“Lean” Management. “Lean” Leadership.

Published by



The buzz word in today’s management circles is “LEAN” — not as against a lamppost, but as trimmed back to basics and making the most of computerized technology to produce a measure of quality efficiency. This is a fantastic concept that works in manufacturing (such as with Swiss Screw precision parts, and with automated equipment operations).

Unquestionably, implementing LEAN can make a difference. The problem is that –as with MBWA and Quality Circles and Theory X and Theory Y and JIT and scores of other management and leadership approaches– too many leaders desperate to make a name for themselves by shaking up their organizations tend to latch on to the latest fad, and expect nirvana.

With LEAN, too many advocates of quality leadership in management are attempting to put this square LEAN peg in a round ultimate consumer hole. The result for many of these forced marriages — especially in healthcare (doctors, hospitals, and facilities of every description)– is that they can end up victimizing themselves by a rush to “leanness.”

It’s not unlike cutting back food consumption to lose weight, then ending up dizzy and disoriented. In other words, too much reliance on streamlining the process can easily overshadow the basic thrust of an organization’s purpose.

Consider for example, what the last few letters (hint: Not “EHR” or “EMR”) in healthcare, are all about. All the cost efficiencies and lightning record retrieval systems in the world cannot come close to the only thing that –in the end– really matters:  care.

Of course a LEAN approach in healthcare can mean more accurate, more efficient, more rapidly delivered patient care. But buying into LEAN as if it were the end-all, be-all, ultimate solution to healthcare is like saying that the process of flying the plane is more important than the pilot. And that may well be the case some day but, for now, reality dictates that computer technology apps are simply tools to afford providers the opportunities to provide better quality patient care.

Use LEAN. But give careful budget and strategic planning consideration to the kinds of staff training and practice development avenues that far override the values of LEAN, such as:

1) Staff, patient and patient family communication. [A world-leading hospital I am intimately familiar with has robots delivering meds to patient rooms, but staff physicians who file endless numbers of computer reports don’t read one another’s reports, or communicate with each other. Few even have direct contact with the nurses dispensing the drugs!]   

2) Staff, patient, and patient family stress management [Did you know that the more relaxed a patient is, the more accurate the diagnosis can be and the better the response will generally be to treatment? The better the odds for reimbursement too, not incidentally! Patients and their families seek trust and  reassurance. LEAN may set that table, but only physicians, nurses and professional staffs can deliver the meal.] 

Target your budget and your process emphasis behind the kinds of communication skills and stress management training that providers and provider support staffs most need and least often get if you really want LEAN to work. Diets are great if you stick to them, and success often reduces itself to maintaining an ongoing dialogue about it with someone who supports your pursuits.

# # #

Hal@TheWriterWorks.com or comment below.

Thanks for visiting. Go for your goals! God Bless You!

Make today a GREAT Day for someone!

4 comments so far

4 Comments to ““Lean” Management. “Lean” Leadership.”

  1. Mark Grabanon 08 Jun 2013 at 1:05 pm

    Hi – I’m a bit confused by one part of your post… are you saying the use of robots is being driven by Lean?

    Actually, Lean environments (in manufacturing, like Toyota) tend to have LESS automation than those who don’t use Lean principles and methods.

    I’m not a fan of using robots in patient areas, because they don’t have the human connection that people can make. A robot that’s delivering supplies in a hallway can’t smile at visitors and can’t answer questions that people might have.

  2. Mark Grabanon 08 Jun 2013 at 1:06 pm

    One other thought. You say: “too much reliance on streamlining the process can easily overshadow the basic thrust of an organization’s purpose.”

    It’s not “Lean” to cut so much that you can’t meet the organization’s purpose. The primary job is adding value and taking care of patient needs. Reducing waste is a secondary consideration.

    Too many organizations just cut cut cut and call that Lean. That’s not really Lean.

  3. Hal Alpiaron 08 Jun 2013 at 3:06 pm

    Thank you, Mark, for your thoughtful response, and please pardon me if I created confusion.

    In the situation to which I was referring, the use of robots appeared to me to have been directly driven by management’s misinterpretation of lean principles and methods. In speaking with scores of hospital providers and managers there, it became apparent that –instead of directly addressing inter and intra communication skill and system weaknesses– they were grasping at some ill-formed concepts of what lean is really all about.

    I don’t know if they thought they might be blazing new trails of efficiency that would override public impressions of hospital wastefulness, but clearly “the robot solution” did little beyond creating some oohs and aahs for some of the very reasons you cited.

    The example was intended to underscore what seems to me to be a disconcerting attempt in some healthcare arenas, to jump –lock, stock, and barrel– aboard every passing management trend without giving much thought to the primary reason for their existence. Given the hectic pace and stressful nature of hospital work, it’s no wonder that the temptation exists to grasp at any new idea and sometimes embrace it superficially, instead of digging into the kinds of truly meaningful thinking that your comments reflect.

    Thank you for taking the time and trouble to comment and for sharing such meaningful insights.

    Regards – Hal

  4. Hal Alpiaron 08 Jun 2013 at 3:19 pm

    And I appreciate your quick re-visit! How “spot-on” you are. Thank you. In the same context as I’ve often advised entrepreneurs that you can’t make money by turning off the lights (i.e., cutting expenses) . . . that it takes sales to make money, one might say that being lean can be a valuable tool but that it cannot replace the entire thrust or mission of an organization.

    In other words, go ahead and turn off the lights when you leave an empty room, but don’t think that doing that (or using robots!) will suddenly plunge your organization into unprecedented success. Only your people can accomplish that . . . and being lean may indeed help them to make that happen.

Please Feel Free to Leave a Comment Below


Tag Cloud