Friday, September 25, 2009

Surgical Care Improvement Value Stream Report Out Today! CCRMC, Building One, Conference Room One at 10:00 AM

To All Staff-


I'd like to remind everyone that the findings from the Surgical Care Improvement Value Stream will be presented this morning. Teams went to Gemba(現場), and many were in your areas this week. I thank you for your cooperation and participation.

In a stand up report using an A3 format the current state will be presented. Teams will show us what they found and present a vision for the ideal future state. Taking the time to learn about our system and ways to deliver the highest quality and highest value service to individuals and their families is essential. Reflecting on our improvement work in the Congestive Heart Failure (CHF) Value Stream, much of the ideal future state presented in their stand up report has now become standard work delivered to every patient every time.

It is imperative that we learn together. Our aim is to provide the highest quality and highest value service to our community, making possible, health for all.

Please join us at CCRMC Building One Conference Room One at 10:00 am.

I slept and dreamt that life was joy.
I awoke and saw that life was service.
I acted and behold, service was joy.
- Tagore

This is ours to do. If not us, then who?

I look forward to seeing you there.

Friday, September 11, 2009

As we look back on the events of September 11, 2001, we remember the bravery, courage, and humanity shown that day and the many to follow. We remember those lost, and those whose lives have been forever changed.

Sunday, September 6, 2009

Being Still

Be still and know...

I’m often asked what my plans for our organization are. For many of us, and I know for myself, not knowing what is going on, where we are going, what will happen tomorrow or other sorts of "blanks" or "voids" can lead to an uneasy feeling. Sometimes when faced with a “blank” we create stories, and sometimes, we even convince ourselves that our stories are in fact the truth. This behavior of filling in the blanks is not that unique. It turns out we do this quite often. Our stories not only help us make sense of/or tolerate the unknown, they move us to action when we are faced with the facts - even facts that feel too difficult to bear. Our stories add texture and context to what information we do have.

This is all sounding vague. Let me draw from the IHI website about the value of storytelling:

Anyone involved in quality improvement efforts knows that scientific principles are at the center of this work. But even the most evangelical quality engineer will caution that this only part of the solution. Improvement strategies and measurement tools are most effective when embedded in an organizational cultural that ensures that changes are embraced and sustained. And there is no better means of inspiring cultural change than through the simple craft of telling stories. As Donald Berwick, MD, MPP, puts it, "Measurement is important, but it’s the stories behind the numbers that are the most enduring wellspring for change."

So what does this have to do with where we are going? How is this connected to what is happening today at Contra Costa Regional Medical Center? It is a time of change for CCRMC, and with that, a time for new opportunity. We have an opportunity to find a new way forward together.

As Edgar Schein notes in his new book Helping, “ Many people in senior management or leadership positions have the ability to be effective change agents.” He says we must do this "by not only learning how to help, but also to learn to accept help." This is what makes leadership so complex. By accepting help he says, we become “genuinely involved in the culture of the group, and how to give help to the group and to individual subordinates as individual areas of improvement are identified." (Helping: How to Offer, Give, and Receive Help, 2009, p 132)

Elias A. Zerhouni echoes this perspective noting that leaders who want to fix things or make change, will be most successful "if they initially adopt a helping role which, in turn requires their willingness to be helped. Once they create a climate of trust, they will elicit crucial information about what is going on and learn the local cultural rules and norms." Discovery and creativity, he argues, are eminently social processes. (Letters from Leaders, 2009, p 61).

So does this mean that part of leadership may include becoming vulnerable, and available? Maybe to rush to find the answer or fill in the blanks is not always helpful? Although it sounds quite simple, this isn't easy stuff. Maybe this is why Hoshin Kanri directs us to "go and see" (Genchi Genbutsu / 現地現物) in order to understand?

I have no answers today. I too am filled with questions, but I do believe that to lead is also to learn.

...and maybe, at least for me, sometimes I just have to be still.