Tactical Lean Won’t Deliver

PRESS RELEASE

The difficult financial challenges facing the health service over the next few years, as it restructures its service models to release cash, are likely to be difficult to overcome for those organisations that take a tactical approach to improving performance, warns the quality, innovation and productivity organisation, Amnis.

 According to Amnis’ Mark Eaton, any health sector organisation taking a tactical approach to implementing changes by focusing on isolated processes or pathways and not linking the front-line improvements to an overall transformation strategy is at risk of failing to bring about the financial benefits that are going to be needed.

 “Significant and strategic change requires a strategic approach,” said Eaton, “and that starts by getting under the skin of the real objectives that need to be delivered, putting real numbers to the improvements that need to be generated and then identifying the key areas that will need to be transformed to deliver the required improvements.

 “In addition, the future for the NHS can only be delivered through organisations working together to tackle the big ticket issues in a collaborative approach,” he counselled.

 “This often means making a change to the way that senior teams work. It also involves the need to promote team working rather than the tribal warfare that can exist both within some organisations and across whole health economies.

 “Moreover, it relies on impartial decisions being made about tough issues and recognising that, while everyone needs to win, they may not win every time.

 “One thing that’s for certain is that organisations don’t need any more isolated ‘Rapid Improvement Events’ that aren’t linked to strategic goals and don’t help health economies to deliver their collective targets,” he stressed.

 Amnis’s healthcare specialists offer a range of services intended to help organisations, especially those in the healthcare sector, to implement Lean successfully. For further details, contact Amnis’ client services director, Ruth Bodman, at ruthbodman@amnis.uk.com or visit http://www.amnis.uk.com

Toxic Cultures Drive Poor Performance

Organisations with toxic cultures are going to find it difficult to change their performance because anything they try will be resisted and undermined by the inertia within their organisation, according to the quality, innovation and productivity organisation, Amnis.

From its many years of experience of working with a wide range of organisations, Amnis believes that toxic cultures – which can be identified as having a general lack of respect for people, a strong people hierarchy, discord in the senior team and disengaged managers – are significantly affecting performance in some healthcare organisations.

Amnis’ work in the healthcare sector has shown that the key to long-term change is to tackle the barriers that toxic cultures can create by:

1. Ensuring that the words that your top team use are aligned with how they behave
2. Tackling any ‘tribal’ thinking and promoting team working
3. Adopting an effective structure for implementing change that engages front-line teams
4. Celebrating every success but accepting the occasional failure

 

Amnis’ Mark Eaton explained: “It is as important to tackle an underlying toxic culture as it is to have a well thought out transformation strategy – and far more important than getting on with tactical improvement programmes using Lean Rapid Improvement Events – if you want to instigate real and lasting change.”

Characteristically, organisations with toxic cultures will struggle to change behaviours and improve performance. Moreover they will find that any investment they make in Lean or other transformation programmes will not lead to long-term improved performance, warned Eaton.

He added: “Toxic cultures also facilitate decreased patient safety and foster other risks to the organisation. Consequently, it’s not just financial performance that will suffer as a result of an organisation experiencing a toxic culture.”

In association with the Institute of Healthcare Management (IHM), Amnis is running a series of masterclasses for healthcare professionals. Toxic cultures – and how to overcome them by instituting a supportive culture – featured in the recent masterclass on ‘Developing a Culture of Continuous Improvement’.

According to Amnis’ Mark Eaton, who is also the author of the book ‘Lean for practitioners’: “Basing improvement initiatives on the concepts of ‘Lean’ and ‘Lean Sigma’ – basically, doing more with less – is a sound principle but, for this to succeed, you need to change people’s working culture and behaviours as well as processes.”

The next masterclass in the Amnis/IHM series is on ‘Thinking Strategically’, and is being held in Birmingham on 26^th February 2010.

