Lean Consulting Challenges

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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Filed under Change Management, Consulting, customers, Improve With Lean, Reflection

5 responses to “Lean Consulting Challenges

  1. There’s a fine balance to strike between doing things “for” people, doing it “with” them, and teaching them how to do it themselves.

    I always erred toward trying to teach people or do it with them (especially the first time we do something).

    I had clients who would get frustrated with my collaborative style, as you describe it. “Just tell us the answer, Mark!!!” they would say. They were used to consultants giving answers. They got used to my style and came to appreciate it (I’ve heard this many times).

    The value, often in a lean consultant, is knowing what questions to ask and knowing what to teach people.

    Earlier in my career, I’d get inpatient and jump in and do things myself (such as set up a kanban system), but those changes were hardly ever sustainable.

  2. I’ve long learned: some plant the seeds, some fertilize the seeds, and some harvest the fruit – they might nit be the same people.

    Being a change agent is rewarding and frustrating, but it definitely requires patience and a good dose of charity.

    Keep on keeping on.

  3. Thanks Mark and Pete for your comments. It is interesting how confidence can get a bit shaken sometimes with challenging clients.

    One of my favorite lean addages is how people are only right half of the time. When I encounter major resisance to my collaborative style, I start thinking “is this the half of the time when I am wrong?”.

    I truly appreciate your words of wisom and encouragement. You really helped me solidify my true north even amidst stormy waters trying to toss me off course.

  4. I have to say I’ve been challenged with this too. Often times clients expect me to be very prescriptive, telling them exactly what to do. This appears to them to be the simplest way to get things accomplished. It takes them quite a while to realize that nothing sustainable does get accomplished when they don’t think/work it through for themselves.

  5. I really enjoyed reading your blogpost, keep up posting such interesting articles!

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