Lean into the Weeds

by | Jul 6, 2018

If I hear another colleague or consultant say “Let’s not get into the weeds…we need to stay at a high level…” I am going to scream! As an operations executive focused on health care transformation, I am a strong advocate for not only getting into the weeds but leaning into those weeds to determine why in the world they got to be weeds in the first place. Working closely with physicians and clinical support teams at the point of service, but with a keen understanding of a system’s big picture, we can create practical strategies to untangle those weeds for a more sane, sensible, and safe environment for physicians and patients. Whether we are responsible for hospital operations, or medical group practices, or an accountable care organization, as health care leaders we must shift our perspective from 30,000 feet above the ground to on the ground with our physicians and providers, our staff, and our patients. There is nothing like rounding with our clinical teams and asking real process questions: what’s working, what’s not working, and what do YOU think can be done to improve things? And don’t stop there. Probe deeper. Why do things not work well? How did things get this way? Indeed, how did these weeds get so tangled??

The nefarious EMR

One of the most telling examples of how health care has become tangled in weeds is the advent of The Electronic Medical Record—the nefarious EMR. The EMR is reported as one of the top reasons for physician burnout, yet often, clinical workflows in the practice setting were never really redesigned when the EMR was installed. The time and effort required to lean into the weeds and transform these workflows was not spent, and as a result, the physicians are left carrying too much of the administrative burden on their shoulders in lieu of spending the time they need and want on patient care. As a prerequisite to EMR or any technology implementation, health care organizations have a much better chance of success when they get down into the weeds, do the work to define their current workflows, and then complete the work necessary to change their old workflows. By committing to the entire operations transformation endeavor, successful organizations will not only achieve more efficient and effective clinical processes enabled by the technology, they will more importantly support their physicians, clinical teams, and the patients they serve. Want to create a transformation culture? Lean into the weeds. Organizations and their leaders who go a step further to create a “transformation” culture—where clinical workflow process improvement on the front lines (e.g., in the weeds) happens every day for the sake of provider sanity and patient experience—will be the winners in the medical group practices and healthcare systems of the future.  To shepherd their organizations successfully into the future, today’s operations executive needs to develop “transformation executive” leadership skills. The traditional health care management background and skill set of finance, accounting, human resource management, and strategic planning will not be sufficient in a rapidly changing environment. The healthcare environment will be increasingly reliant on leaders who embrace point-of-service clinical transformation and champion well-engineered processes carried out by LEAN performance improvement–minded people and enabled by clinically mindful and integrated technology. The operations transformation executive of the future will have no trouble leaning into the weeds. For more information on how Hopkins Tirrell & Associates can help your organization create effective and practical operations transformation strategies, contact us at: Amanda@HopkinsTirrell.com.