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6 Questions to give your service improvement strategy some pace

Recognising that different groups of people within your organisation will need differing skills and will also need to have differing responsibilities for making your improvement programme work and that the actual service improvement journey for a typical healthcare organisation is 3 years (and more) then the following six questions will help you give your programme the pace it needs;

1. At the end of 3 years how many people do you want to be ‘aware’ of the overall service improvement strategy?

2. At the end of 3 years how many people do you want to have participated in an improvement activity?

3. At the end of 3 years how many people do you want to capable of initiating projects?

4. At the end of 3 years how many people do you want to be leading your service improvement programme?

5. How many senior improvement sponsors (and clinical champions) will you want in 3 years time?

6. How many managers will need to understand their role in delivering your improvement objectives?

Now obviously you will have your own objectives but normal answers to these questions will give results that represent the following percentages of your total staffing;

1. 100% – everyone needs to understand the basic skills and objectives of your strategy.

2. 30-40% – maybe more, maybe less (but not much less).

3. 10-15% – these are people with a ‘day job’ who also have a role in service improvement.

4. Around 0.5% – these people lead your improvement activities, train everyone else and facilitate events and activities – they are not project managers!!

5. At least 2 senior management sponsors and 2 (or more) clinical champions.

6. 100% of your managers need to understand their role and the objectives of the strategy.

What this means for an organisation with a total workforce of 3,000 people is that;

• All 3,000 will need to be made aware of the basic skills and the details of the service improvement strategy. Assuming each awareness session lasts 2-3 hours and has 25-30 attendees will mean around 120 training sessions over the 3 years.
• Around 1,000 people will have been involved in an improvement activity. Assuming that each event (such as a Rapid Improvement Event) has an average headcount of around 10 people (some will be smaller and some larger) means 100 improvement activities over the 3 years.
• Around 300 people will have the skills to initiate projects and to lead small and localised improvement activities. These people will need to be practitioners, having skills such as those offered by our ‘Accelerated Lean Skills Programme’ (http://www.downloads.amnis.uk.com/ALSP.pdf). Assuming each training programme has 15 attendees means 20 need to be run over the 3 years.
• 0.5% of your team (15 people) will be Service Improvement Leads with skills such as those provided by our Lean Leaders Programme (http://www.downloads.amnis.uk.com/LLP.pdf).
• You will also need to undertake training for your Process Owners of around a day and for your senior team and clinical champions of around 1/2 day. There should also be regular reviews of progress with your senior team and ‘top up’ training for your Process Owners and Practitioners.

Does this seem excessive? Well, maybe – but the returns it will bring to your organisation in terms of improved safety, quality, productivity, efficiency and capacity, not to mention patient and staff satisfaction, is worth the effort isn’t it?

We call this approach to building an improvement strategy ‘EQIP’ (Enabling Quality Improvement Programmes) and to find out more contact us via info(a)amnis.uk.com or visit our website at http://www.amnis.uk.com.

8 Dimensions of Lean Leadership (3 of 4)

In the third in our series of blog posts about Lean Leadership we introduce the 5th and 6th Dimensions.

5th Dimension – Strategic Approach to Lean

Linking your Lean programme and activities to your organisation’s strategywill ensure that you select the right projects and also will help to engage your senior team. Successful Lean events that do not deliver strategic benefits are a waste of time. They might generate some very worthy improvements but they won’t be sustained. They might generate some excitement but it won’t last. In the end it will only be those activities that deliver strategic benefits that will be of interest to the organisation or be sustained.

6th Dimension – A Focus on Continuous Improvement

Lean is not a ‘one off wonder’. In addition, things will not be perfect first time, there will be problems and even more opportunities for improvement. Capturing ideas for improvement and dealing with problems with the new process are key to ensuring that the team do not just dismantle it and return to the old ways of doing things.

Next week we will publish the fourth blog post introducing the last two dimensions. If you can’t wait or have any questions contact us via info@amnis.uk.com, visit our website (www.amnis.uk.com) or ring +44(0) 870 446 1002.

Amnis helps improve clients’ return on investment in project management

PRESS RELEASE

The quality, innovation and productivity organisation, Amnis, has developed a training programme that focuses on the essential skills needed to plan and run successful projects. The programme – ‘People Based Project Management’ (PBPM) – is intended for healthcare professionals who are concerned that their organisation’s project management performance has not improved despite their staff receiving training on PRINCE2 project management techniques.

