by Ted Eytan, on 20 Mar 2007 10:26 am
The Journey
Locking the side door
What if you were the steward of an information system that could improve outcomes, affordability and the care experience if implemented and managed well, and do the opposite if not? It’s likely that you would be working with a lot of smart people who would do their best to assure the former, rather than the latter use of the tool.
We are transitioning to a hoshin process for planning enhancements to the tools we have in place for the purposes above. In an organization with a lot of smart people, there is no shortage of ideas, which I consider to be a form of inventory. We are hoping to do this process every 90 days, which gives us a chance to make adjustments and improvements fairly frequently.
As the official medical steward, there are things I believe have the best impact on the goals we want to achieve based on what I know about the system. Should I therefore have my own “side door” to prioritize the things that I think are best done with our limited resources?
I have thought about this. I believe in most information technology organizations of the non-LEAN variety, the side door is the state of affairs. It’s assumed that the stewards know best what is relevant to the customer and will execute a plan based on this knowledge. Sometimes this knowledge is gained second hand, though.
What I think about with my LEAN hat is something different. What if I use the front door instead, and treat my ideas as inventory to be respected along the ideas presented by operations leaders and those closest to the customer? This would mean spending some time (some nemawashi) to align the “why?” of my ideas with those providing direct care to the member. In some cases, the thing I think has the most promise might not get prioritized. At the same time, if I make the effort, and the idea gets prioritzed, I think there’s a greater chance of success because we are prioritizing together.
Should I put a lock on the side door and ring the doorbell to get into my own house? In this case, the house really isn’t mine; it belongs to the members, so I think it is incumbent on me to enter it with the other guests. Once we get inside, though, I am sure I will be able to cook a terrific meal, because I know how to use the kitchen really really well.