Success in Healthcare

Last Friday I was delighted to host a meeting of one of the Ecademy clubs I belong too (CEN). The event focused on issues relevant to Healthcare and we had a great mix of people, including some with extensive 'in house' expertise of working in the NHS.

What we discovered is that (not unsurprisingly) the opportunity for improvement is great, especially in the area of sustainable improvement (using a variety of tools such as Lean etc). It is perhaps one of the best environments for leading change - you have motivated and skilled people who share a common aim (delivering patient care).

However, the issues of 'improvement fatigue (IF)' and changing public priorities will make it a long and slow process to implement (and sustain) the benefits that individual trusts can realise.........fancy joining us to help make it happen?

Loyalty in Adversity

When things start to go wrong in relationships (whether personal or business), loyalty becomes a very important issue.

If you have built up relationships with your network, when things start to go wrong they will support you - whether you are right or wrong - but when you haven't built the relationship, or if you use up all of your 'emotional credit', the loyalty and support is not there everything becomes much harder.

In change, it is important to have a relationship with the people you are working with so that when things start to 'get sticky' (and they will), they support the change.

The Duke of Wellington had a great saying which emphasises the power of loyalty and training and went something like, "When other Generals make a mistake they are beaten, but when I make a mistake my troops pull me through."

When things go wrong, who will support your change programme?

Buzzword Bingo

It is a very worrying fact that a lot of consultants use very complex language. Well, it isn't even limited to just consultants, but to pseudo- academics and pompous people of all persuasions!

Is it because they like the sounds of the words or because they do not really know the answer and need to use complexity to mask stupidity? In my time, I have worked with both groups of people, some of them even believing that they were really impressing others by using 'complex interactive knowledge processes' when in reality they were boring the others rigid and demonstrating quite the reverse of what they were hoping - instead of appearing intellectual, they appear confused and instead of appearing dynamic they appear boring.

I was prompted to write this entry by a good friend emailing me the link to Buzz Phraser which is, I am sure, where these people get their words from!

Every experience is unique

If you think about it, everything we experience is completely unique.

Where we are sat in a room of people is unique and therefore the acoustics at that point is unique. The way our brain processes the sound and then our conscious and sub-conscious analyse the sound into concepts we can understand is completely unique.

Two people sitting side by side listening to a speaker on a training workshop will both experience different events, take different learning and have different emotions.

This makes communicating such a fascinating topic for a consultant such as me - how do you ensure that the message you are transmitting is the message they are receiving - and how do you ensure that the activity you are leading is the activity they are needing.......

I don't have the answer, I only pose the question......

Random Connection

I realised yesterday that all the important people in my life (other than brothers, uncles, aunties and children) I have met because of a random connection.

In a family context, I met my wife because she happened to be at a mutual friend's house when I was and in a business context, one of my business partners I met because I decided to try a different form of networking event.

Subsequently, these random connections lead to a wide range of things such as children, contracts, further introductions and friendships, but the root of all success comes from a random connection.

In analysing why this is an important message, it is because the more random connections you make, the more success you will have - but the real issue is pushing yourself to go and make those connections!

On a different issue, have you seen my other blog on Lean Sigma (called Flexiblean - pronounced Flexible Lean)

20 Year Complacency

I was preparing some materials for an event that I am speaking at next week (download the brochure here) and realised that we are possibly heading toward another period of complacency in the UK.

In the 1950's, there is a lot of historical evidence about the fact that UK industry were complacent about the impact that the rising quality and productivity of Japan would have on us and in the 1960's/70's it killed off our motorcycle industry (for all intents and purposes) and a lot of our electronics and automotive industry as well.

In the 1970's we were complacent about the Asian revolution, joking about the quality of what they were capable of and in the 1980's and 90's they stripped our manufacturing and are now advancing on our service industries.

In the 1990's we were complacent about the rise of China saying they would be become the 'low cost but low tech' outsourcing centre of the world and today they are encroaching upon our high tech industries and sectors.

As we move toward the 2010's, I am beginning to wonder whether we are facing another period of complacency in the UK....perhaps because of the impact of Eastern Europe, the BRIC nations (Brazil, Russia, India & China) or even the Middle East or Africa - maybe it will not happen at all but history seems to be against us on that!

Stress + Depressed = No Success

Individuals who are stressed under-perform - everyone knows that - hence the growth in stress coaches, but have you considered that organisational health and levels of stress also affect performance?

Organisations which are feeling the squeeze find it difficult to focus on the longer game and it permeates through to the individuals working in the organisation, which in terms affects their performance and hence the results achieved by the business.

