Going lean in radiology leadership
May 02, 2022
By Alpana Patel Camilli
Over the past few years, adoption of Lean based management approaches has gained momentum in contemporary healthcare institutions, and understanding a few foundational concepts of Lean Leadership can serve as useful tools for healthcare management. Radiology departments are a key component of value-based healthcare, and engaging Lean Leadership processes helps establish a critical refinement mindset for radiology leaders to implement value-based healthcare.
Lean leadership begins with consistently assessing workflow and related processes through the lens of continuous improvement. Assessing a daily environment through this lens is a constant practice that becomes a habit and eventually a trait in each individual management style. Lean leaders will begin to realize they are more of a teacher than a “manager.”
As leaders in radiology, we often believe that we are responsible to find the answer, to problem solve in the moment. For example, I used to encounter the busy staff “putting out fires” on a day-to-day basis. I often heard managers discuss the daily operational fires they addressed. We attempted to solve problems, but what does this actually mean? That an unexpected issue or problem arose and we did not know how to manage it over time. The solution we used to manage one issue did not work again over time. When we are unprepared, we are reacting and we neglect to anticipate this problem. When we encounter operational fires, we are not allowing the team to distinguish the non-value-added steps from the value-added steps, resulting in the same fires over time. Then, we create workarounds, which are the antithesis to continuous improvement and are anti-improvements.
Also, the same fires arise because we haven’t begun to ask the right questions of why. Why did this happen, what is going on, when did it happen, where did it happen, and who found the problem? Teams often jump into not only identifying problems, they will also fail to discover and define the root cause of the issue.
Inside the radiology department, when we ask the whys and practice uncovering root causes of a workflow obstacle or flow failure, we will break down the silos and discover there are several paths leading to a solution or there are a variety of solutions. Most often, there are no one size fit all, for value-based solutions, like purchasing the most updated software system to solve why images are not being sent to PACS in a timely manner or that hiring more staff will keep the fluoroscopy scheduled on time. Lean thinking, at its core, is achieving more with less. Lean leadership teaches teams to practice dynamic resourcefulness and creating efficient approaches to their everyday workflows. My mentor and the director taught me that we can experiment with a variety of solutions to discover which approach works efficiently in the particular environment at the given time. However, leaders and their teams must be comfortable with experimenting.
The most important way to foster our teams to embrace changes and view workflows and practices through the lens of continuous improvement is to directly involve our respective teams in the improvement process. Have your team follow a workflow idea suggested by the technologist or nurse. Has the team provided feedback by huddling at the end of the day, can any step be adjusted or fine-tuned? Try it again the next day and you will create an environment where it is allowable fail, and then to try again.
Also, lean leaders must be comfortable with change. When we are comfortable with change, we empower our teams to be comfortable with change. When creating short term goals, the small successes will empower your team and the small failures will teach your team that its acceptable to change course.
Lean leadership requires building trust within your team and we cannot build trust by edict. Lean leaders build an environment that allows teams to change course so they can continuously improve the department and experience a better set of results. When better results are achieved, teams become confident in the process and that begins with lean leadership.
Over the past few years, adoption of Lean based management approaches has gained momentum in contemporary healthcare institutions, and understanding a few foundational concepts of Lean Leadership can serve as useful tools for healthcare management. Radiology departments are a key component of value-based healthcare, and engaging Lean Leadership processes helps establish a critical refinement mindset for radiology leaders to implement value-based healthcare.
Lean leadership begins with consistently assessing workflow and related processes through the lens of continuous improvement. Assessing a daily environment through this lens is a constant practice that becomes a habit and eventually a trait in each individual management style. Lean leaders will begin to realize they are more of a teacher than a “manager.”
As leaders in radiology, we often believe that we are responsible to find the answer, to problem solve in the moment. For example, I used to encounter the busy staff “putting out fires” on a day-to-day basis. I often heard managers discuss the daily operational fires they addressed. We attempted to solve problems, but what does this actually mean? That an unexpected issue or problem arose and we did not know how to manage it over time. The solution we used to manage one issue did not work again over time. When we are unprepared, we are reacting and we neglect to anticipate this problem. When we encounter operational fires, we are not allowing the team to distinguish the non-value-added steps from the value-added steps, resulting in the same fires over time. Then, we create workarounds, which are the antithesis to continuous improvement and are anti-improvements.
Also, the same fires arise because we haven’t begun to ask the right questions of why. Why did this happen, what is going on, when did it happen, where did it happen, and who found the problem? Teams often jump into not only identifying problems, they will also fail to discover and define the root cause of the issue.
Inside the radiology department, when we ask the whys and practice uncovering root causes of a workflow obstacle or flow failure, we will break down the silos and discover there are several paths leading to a solution or there are a variety of solutions. Most often, there are no one size fit all, for value-based solutions, like purchasing the most updated software system to solve why images are not being sent to PACS in a timely manner or that hiring more staff will keep the fluoroscopy scheduled on time. Lean thinking, at its core, is achieving more with less. Lean leadership teaches teams to practice dynamic resourcefulness and creating efficient approaches to their everyday workflows. My mentor and the director taught me that we can experiment with a variety of solutions to discover which approach works efficiently in the particular environment at the given time. However, leaders and their teams must be comfortable with experimenting.
The most important way to foster our teams to embrace changes and view workflows and practices through the lens of continuous improvement is to directly involve our respective teams in the improvement process. Have your team follow a workflow idea suggested by the technologist or nurse. Has the team provided feedback by huddling at the end of the day, can any step be adjusted or fine-tuned? Try it again the next day and you will create an environment where it is allowable fail, and then to try again.
Alpana Patel Camilli
Lean leadership requires building trust within your team and we cannot build trust by edict. Lean leaders build an environment that allows teams to change course so they can continuously improve the department and experience a better set of results. When better results are achieved, teams become confident in the process and that begins with lean leadership.