Care Design 2016

3 Pillars: Operating System-Management Infrastructure-Learning organization

For Care Design 2016 to be successful healthcare institutions need to balance three pillars:

1. Efficient and effective operating system
2. Supportive management infrastructure
3. Deep-rooted learning organization

Operating System

The operating system is the nuts and bolts of the organization’s processes. During a transformational journey, the operating system is commonly improved by applying “improvements” techniques. Areas of focus include: reducing variation in processes; eliminating non-value-added activities; ensuring the right people, information and materials are in the right place at the right time; improving equipment availability; reorganizing workplaces and activities; and basing staffing on demand patterns.

Some ASK LISTEN TALK ACT themes for consideration:

1.    You know what success looks like in 6, 12, 18 months

2.    The critical front line, clinical staff and patients feel engaged in all process improvement activities including ownership to proactively raise as well as tackle process bottleneck

3.    You have a proven methodology to deal with both “long push” initiatives as well as “quick hits”

4.    Each ward, unit, area is clear on their largest process bottlenecks

5.    You know which units/areas have the greatest/least capacity for sustainable change

6.    You know how /fast it is realistic to move know how far to move each area, unit, ward, organization

7.    You know your champions for KT

Management Infrastructure

Management infrastructure is composed of the formal mechanisms put in place to support and encourage the desired elements of the transformation. Areas of focus include: putting the right people in the right jobs to drive change; clearly defining roles; frequently measuring and widely sharing operational metrics.

Some ASK LISTEN TALK ACT themes for consideration:

1.    Pivotal management positions are filled by change leaders, down to middle and lower management levels

2.    You have enough change leaders to go after the major areas of value

3.    There is sufficient real time on the job coaching to drive change at the front line

4.    You are confident in your ability to implement the required rate of change with the people currently in place

5.    You will hire for fit with continuous improvement culture in addition to clinical and/or administrative activities

6.    You have the right organizational structure to drive change and performance

7.    You attract people from outside healthcare and you move the highest performers between areas

8.    You will drive change fast enough at the top and at the middle management level

Learning Organization

The learning organization forms the cultural fabric of the organization. Areas of focus include: creating mindsets that support superior delivery of patient care; building capabilities to improve the system; engaging the front line in problem solving; clearly defining performance expectations; being willing to improve operations; and sharing knowledge.

Some ASK LISTEN TALK ACT themes for consideration:

1.    Employees feel real ownership in setting targets as well as executing

2.    Measures exist to operationalize “ work place/organizational health” and “sustainability” as well as performance

3.    Patient, front-line and clinical staff in all functions know exactly where and how much they contribute individually and collectively to improve the performance

4.    You are aggressive enough in target setting against technical or theoretical limits

5.    When targets are missed, there is a more focus placed on taking corrective measures to achieve targets than on justifying why they were missed.

6.    You really execute well. To quote Jim Collins – Good to Great…”Execution – Results – Momentum – Alignment will happen.

7.    You will track the really important and high leverage metrics. You will reduce the measurement burden and fatigue and free up space to include a set of patient experience metrics



edited on Nov 20, 2015 by Hugh MacLeod
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