This is not about 'benchmarking', but is purely a matter of fact that organisational stress is a real phenomena and has a major impact on the results achieved - any comments?

Innovation?

I was invited to an 'Innovation Dinner' this week at which some 150 people had booked and paid to attend.

The dinner had a good keynote speaker, but the topic was less about Innovation and more about how they had grown their business from scratch.

The problem for me is that the whole affair seemed to be a 'ra ra' session about innovation without any practical advice or information for the participants - the typical 'Innovation: Its a good thing' type approach.

For many, Innovation means developing a new product, whilst others think of it as a new creative design for a brand, but if we take the government definition of Innovation it is about 'the exploitation of new ideas' - meaning that it is equally relevant to the improvement in a process as it is too the development of a completely new process.

To find out more, read my article on INNOVATION at Ezine Articles.

Changing Direction

I have decided to split my ramblings into two seperate blogs.

This one will change to be about the activities I am involved in, the people I have met and what I have heard, whilst my blog FLEXIBLEAN will evolve as the main site for comments on making change sustainable, flexible and high impact.

I hope you enjoy the journey!

Are you completeLEAN mad?

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I was speaking late last week to a real 'Lean Jockey' with a well known American consultancy who are building a presence in the UK.

I found the conversation both interesting and a little disturbing on the basis that the approach being followed appeared to be 'tools only' - a quick 'Value Stream Map' and a series of Rapid Ram-Raids on the business, with no focus on sustainability.

One of the worrying things about the approach they are adopting is that the consultancy concerned it is growing nicely with an impressive range of new clients - and this fact made me challenge what I believe to be true - namely that the 'tools approach' is not sustainable in the long term.......so why were these guys being so successful?

Having spoken to a couple of people last week, including one of whom has been a current client of the consultancy concerned within the NHS, my fears have been allayed - it appears that whilst the price is high and the benefits good in the short term, the results last as long as the consultant is on site, creates bad feeling in the team and does not create an optimal solution.

We are about to extend our research into the sustainability of Lean, the first phase of which led to the development of our PROTOCOLS(tm) approach which assists organisations to prepare for Lean (or any form of transformational change). We will be speaking in depth to up to forty organisations from the service sector who have tried Lean to correlate our findings - although initial feedback says that the same bunch of cowboys who saddle their Lean tools outside manufacturing companies are now putting on their boots and striding into the service sector!

Beware the 'tools only' approach to Lean - unless your people bed it in and believe in the change, it does not matter how good the consultancy presentation is, the project will fail!

Public Profile

I was delighted today to receive a report about the growing use of Lean and related techniques in the public sector.

Having spent a number of years working in the public sector on transformation programmes, including with the RAF, NHS, Public Agencies and Local Authorities, I have seen many of the pitfalls that can behalf public bodies embarking on a transformation programme.

It was a long time ago that I gave up being a 'Tools Jockey' - partly because I realised the damage it was doing to organisations when I was leading programmes of support in the private sector. Luckily I was able to take this knowledge of sustainable lean into the public sector.

Sadly, for many public bodies, it seems they are going down the route of a 'tools approach', using 'drive by kaizen' which makes a quick improvement and collapses even quicker, unless you pour an ever increasing amount of money into supporting it (normally ever increasing consultancy fees).

True sustainability of change (and particularly Lean), relies on employee engagement, a vision of the future and development of internal capability. These are hard learnt lessons which it seems that many public bodies are going to learn the slow and expensive way.

Ho hum..........

Your Attitutde Affects Your Performance

For some, this might be a statement of the blindingly obvious, but I think it is an important point to make.

My attitutde at the current time is based upon a range of external influences such as my relationships with my colleagues, clients, friends and family. It is also influenced by some internal influences, such as my energy levels and levels of confidence.

Now, my current attitude is based on the combination of these (and other) internal and external influences, and this attitude affects my performance. Obviously, as the influences change (perhaps after a good nights sleep, or receipt of some good news) so does my attitude and in turn my performance.

When you are the manager or leader of a change programme, the attitude you have makes a significant difference to the performance of your team and therefore the success they achieve.

Being aware of the affect external and internal influences have on you is an important step to maintaining an appropriate attitude - which in turn is essential to the success of your team in leading change - and the bigger the change, the more the attitude of the leaders affects the result.

Several development processes exist to assist leaders of change to manage the effect influences have on them - and these include NLP and Emotional Intelligence - and for further information please feel free to contact me about them.

