Posted by: knightbird | September 10, 2015

System Connectivity

WIth buy in from the healthcare staff, for the most part, the next steps are education and action. While leading the Lean effort at this organization, I did have substantial duties to fulfill. The board of this organization was very hands on (i.e. micromanaging). In 4 months, we had to prepare for five different meetings of up to 5 days in duration. Mind you, I have been engaged with boards both as a member and trainer. I am a nationally recognized Parliamentarian with glowing compliments from many leaders. I was on my way to the airport to make a scheduled flight and left a meeting that was still in progress. As I left the meeting parking lot, I started receiving texts and phone calls asking me to return. A crisis had struck. I returned, and the crisis was over based on my advice. The meeting adjourned quickly but I had to reschedule my flight. I have been told that my presence at a meeting introduces calmness and rational debate. While at the meetings, some of them 5 days in length, I literally spend almost no time addressing Parliamentary issues. And if they do come up, I generally have a solution within minutes.

WIth over 30 years of experience with boards, I am able to make assessments very quickly. And with this organization, I knew I was dealing with a very inexperienced board interested mostly in protecting employment opportunities for local tribal members. I tried to work with preserving and increasing employment while at the same time dealing with a potential loss for the previous year of in excess of $9 million and a $5 million budget deficit. It was easy to deal with the deficit. It was erased in less than 4 months. It was more difficult to deal with the board and its many meetings.

Every aspect of any business is part of an interconnected system. If you make a decision at the board level, it slowly permeates the organization. With the board choosing to make little or no work positions available to tribal members, there was a substantial impact on revenue and ability to provide services. When I teach Lean Thinking, I talk about control charts and Dr. W. Edward Deming’s discussion of common cause and special cause. Even a relatively unmanaged process in any business can be described as a stable system. And by stable, I don’t mean a good system. What is means is that any measurements you take will fall with a range around a 3 sigma upper and lower control limit. If a data point falls within this six sigma range, it is an expected result, even if it is defective. I often call it a stable chaotic system. This organization was a stable chaotic system with innumerable defects. A huge part of the reason was the culture supported by the board. For example, the vehicle use I wrote about earlier was well known to the board, but had not been addressed because of the system of fear the board used to control its executives. Because I was an experienced executive, I had far greater knowledge than our board about management. But they would not let go of their control. So while they were fighting over employment, during my tenure I only let 2 employees go. One was because I did not need the position. The second was because of theft that occurred by an employee. Still, the board chair wanted to know if the second dismissed employee could be “rehabilitated.” I took that to mean keeping their job. The organization’s attorney told me in one of our many conversations that the board over decades often choose to overlook theft by managers. As I said yesterday, whenever allegations of theft or fraud are brought to the attention of a CEO, they have an obligation to investigate. I had allegations that seemed credible, so I did investigate. That story will be left for another day.

When I arrived at the organization, employees would show up late for work, take long breaks and leave early. I even heard allegations that the C Suite would play cards during the day around the CEO’s conference table. And many trips had allegedly been taken for the benefit of an employee (to participate in sporting events, go shopping or visit casinos). I made it very clear on my first official day that being on time was mandatory. Because I was at my office before hours and for at least 2 hours after, employees complied. This was not as much a problem at the healthcare facility. Facebook usage was rampant. At one time I was told that Facebook use constituted over 70% of internet usage at the organization. And as I said, many jobs in the organization were basically there to distribute income to tribal members and did not have a full day of activity. One position had been created for a board member who already had a full time job. The board inspired culture was going to be difficult to overcome, but I did my best to address their concerns. For example, while they focused on individual employees who were let go, I hired and promoted many, many tribal members. One huge success was filling 20 long time vacant Community Health Aide (CHA) positions. And we had an additional 6 experience CHA’s interested in returning.

For a system, it is destructive to have a class of employees who enjoy special privilege, such as access to a vehicle for personal use during and after hours, showing up for work whenever they choose to and using organization assets for personal gain. And having a job where they literally did no work but received full time compensation. I am pleased to say that I made very good progress on changing this culture while I was there. Many local members of the community would stop me, or even come in to visit, and compliment me on the changes that occurred in such a short period of time.

Changing a system involves numerous cultural changes that have to be understood and accepted by a board of directors. Because this organization had no long term strategic vision, and a culture of fear tolerated by the board, changing the culture was imperative. In 4 months, the changes that did occur were a testament to many fine executives. That they did not sustain after I left was testament to the board and a small group of arrogant executives.

Systems thinking requires a deep understanding of the existing culture, and a vision for changing it. We did it. As we explained to our board at its annual retreat, we absolutely believed we had a potential for adding over 100 new jobs to the organization using existing funding and increased revenue from improved services. But we did not have enough trained people in the community to fill the jobs, so we were actively working with local education and training organizations on a plan to fill the jobs locally.

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