Journal of Healthcare Management - November/December 2015 - (Page 386)
O P E R A T I O N S
A N D
S T R A T E G Y
The Framework for a
Whole-System Transformation
John S. Toussaint, MD, CEO, ThedaCare Center for Healthcare Value,
Appleton, Wisconsin
I
n my previous column in this series (see the Operations and Strategy column in the
September/October issue of JHM), I described the structure of a Lean healthcare or
rapid-adaptability system. In such a system, every employee's job is to find and fix
problems using the scientific method. The system consists of varying degrees of
standard work for all-from technicians to senior executives-and management
practices that are as reliable and repeatable as the transformed frontline care-delivery
processes. The pieces of the system fit together to ensure that people are not only
solving problems but are solving the right problems.
To people who have not worked in a Lean system, this can seem like pie-in-thesky idealism. While it is true that much change is required for traditional systems to
become Lean and rapidly adaptable, these transformations are happening around the
globe and the changes required have become well known. In this article, I describe
the more systemic changes that must be made to ensure that all support systems
transform along with operations.
BREAKING DOWN SILOS
Most healthcare systems keep support functions such as finance, human resources
(HR), and information technology in separate silos. Each department speaks its own
language and keeps jealous control of certain aspects of the organization. When
operations leaders begin the Lean transformation and experiment with new roles for
managers or new job descriptions for registered nurses, they often hit the HR silo's
brick wall. When they try to obtain daily data reports or rewrite profit and loss
statements to reflect the new focus, leaders run into walls labeled "IT" and "finance."
This happens at every organization. Misunderstandings that turn into turf wars can
scuttle a transformation. On the flip side, stronger partnerships between operations
and support functions will accelerate progress. Over the past decade, as I have studied
and assisted in transformations at more than 160 organizations around the world, I
have seen many health systems take creative approaches to breaking down the silos
and begin rowing together.
O P E R AT I O N S A N D S U P P O RT S E R V I C E S W O R K I N G T O G E T H E R
At ThedaCare's hospitals and clinics in northeast Wisconsin, our biggest breakthrough with HR occurred when leaders in operations (I was CEO at the time)
386
Table of Contents for the Digital Edition of Journal of Healthcare Management - November/December 2015
Journal of Healthcare Management - November/December 2015
Contents
Interview With Nancy M. Schlichting, FACHE, CEO of Henry Ford Health System
The Framework for a Whole-System Transformation
Building the Foundation for a Successful Medicare Shared Savings Program
Rural Hospital Mergers and Acquisitions: Which Hospitals Are Being Acquired and How Are They Performing Afterward?
Understanding U.S. Physician Satisfaction: State of the Evidence and Future Directions
Business Models, Vaccination Services, and Public Health Relationships of Retail Clinics: A Qualitative Study
Process-Improvement Cost Model for the Emergency Department
Journal of Healthcare Management - November/December 2015
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