Part 4 of 6, Full Interview
John S. Toussaint is CEO emeritus of ThedaCare, and CEO of the ThedaCare Center for Healthcare Value. As a strong proponent of applying the lean methodology to rooting out waste across the healthcare industry, we asked John about his experience at ThedaCare, specifically how he measured the return on their lean initiatives.
One thing that we always made very clear, at least I did, was that this wasn’t a project. This is what we’re going to do. We are going to change the organization. Some people for a while kind of hid under the table and thought it might go away, which is typical for new management ideas. But I stayed very, very focused on this and it became pretty clear to just about everyone that this wasn’t going away. A few people chose to leave. We had to take a few out, but I would say most people who weren’t’ compatible with this new culture that we were building left of their own volition.
We were told by our consultants, ‘All you have to do is just do events and that’s how you learn it.’ I don’t disagree with that, but the reality is when you have 40-plus sites and 5,500 employees, it just doesn’t work. You really have to be out communicating all of the time. You have to be training. We spent about a year getting everyone in the organization on board with what lean means. Lean isn’t mean.
I could have easily told [the teams] what to do and in the end, in some cases, we probably would have had better results. But that wasn’t the point. The point was for them to make mistakes, ask questions, understand what the problems were…, and then have them do that with their subordinates and so on.
We began to build a community of problem solvers that actually attack and manage anything that came their way rather than wait for the “brain” to make a decision.
If you think that you can judge each activity as to whether or not it’s going to make you any money I think you’re missing the forest for the tree…. What you’re doing is creating a culture and in some cases it takes years for that culture to actually drive results. But once that culture actually starts to take hold, organizational performance skyrockets.
I get a little bit concerned that some people think of this as a short term strategy, which is why only one out of every twenty companies ever becomes transformed using the lean methodology. The autocratic leaders, within the first couple of years, they get their few million bucks and then it gets hard and they move on to some other fad, which is quite disrespectful for all of the people that you’ve put through all of this work.
[...] Culture Change [...]