This will be my last posting on the wonderful book, The Nun and the Bureaucrat. In this posting I'll be talking about empowering front line workers an then some on leadership. I hope you've enjoyed reading about this book and I do encourage you to go buy it.....especially if you're in the healthcare field.
Before all of the improvement efforts experienced by these two healthcare organizations began, it was not uncommon to have an "expert" come in, study the problem and then make recommendations on how to improve the situation or solve the problem in question. It was not uncommon for this process to take six months to a year to complete. Today, both organizations use what is referred to as real-time problem solving. This technique was developed by Toyota where workers would spot a problem on the assembly line and they were empowered to pull a cord to shut down the line to fix it....even if it was a minor problem.
At the PRHI hospitals, the front-line workers see a problem, analyze it and then propose a solution which is then tested as soon as possible. If the solution works, it is implemented throughout the department and ultimately, the entire hospital. If the solution doesn't work, then they try a different solution and keep doing so until the problem is resolved. SSM developed a similar way of solving problems referred to as "Shared Accountability." The key point is that front-line employees can solve problems because they have become systems thinkers. Both organizations recognized the creative power and potential of front-line workers and empowered them to help heal their healthcare systems. You can only imagine how these front-line workers now feel about coming to work nd knowing that their opinions matter.
But even though major improvements have been made in these two healthcare organizations, they still have a lingering problem which is a difficult one to solve. It's the problem of built-in opposition between the Physicians and Surgeons and the Hospital Administrators. Deming said it best in one of his Fourteen Points..."Break down barriers between staff areas." Systems Thinking tells us that theoretically both sides should be trying to achieve the same goal.....improving patient care, but are they? Not all doctors and administrators have embraced system thinking, so therein lies the problem. But the good new is....things are getting better as both sides of the same equation are slowly accepting systems thinking.