 Amnis’ Mark Eaton commented: “PBPM came about because a number of NHS organisations have invested in PRINCE2 but, as yet, have not seen much of a return on their investment. “This is because PRINCE2 is suited to large scale projects while most NHS organisations tend to have lots of small projects. In addition, PRINCE2 does not really address the people issues that affect the success of projects.”

Amnis’ PBPM programme provides an overview of project management; reviews the project life cycle; explains how to plan and organise projects, manage risk and conflict, control and monitor projects, manage change and project teams, influence stakeholders as well as complete and review projects. The programme is relevant for all project managers, irrespective of whether they have received PRINCE2 training or not. It is designed for those who have found themselves running projects and want to top up their knowledge as well as those who need to fill in the gaps in their knowledge and practical skills relating to PRINCE2 techniques.

Delivered by experienced project and programme managers using a combination of practical exercises, presentations and interactive discussions, the PBPM programme consists of three days of training plus a post-training project. Course graduates receive on-going telephone and email coaching support as well as an endorsed certificate, CPD points and credits towards Amnis’ Lean Leader and Performance Excellence training programmes.

Davinder Virdi, director of strategy at Amnis, observed: “PRINCE2 provides an excellent methodology for project management but, in order for a project to be implemented successfully, you also need people and management skills. Amnis’ three day PBPM programme focuses on these key areas. “For large scale, high intensity projects with a complex structure, such as the redesign of a new hospital, creation of an autonomous provider organisation (APO) in primary care or similar, PRINCE2 provides a valuable structure. Yet most projects in healthcare are far less complex and rely far more on interactions between individuals, a simple structure and effective management skills.”

“Amnis’ trainers can take complex concepts and communicate them in a way that is both understandable and easy to grasp,” commented Bridget Fitzsimon, Quality & Professional Standards Manager, Addiction Service, at Wolverhampton City Primary Care Trust (WCPCT). “Students can take these concepts away with them and apply the practical principles, methods and techniques immediately.

“The training provides straightforward techniques which are necessary to make any project happen. I felt I could leave the training room and have a go at sorting out pretty much anything,” she added.

For further details of Amnis’ PBPM programme contact Amnis’ Ruth Bodman at ruthbodman@amnis.uk.com or call 0870 446 1002. End

About Amnis Limited

Working with both public and private sector organisations, Amnis is a consultancy which specialises in innovation, transformation and organisational improvement, helping clients plan and deploy strategies for successful transformation. Its goal is to help clients not only deliver sustainable change but also to develop their capability to tackle their next challenges. Providing both consultancy and training services, Amnis’ team includes specialists in Lean/Six Sigma, organisational development, strategic planning, change management and systems thinking.

Further information from:

Ruth Bodman, Amnis, 00 44 (0) 870 446 1002; ruthbodman@amnis.uk.com

Bob Little, Bob Little Press & PR, 00 44 (0)1727 860405; bob.little@boblittlepr.com

New Masterclass Programme for 2010 Announced

Amnis (www.amnis.uk.com) and the Institute of Healthcare Management are delighted to announce their programme of next series of activities for 2010. These masterclasses build on the successful first series of 5 that Amnis and the IHM have run together.

Titles and dates include;

Lean Fundamentals for Managers & Executives	24th May 2010
Problem Solving Tools for Service Improvement	7th June 2010
Developing a Culture of Continuous Improvement	13th September 2010
Thinking Strategically	28th September 2010
Value Stream Mapping	12th October 2010
Managing a Lean/Service Improvement Programme	22nd November 2010
The Lean Toolkit for Service Improvement	7th February 2010

For more information contact Ruth Bodman (ruthbodman@amnis.uk.com) or ring +44(0) 870 446 1002.

8 Dimensions of Lean Leadership (2 of 4)

One of the key criteria for a successful Lean programme is that there is effective leadership. In the second of four weekly posts discussing the 8 Dimensions of Lean Leadership we will explore two more of the dimensions.

