5% built in deficit. We had insufficient reserves to operate without a line of credit. And a paucity of health care professionals in all of our programs made service delivery difficult.

The first move I made was to hire a qualified Sensei to guide our newly formed continuous improvement program. Through cooperation with the Executive Team I inherited, we imposed a hiring freeze on non essential positions, started an energy leadership team to reduce our energy expenditures, imposed a ban of Facebook use during the work day, and enforced a policy prohibiting non business use of company vehicles. Within 4 months, we had eliminated the 5% deficit. We also secured a line of credit to allow us to meet operating expenses. Unnecessary travel was stopped, and we worked hard to recruit health care professionals. We filled 20 Community Health Aide vacancies along with the supervisor position. To deal with a crisis in the CHA training program, we were working to innovate CHA training within the Health Care System.

The Sensei conducted 11 Kaikaku in the 4 months I was there. Kaikaku helped us identify about 500 improvement targets, although many of them identified similar problems. This was my first effort at Kaikaku, and it proved its worth. We understood very quickly the magnitude of improvements available to us. We were able to roughly project a potential for substantial increased revenue and significant reductions in cost. We projected many of they improvements could be achieved within a 2 to 3 year time frame. What impressed me the most was how quickly and passionately many employees embraced the Lean concept. I had far fewer resisters than I thought. The ones I did have were tough, however.

I also brought my medical leadership team to Virginia Mason Medical Center is Seattle for a 2 day workshop. What an amazing visit. My team was pretty excited about the possibility, and our medical director came forward with some very innovative ideas to improve health care services.

I left grateful for the many employees who contributed so much of themselves to our Kaikaku, especially my Lean Sensei. He worked tirelessly and with great skill to educate and engage our employees. The A-3’s produced in our Kaikaku gave us a solid road map to a great future state. I have been told that many of the staff continue to try and make the improvements despite the absence of any Lean knowledge remaining in the organization. And I am grateful for the many fine staff who tried to put the Lean Culture in place.

My biggest disappointment is that the patients in the region will not receive the many benefits that were identified as within out reach in a timely manner. They are the reason I took the job, and when I left, I felt sad that the promise of Lean would not be realized. Still, the addition of 20 CHA’s makes a big difference.

I plan to post a little more frequently. I have learned a lot more, and have a lot more to learn.

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