Sustainable Does Not Mean Forever

An interesting concept that has raised its head this week is the idea that some organisations are looking to 'fix' their change - and are turning to the concepts of Sustainable Change as a way of achieving it.

Whilst Sustainable Change does ensure that organisations get the most benefit out of their improvement activities, motivate their people effectively and also ensure they maintain their position in there market, it is different to 'fixing' change in place.

To fix change would imply a rigid system - a winning formula that once developed was never changed. But what would this mean when the circumstances changed and the world, the market or individuals moved on?

Look at McDonalds, for years they had an almost winning formula; Burgers, Beverages & Breakfasts, but over the last few years they have recognised that society has moved on and demands more variety - especially healthier options.

Sustainable Change ensures an organisation remains 'best' for a period of time, but also leaves them with the capability to move on when circumstances change.

So, the idea is not to 'fix things forever', but to fix them and flex them as the requirements change - and this is the basis of Sustainable Change.

By the way - our new book entitled 'A Beginners Guide to Continuous Improvement' is now available.

Visit my Ecademy profile and then drop me an email for further details.

Surviving Change

More organisations lose money on their change programmes than gain benefit.

This is a true whether they base their approach on Lean, Six Sigma, Concurrent Design, Kaizen or something else......

To combat this, I would like to extend a personal invitation to the Surviving Lean Conference on the 18th May (Right Click & Download the brochure HERE)

Look forward to seeing you there!

Best is only a moment in time......

In addition to running one of our regular masterclasses for the public sector in how to sustain change and running a two day strategic planning programme with a 'running' client, I also had an evening meeting with a potential manufacturing client this week who said they felt they were 'best in class'.

When I explored this statement it appeared that they felt this way because they were profitable and because they had relatively low customer churn. They did not know how they matched to their competitors in terms of price, quality, options, flexibility etc. In addition, they had not done anything to improve their internal operations for a number of years because they were 'too busy' everyday to make the changes.

These were interesting responses - surely, you cannot be 'best in class' without knowing the details of who else is in the room? Also, being 'best' is only a moment in time and things move on. Being profitable today does not mean profitable tomorrow and being busy today and not focusing on tomorrow almost guarentees that profits will drop over time.

Perhaps it is counter-intuitive but the best time to improve what you are doing is when you are busy and profitable as this is the moment when you can be best without worrying about the worst!

Pan-Sector Panacea

The more I get involved in transforming diverse organisations - from NHS Trusts to RAF Stations and from Manufacturing Companies to Housing Associations - the more I realise that every sector faces the same problems when it comes to leading and sustaining change.

With so many organisations failing to achieve sustainable results (in our survey 87% and in one undertaken by Henley Management College >75%) I am surprised that not more organisations want to find out why their change programme is more likely to fail than to succeed.

Across all the diverse sectors we work in, the one universal truth is that transformational change is only possible when the organisation is ready for it and when it has some infrastructure (and I mean internal people and systems to sustain change and keep it going) to support it.

Interestingly, the issues faced in every sector is the same - and the broader my experience becomes the more I believe this to be true. Maybe the language is different and the prevailing management culture is different (think of the difference between the Command and Control structure of the RAF and the inclusive management style of the NHS), which creates slight differences in the responses seen by organisations, but the underlying issues are the same.

I have seen organisations which have pushed forward change so rapidly it has created long-term health issues for the business, and others which have gone so slow that the initiative has drowned in its own inertia. I have also seen organisations who have led rapid change in a sustainable manner by utilising internal talents, addressing underlying concerns and through constant communication - the same problem approached in a different way generating different results.

That is our approach in summary - using different approaches to solve common problems and generating different results. I would be delighted to discuss the top four causes of organisational change failure with you - just send me a message or indeed look to attend one of our regular masterclasses where we share these insights with a broad range of organisations.

Making It Meaningful

I heard a quote that went something like 'Only a wet baby likes change', a very true statement even though we are all involved in 'change' everyday.

An important aspect of change is to make it meaningful to the people involved - the old 'WIIFM' test (What's In It For Me?) - meaning that people immediately consider what the impact of the change will be on them personally - will it increase their wealth, decrease their stress, improve their working environment, stop them from doing things they like etc etc.

Any change that is imposed will generally fail to address these issues for individuals and result in CPF (Change Programme Failure) as individuals and small groups undertake guerilla activities to undermine the change and return it to the status quo. Even given this figure, something like 50% of change programmes will be substantially driven by managers, or worse, external consultants, forcing people to make changes they may not agree with and which have not past the WIIFM test.