3rd Dimension – A Disciplined Approach To Implementation

Avoiding a crisis mentality and following up Lean events and activities relentlessly is the key to ensuring that Lean plans turn into Lean improvements. A key problem with Lean Leaders is the fixation on the ‘exciting’ parts of transformation such as the ‘ Rapid Improvement Events’ but when the excitment of the closing brief is over there is a need for leaders to follow up on remaining activities, to manage the process of continuous improvement (and in particular to deal with any issues with the way the new process works). Leaders who allow programme ‘to do’ lists to go into the ‘not yet to do’ pile and who do not apply the process relentlessly will contribute to a ‘Lean Stall’.

Having a disciplined approach to Lean, including ensuring that the right people are involved throughout, is a key part of ensuring long-term success.

4th Dimension – Visible Sponsorship

Visible sponsorship is just that. It means being seen to support the Lean programme and to play an active part in championing it, dealing with issues when they arise and ensuring that rather than things being talked about, things actually get done. When there are problems, visible sponsorship means that leaders do not shy away from tackling tough issues.

The next two dimensions will be discussed next week. In the meantime if you can’t wait, or are just interested, then contact us on info@amnis.uk.com or visit our website (www.amnis.uk.com).

Thinking Strategically Masterclass

Amnis (www.amnis.uk.com) in partnership with the Institute of Healthcare Management are running a masterclass on the 26th Feb in Birmingham entitled ‘Thinking Strategically’.

The masterclass will focus on the core tools and concepts that underpin strategic thinking and particularly strategic thinking in a healthcare environment.

To find out more or to book a place visit http://www.ihm.org.uk/events/view/527 or email info@amnis.uk.com.

Accelerated Lean Skills Programme

Amnis (www.amnis.uk.com), in partnership with Training Bulletin, will be running one of their popular Accelerated Lean Skills Programme’s from the 13th-15th April 2010. Details of the programme can be found from this link: http://www.trainingbulletin.co.uk/course_details.php?course_id=292.

Alternatively, if you are interested in running a programme on-site, download our training brochure for the Accelerated Lean Skills Programme from here; (http://www.downloads.amnis.uk.com/ALSP.pdf) or ring +44(0) 870 446 1002 or email Ruth Bodman (ruthbodman@amnis.uk.com).

The 8 Dimensions of Lean Leadership

Leading Lean programmes in healthcare is less about getting involved in the tactical delivery and more about linking improvement activities to the organisational strategy.

In a recent workshop run jointly between Amnis (www.amnis.uk.com) and the Institute of Healthcare Management (www.ihm.org.uk) on Sustaining Lean, participants were introduced to the reasons why Lean programmes go wrong and what it is that successful organisations are doing to ‘get it right’. One of the key areas that determine success in Lean is how leaders perform and there are 8 dimensions to this performance.

In this blog post, and in three more that are scheduled to be produced over the next three weeks, I will introduce these 8 dimensions and what they really mean in a healthcare environment.

If you work for a healthcare organisation and are interested in the 8 Dimensions and would like to find out more contact Amnis via info@amnis.uk.com.

1st Dimension – A Desire To Improve

The first leadership dimension is the desire of a leader (and not just the top leader) to improve and a recognition that things need to change. Leaders who do not believe that ‘now is the right time’ or accept that ‘our performance is not that bad’ or even think ‘just give me more staff and it will be sorted’ are liable to undermine the Lean programme. Their behaviour will lead their team to disengage from Lean and they will put out conflicting messages to those that other leaders are putting out, reinforcing tribal thinking rather than encouraging team working.

This dimension is about ensuring that your leaders believe that now is the right time to improve and also that they ‘own’ the change and do not feel the need to just recruit more staff.

2nd Dimension – Lean Understanding

It is impossible for a leader to support, engage, encourage and inspire others to be involved in a Lean programme unless they have an understanding of Lean. Even a rudimentary understanding is better than no understanding but it is best if they have been involved in a Lean event, seen what it can deliver and understand both the process and the principles.

Over the next three weeks I will introduce the remaining 6 dimensions of Lean Leadership in weekly chunks. If you would like to know more contact Amnis via info@amnis.uk.com, call +44 (0) 870 446 1002 or visit www.amnis.uk.com.