by Emily Swaney, Sr. Director, Lean Promotion Office at OhioHealth
When asked about my work, I often say, "I cultivate a culture of 35,000 problem solvers." If this is our mission—my team's mission—it is mission-critical (pun intended) to kickstart our efforts by focusing on the journey of every individual.
At OhioHealth, our continuous improvement journey began in '06, emphasizing removing waste from the organization. While we facilitated the occasional Rapid Improvement Events and initiated using Hoshin Kanri, our continuous improvement team spent most of our time leading system-wide cost savings initiatives. This work was critical in setting our organization up for financial success. Still, our niche focus on finance prevented us from developing what was our most valuable asset – our people. In '16, we acquainted ourselves with the transformative Shingo Model and we unanimously adopted it as our True North.
Principle by principle and concept by concept, we began carefully crafting the OhioHealth Management System to drive us closer to organizational excellence. We understood that for this system to function, we had to fully integrate it into our business – it had to become how we conducted business.
We began by understanding how OhioHealth defined organizational success. What routine performance metrics drive our balanced scorecard? What is our strategic framework? Who do we, as an organization, aspire to be? Finally, and most importantly, what is each person's role in this system, from CEO to frontline caregiver? For our management system to reach its maximum potential, we must focus on developing and empowering every associate to feel confident and capable in their daily problem-solving. Effectively equipping our associates drives us closer, one day at a time, to organizational excellence.
At the core of an effective management system is comprehensive simplicity. If our goal is to engage every individual in the journey toward enterprise alignment, we must do so methodically and in the simplest way possible.
Every Individual Must Know the "Why"
At my organization, we share the first "why" in new associate orientation as we lead with OhioHealth's vision statement: "To provide exceptional care for all through experiences that earn a lifetime of trust." At the same time, our vision remains every associate's primary why; providing them with timely and appropriately thorough communication on all items that impact their job is equally important. In our most recent associate engagement survey, associates who responded favorably to the question "My manager communicated the reasons for business decisions" were 2.4x more likely to respond favorably to "My manager cares about me as a person." With the goal of respecting every individual, we must understand the "why."
Every Individual Must be Supported & Empowered
It is critical that organizations continually prioritize and invest in their people. When we pair the subject-matter expertise of every individual with high organizational trust, we unlock the innovation we seek to foster. To help us realize the potential of each team member, we focus heavily on developing leaders, not managers. Establishing a solid foundation for our leaders' success begins with clearly defining principles and behaviors that align with our ideals -- this ensures that our leaders have the necessary qualities to uphold these principles effectively. Guided by the Shingo Model as our True North, this leader behavior self-assessment tool incorporates the model's Guiding Principles and identifies specific behaviors that enhance cultural enablers, promote continuous improvement, and align with the overall enterprise goals.
Additionally, our management system incorporates two intentional check-ins that leaders have with their staff each day to ensure they feel supported and empowered:
Every Individual Must Encounter Continuous Improvement Principles
We laid the foundation with the "why"; we empowered individuals to make change; now, we must equip them with the knowledge to challenge the status quo. What is it that holds us back from flawlessly executing our vision today? Thoughtfully consider introducing the continuous improvement principles in a way that best resonates with everyone. While training may lay the foundation, direct application is the most effective form of exposure. When faced with opportunities for improvement, our organization has tremendous success encouraging A3 thinking, going to Gemba, facilitating kaizen events, and embedding standard work versus our classroom-style training. Weaving continuous improvement principles into the culture allows everyone to experience the organic connection of these principles to their work.
Every Individual Must Have a Set of Continuous Improvement Tools
For over seven years, OhioHealth has consistently had four tiers of standardized improvement activity, each having a supporting tool:
These standard tools, available to everyone, guide our problem solvers to focus on continuous improvement, supporting concepts such as relying on data and facts, ensuring no defect passes forward, and identifying and eliminating waste. When problem-solving needs to occur, our organization assesses the complexity of the problem and utilizes the tool believed to close the gap best.
Every Individual Must Understand How and When to Use Continuous Improvement Tools
While we recognize the power of an effective tool, tools are only helpful when used at the right time and for the proper purpose. OhioHealth has built a management system that consists of the tools, processes, and structure we rely on to 1) define organizational success, 2) drive organizational progress, and 3) sustain progress. In this system, we have integrated prompts to facilitate the use of our tiered improvement activity when we fall short of our target condition. Below are two clear examples of our built-in prompts for problem-solving:
Every Individual Must Have Clarity on Their Role in Driving Organizational Progress
When the management system is well-calibrated, individuals at every level hold equal responsibility. We have provided the "why" and the "how" – now we share the "what." Our responsibility is to ensure transparency in communicating expectations regarding an individual's role within the management system. Various strategies, including standard work, job descriptions, and well-defined protocols, foster openness. By providing comprehensive information and fostering clear understanding, we can effectively guide and empower individuals to fulfill their accountabilities. What is their role today in how they are responsible for providing exceptional care for all through experiences that earn a lifetime of trust?
In the pursuit of enterprise alignment, we must relentlessly strive to unlock the power within each person. Each of us must actively foster a culture that respects, honors, and nurtures individual capabilities. Regardless of your progress on the path to enterprise alignment, take a moment to reflect on the "why," "how," and "what" pertaining to each team member. Consider how you are positioning your organization and, crucially, your people for success.
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