Being an internal lean consultant at a hospital has some challenges. In my consulting practice, I find countermeasures vary greatly depending on relationship with client and what stage they are on in their Lean journey.
Below are a couple of challenges to which I am still trying to discover my best approach. I love what I do and things like this make everyday exciting.
- Pair of hands consultant versus collaborative consultant – A good portion of my clients initially expect the internal consultants to go and do for them. They want their people involved in an improvement event but claim too busy or too understaffed when resources are needed for assessment, planning, and sustaining. As a collaborative consultant I try to do as much WITH the client instead of FOR the client so they can be engaged and learn how to do this work themselves in the future. I really see a lot of people struggling with this collaborative model.
- Physician culture can be a tough nut to crack – While we have some excellent physician Lean champions, there are still a fair number of doctors that are not fully committed to the journey yet. Providers are incredibly smart and independent. They have a lot of goals such as providing excellent patient care, doing research, writing/publishing papers, and educating Residents/Fellows. Sometimes the systems-thinking focus and overall patient flow is not a top priority for them. Some incentive plans make them compete against each other for surgical time so they are less likely to share best practices with each other. The “what is in it for me” part isn’t always an easy answer if a focus on the patient doesn’t seem to be enough.
Have you experienced either of these? Do you have a best practice? Is everything really a case-by-case issue (get to root cause for each individual)?
My 2009 Hansei: Scarcity inspires creativity and innovation. How can I help harness that inspiration?
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