Lean projects were selected based on alignment with

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Lean projects were selected based on alignment with criteria; metrics established by top management while balancing frontline interest. Leadership Heights CEO’s single-minded commitment to Lean and hands-on approach (e.g., Management By Walking Around) has been pivotal to engaging others, particularly those that were resistant. Leadership understood that Lean was a learning process and, thus, took challenges and setbacks as an opportunity to improve their approach. An executive-level leader who was highly respected and liked by staff at all levels was reassigned full-time to lead Lean implementation at the hospital. Leadership adopted an inclusive approach that allowed staff at all levels to participate. Availability of resources The corporate offices supported Lean planning and implementation at Heights Hospital by funding consultant services and Advance office positions that provided hospital-wide leadership of Lean and facilitation of Lean projects. Project scope A series of small projects concentrated in one area had greater overall impact than scattering projects over a number of value streams. Staff engagement Heights Hospital was able to make progress through Lean despite lack of full engagement by all leaders and staff. RIE teams were extremely diverse, with staff from all levels of the organization and varied departments . “ Fresh eyes on the team provided a different perspective. Frontline staff and physicians were more willing to make changes when they participated in finding the solutions to problems or when they had a peer motivating them to change.
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200 Exhibit 5.18. Major Factors that Inhibited Lean Success Factor Lessons Learned Leadership There sometimes was a lack of accountability for maintaining changes and tracking outcomes over time. Resources A hiring freeze during Lean implementation can contribute to staff and manager resistance to work redesign. For example, a manager resisted reassignment of a staff person to a different department, and staff were not willing to assume new tasks. Communication about Lean Progress made by Lean has not been effectively communicated to frontline staff. Engagement Middle management and frontline resistance remains, particularly among nursing staff. Concentrating projects in one clinical area can be overwhelming for frontline staff and department managers. Organizing the Lean Initiative In this section, we discuss barriers, facilitators, and lessons learned concerning organization of the Lean initiative. The most frequently mentioned facilitators and barriers discussed by interviewees were engagement and leadership. Notably, there were very few statements related to alignment and routinization.
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