A department director commented that if employees

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presented to them means that what is being proposed will work or is working. A department director commented that if employees “have their information and ducks in a row, they are given support including the needed resources to figu re out a solution to a problem.” A few interviewees also noted that project-level leadership facilitated successful implementation of new processes at Horizon. These project leaders specifically process owners and department leadership held other staff accountable for adherence to the changes and ensured sustainability of the Lean successes. This accountability and commitment to the Lean changes was critical to ensure the new processes were maintained. An executive commented that having high performing staff on the team to role model implementation of a new process was critical for achieving uptake among other staff. Communication About Lean A process improvement department lead noted that building the facility required considerable communication between architects and medical staff. Management engineers served as translators because they understood the organization and had an engineering background that was useful in communicating with the architects. Both department leadership and management engineers noted that this ability to communicate between the architects and staff was critical to the successful design of Horizon. Another department leader noted that communication of best practices is sometimes a struggle across the organization. Because the organization is so large, changes or best practices from one One of the things that saved a huge amount of steps for everyone was having a thermometer in every room. That did not initially translate over here. If one of us had not been involved in a Kaizen at another division [w e would not have known].” Administrative director It is hard to change people so you have to stay on top of them. Someone that can actually enforce the [new] process. If you have a weak leader, they won’t do that, they’ll go amok.” Executive From the leadership perspective, it has to start at the top. This is not like the Quality Department where you delegate it to an area and say, ‘take off.’ This has to have the support of senior executive leadership to be effective because it is part of the dynamic change.” Senior executive
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238 unit are often not translated to another unit. According to this interviewee, the size of the organization also results in a struggle to keep all staff informed of Lean changes. Staff Engagement Nearly all senior executives and management engineers provided insights on staff engagement in the Horizon process. A few senior executives and management engineers indicated that getting more people involved in designing the new processes garnered more ownership in processes designed into the new hospital. Personal involvement did not always result in support of changes.
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