To make change meaningful to people, they need boundaries to operate within, the skills and vision to enable them to create a mental picture of an improved process, guidance when they get stuck and the freedom to make mistakes on their journey.

Whilst this goes against many of the philosophies of change which focus a lot on ram-raids and detailed analysis by externals, it leads to change that people believe in - something they find meaningful.

Are you really ready? Are you?

My own research undertaken several years ago demonstrated that 87% of change programmes failed to achieve sustainable results. I was therefore pleasantly surprised to have these results confirmed by Henley Management College at a recent seminar which stated that 'over 75% of change programmes fail to achieve results that are sustainable meaning that of the $60 Billion invested by the UK annually in change, over $45 Billion is wasted.'

In analysing why such a large percentage of programmes fail to achieve the desired results, my research again was confirmed by Henley, with the environment created by Leaders stifling change, internal cultural misalignment to the aims of the business not being addressed and the misapplication of tools being some of the common areas our work agreed on.

To quote a well know saying, "Prior Preparation Prevents Poor Performance", and this is as applicable to general change programmes as it is to the planning of military operations. Some of the key aspects are obviously understanding why the change needs to happen and where the organisation needs to improve most, but other issues such as identifying how leadership style might affect success or failure and how the organisational environment needs to be adjusted to support the change process, are often ignored.

As such, we regularly undertake a 'Strategic Change Readiness Review' with clients which looks at the drivers and barriers to successful change with the aim of minimising the risk of failure and also maximising the returns on investment covering 10 'success factors' from organisational culture to performance measures and from the tools of change to 'Change Planning'.

With so much at stake, it has to be asked: Are you ready for change?

Fed Up With Lean!

For every ten genuine Lean Experts, there are 100 people who claim to be experts but are not. The biggest mistakes made by these others is to apply tools blindly without considering the people, who ram-raid organisations creating very short term results but leave nothing sustainable, fail to transfer knowledge to the teams involved and do not engage the leadership in the change process.

I have headed this blog 'Fed Up With Lean' on the basis that there are so many people claiming to be experts who are not that it has started to devalue something, which if applied correctly, is highly valuable. Because some people feel that by having read a book they are somehow been transformed into a Lean expert who can revoluntionise entire enterprises, the feeling among many others is that Lean 'must be easy' without having seen it done properly by professionals.

Lean is not a 'quick fix', although it can generate quick returns, it is not something that can be imposed, it is not something that is purely tactical, it is not something which can be undertaken half-heartedly, it is not something that can ignore organisational culture and it definately is not the answer to all problems by itself.

Lean is a key tool in the business armoury which if applied correctly and professionally will transform an organisation's performance and when coupled with effective leadership development and an aligned organisational culture will lead to strategic change at the highest level.

It is not something to be dabbled in by half trained facilitators at a tactical level - although I am sure they will continue to have short term, unsustainable, success whilst continuing to damage the general view of true and strategic Lean.

Leadership Makes The Difference

Change in business takes many forms and I have worked with many hundreds of businesses and seen all sorts of change processes being used - from the straight 'Lean on the Factory Floor' in manufacturing to high level strategic planning using Hoisin Planning and Policy Deployment. I have also worked with the organisations who think change is about investing many thousands in new machines, buying MRP/ERP systems or purely undertaking training.

However, the thing that sets apart a successful change programme from a mediocre (or damaging one) is the ability of leaders to set the right tone and direction for the change and their ability to inspire people.

In this short statement we see three key issues:

1. How does a leader set the right tone or create the right environment in which people can feel valued and successful during the change process? This is often a function of the individual's levels of Emotional Intelligence.

2. How do leaders set the right direction for the change process? This needs to take a medium to long-term view as although change can generate results very quickly, the reality is that sustainable change can take up to 12 months or more to become 'embedded' in the organisation to the extent that behaviours change, which is what change is al about. We often talk about the '3 Coffee Shop' measures which will be used to describe success a year from now - meaning that you should imagine you are in a coffee shop with a colleague a year from today and they say to you 'I hear your change programme was great' and you reply 'Yes it was, because.....' - these three measures will follow and will be things like 'Our Productivity Improved', 'Our Costs Reduced', 'Our Sales Doubled' etc. Selecting the right 3 measures will set the tone for the entire change programme.

3. The ability to inspire the team - which combines vision with the ability to communicate that vision and which is a key determinant of success. Someone once wrote that 'Leaders give meaning to the work of others' - as true of managing the status quo as it is of managing change.

These thoughts are things that we continue to develop our thinking in and which influence the way we deliver rapid change as change that is not sustainable is not change at all.