DailyKaizen

Over the last couple of years of writing on this blog I have probably written three of four posts discussing the need for the organization to cut down on the amount of improvement work in progess and to focus on only those improvements that will be truly transformational for the patients we serve.  So what the heck, why not a fifth?  I am worried that this year we may repeat the mistakes of the past so I wanted to write this post to share some of my thinking.

So why is there a lack of focus?  Overall, we really are an amazing organization at coming up with innovative ideas and solutions.  Since we lack an organizational competency in developing improvement hypothesis based on data (although we are getting better) most ideas end up being good ideas.  Additioanlly, because it is a lot easier to say yes then it is to say no we end up with far more work in the pipeline then we can get done.  As a result, the same leaders get tagged with leading far to many improvements.  The same supporting resources have far to many number one priorities.  The work drags on slowly and we don’t achieve the results we all know we are possible of achieving.  I am sure that many of you readers know this story pretty well since I am sure we are not alone in having this problem. 

The good news is that over the last couple of years there have been a couple of times that the organization has taken a piece of work and really focused.  When this has happened the results have always been impressive.  Implementing our electronic medical record, rolling out the Model Line in our Health Plan, developing our five year strategic plan and developing our enterprise value stream maps are all examples.  In each of these cases there has been a razor focus of leadership and supporting resources on getting high quality work done very quickly.  In a relatively short period of time work moved forward rapidly and people lined up to support the work.  Why was this work successful?  It is because the entire organization focused on moving this work forward.  From the senior leaders to the front line staff.  The problem is that when we have been successful it has taken a huge amount of organizational energy to make it happen.   

The organization needs to look at these improvements as examples of what is possible when we focus.  What if we were able to put this amount of focus and energy into each of our strategies?  The results would be far better then the norm.  Yet, this will only be possible if we limit the work in the system.  Focus on three or four things at a time as oppossed to fifteen or twenty and get them done thoroughly and quickly.  An interesting challenge we will continue to wrestle with.