New Roles and Responsibilities of Leaders that Empower Workers

"My theory of waste goes back of the thing itself into the labour of producing it." 

                                                                          -Henry Ford

Last month I was reading Taiichi Ohno's 1988 book describing how the Toyota Production System evolved and was quite taken with how much inspiration he took from Henry Ford. As Ohno noted,

"I believe Ford was a rationalist- and I feel more so every time I read his writings. He had a deliberate and scientific way of thinking about industry in America. For example, on the issues of standardization and the nature of waste in business, Ford's perception of things was orthodox and universal."

Ohno goes on to observe:

"We see in Ford's thinking his strong belief that a standard is something not to be directed from above. Whether it be the federal government, top management, or a plant manager, the person who establishes the standard should be someone who works in production." 

This one of the differentiating bases for the success of what has become popularly known as a Lean management culture, namely: 1) Employees are in charge of their own jobs, and 2) Employees design their own standardized work.


Role of the Leader

How and what would you as leaders and managers need to change to foster and sustain this management system of empowered workers? In the previous 3 parts of this series we addressed the philosophy and behaviors of a self-sustaining continuous improvement culture, the business case and methodology of change and then creation of organizational structure and teams that promote that culture of continuous improvement.


Your new leader role is that of cultural transformer.

To achieve that cultural transformation will require a transformation in how you lead, that is, to move from the typical Western manager to the Japanese or Deming-style manager as described in the management systems below.

Deming's philosophy of work and leadership can be summarized as:

"Management’s job is to ‘work on the system’ to achieve continual product and process improvement."  -W. Edwards Deming

Specifically, the Deming redefinition of management leading to cultural transformation has been described by Andrea Gabor in her book The Man Who Discovered Quality: How W. Edwards Deming Brought the Quality Revolution to America as follows:

Recognize that Lean quality cultural transformation:

• Is leadership driven- without leadership, it doesn't happen
• Is based on the organizational structure you create and values you espouse
• Has redefined roles of middle management and workers
• Values, respects, empowers, protects the workers
• Aligns incentives
• Recognizes, rewards the new behaviors continually
• Educates, develops the workforce (the next leaders) continually

Your leadership and management goals now include:

• Adopting Deming's philosophy of work and leadership
• Managing through a focus on quality- your constancy of purpose
• Creating a learning organization and culture
• Developing people, with active participation of all staff
• Creating ownership for problems and resolution
• Operating according to defined structure, work rules, and using manufacturing based tools in empowered teams
• Continually improving quality, not just to meet, but to exceed customer needs
• Moving incrementally to the ideal target condition, continuously

Or in other words, relentlessly pursuing perfection.

Other roles of the Leader and Manager are now to:

• Develop and communicate
• Vision, Goals, Priorities, Resources
• Strategies for leaders, team members, ownership
• Facilitate
• Remove barriers and roadblocks
• Communications, connections outside department
• Accountability for progress
• Require follow up, monitoring, documentation of changes
• Encourage
• Celebration and recognition of contributions
• Spread enthusiasm

In this manner, leaders can continually promote the goals of 1) zero defects, 2) teamwork, 3) team problem solving and group learning, 4) unleashed creativity and innovation. By creating a culture that allows change from the level of the workers, you enable the continual redesign of work systems that consistently attain excellence. This is the essence of 'kaizen,' hundreds of process improvements contributed by expert workers at your bequest. Did someone say Employee Engagement again?

References:

-Ford H. Today and Tomorrow. New York, NY: Doubleday; 1926.

-Gabor A. The Man Who Discovered Quality. How W. Edwards Deming Brought the Quality Revolution to America--The Stories of FORD, XEROX, and GM. New York, NY: Penguin Books; 1990.

-Ohno T. Toyota Production System: Beyond Large-Scale Production. Portland, OR: Productivity Press; 1988.

 

Creating, Structuring and Sustaining a Culture of Continuous Improvement in Healthcare

These words are meant for those who are tired of the status quo and intend to create, lead and manage a Lean enterprise based on a Deming-style management system.  I am not talking about accomplishing leader-prioritized Lean projects with selected tools but rather creating a culture of a healthcare workforce engaged, structured and incentivized to participate in the work of improvement at all levels. That is to say, a Lean enterprise, defined as a culture of continuous improvements made by empowered workers. 

As of this writing, we have had the pleasure these past 6 years to lecture, train and share the story of our journey of continuous improvement all over the world. Most audiences see the results we describe, the standardization, and the visual artifacts of our way of working throughout the laboratories as the success. Initially, we described in the peer reviewed literature our plan to transform to a functional culture that allowed for continuous improvement (Transforming to a Quality Culture: The Henry Ford Production System, AJCP 2006;126(Suppl 1):S21-S29). We have learned much since that early plan. But it is that culture change and what we have learned in that quest that is the true success.

As a product of the culture that we created, we have been transformed, leaders and workers alike. We have learned many lessons by doing, succeeding, failing, adjusting, reinventing, innovating and doing again. In reflection, we have performed continual and successive PDCA cycles in that transformation to a quality culture.  In this next series of blog entries, I will review our lessons in the implementation 'how to' create, structure and sustain a culture of continuous improvement in healthcare with parallels borrowed from Henry Ford, W. Edwards Deming, and the successful Toyota Motor manufacturing management system.

We don't make cars in healthcare. We make people well and we work differently in a very complex environment of hand-offs with much variability. We don't have a 'shop floor' but we do have work as seen by those closest to it at the level of the 'bench' and at the level of the 'bed pan.'  Lessons from Lean must therefore be extrapolated to very different work conditions and professional relationships. This is hard work and requires understanding the best from others' work systems and innovating and adapting approaches that mine those successes to achieve our goal of transforming our healthcare culture.

What will follow in subsequent blog entries are our lessons learned from first hand experience in creating an effective PDCA-based culture of continuous process improvement that aren't typically taught in Lean training courses. This is from the 'school of hard knocks.' I was intent on writing a book but I feel this is the most efficient way of sharing these lessons so others may adapt and implement successfully in their own environments as well. We don't have time to waste in American healthcare.

I call this series that follows THE LEAN LEADERS GUERRILLA HANDBOOK.

I hope it helps you.

Let me hear from you so we can all learn something.