In a recent interview, Joe Swartz, the administrative director of business transformation for Franciscan St. Francis Health, spoke about his organization’s ten years of effort in engaging every staff member in “kaizen,” or continuous improvement.
Their work and leadership approach is documented in our 2012 book Healthcare Kaizen: Engaging Frontline Staff in Sustainable Improvements. Listen to the entire conversation in episode #301 of my “Lean Blog Podcast,” which can be found in the major podcast apps and directories.
When asked how to define a “Champion of Change,” Joe said they are people who are not only willing to embrace change in their own work, but also work to influence their co-workers. A Champion of Change is “potentially going to go against some of [their] other fellow colleagues and their strong opinions.” Doing so often takes courage, as Joe said, “It has huge risks for them, and they're willing to step into that risk,” a trait he admires and commends.
Joe also said Champions of Change are “people that see the vision. They catch a glimpse of the vision and say, "I think this could work." I say, "Well, here's what we need to happen so that would work."
Joe recalled a supply chain project in their Lafayette facility. In his own words:
“We were considering doing color coding [of materials bins]. There was a nurse that sat in the front row in the event, and I noticed she had color coded highlighters. She was highlighting all her notes.
I turned to her and I said, "Hey, I see you like color coding. Would you be willing to think through a set of color codes for our supplies?" She said sure, and she worked with her other nurses. They came up with color coding system, and it was good.
It was really obvious, like urinary tract items were yellow. We put it in place, and it worked really well. That system is now spreading throughout our systems, slowly, but spreading throughout our system."
Joe also remembered a Champion of Change – the manager of materials in Indianapolis – who was involved in the conversion to a two-bin Kanban system. As Joe explained:
“She was resistant at first, but after she saw the benefit, the value of two bin, she was on board. She shifted. That's a Champion of Change, someone that can shift their perspective, that's not just stuck in a way of thinking. They're willing to look at a different approach and try it, because that's risky. Someone willing to step out of their comfort zone and take a risk is a Champion of Change.
I remember going through a cost justification exercise for the two bin system. We really couldn't cost justify it.
It would lower inventory levels, so our holding costs would be lower, but when I calculated it out, we're going to do ten more units, it was only $3,000 a year that it would save us. It would cost us about $3,000 per nursing unit to put in a two bin system. You had to change the shelving. You had to change all the little bins, so that you had one bin behind another.
Even when you considered outdated supplies, stock outs, the search time for nurses, and even the supply tech – we needed less of a supply tech – it wasn't a whole person. It was just a partial, so it was one of those windfall to the bottom line today.
[A nursing leader] had an opportunity when we were going to consolidate campuses. They were going to redo all the supply rooms. He approached me. He said, "Joe, I think the timing is now." He's now our director of nursing operations there. He just took it on to convert all the nursing units to two bin systems.
One of the things he used was simulation, a little game they played that showed nurses the difference. The nurses got to actually play this game with real supplies to show them the difference between a PAR level system and a two bin system. They could see the difference before they even had to make the change, so they bought in. That really helped accelerate that.
That nursing leader was a Champion of Change who said, "You know it's not the most important, highest leveraged thing to focus on, but it is a really important practice to put in place. So, I'll step up and I'll make sure it gets put in place throughout Indy." Now that system is being spread throughout our system.”
Franciscan has a powerful culture where every leader encourages every employee and manager to be a Champion of Change. Many organizations emphasize huge projects that require a lot of time and money. At Franciscan, they have emphasized the power of thousands of small ideas, the “just do its” that are less risky and have a quicker impact. Starting with small improvements reduces fear and encourages participation, which leads to increased confidence, which then allows staff to bravely take on larger change initiatives. Franciscan is a great example for other healthcare organizations who are trying to get everyone to embrace and lead change.
When leaders are Champions of Change, it doesn’t mean they do everything themselves. It means they create an environment that allows everybody to participate in change, to lead change and to personally benefit from change.
In a recent interview, Joe Swartz, the administrative director of business transformation for Franciscan St. Francis Health, spoke about his organization’s ten years of effort in engaging every staff member in “kaizen,” or continuous improvement. Their work and leadership approach is documented in our 2012 book Healthcare Kaizen: Engaging Frontline Staff in Sustainable Improvements. Listen to the entire conversation in episode #301 of my “Lean Blog Podcast,” which can be found in the major podcast apps and directories. When asked how to define a “Champion of Change,” Joe said they are people who are not only willing to embrace change in their own work, but also work to influence their co-workers. A Champion of Change is “potentially going to go against some of [their] other fellow colleagues and their strong opinions.” Doing so often takes courage, as Joe said, “It has huge risks for them, and they're willing to step into that risk,” a trait he admires and commends. Joe also said Champions of Change are “people that see the vision. They catch a glimpse of the vision and say, "I think this could work." I say, "Well, here's what we need to happen so that would work." Joe recalled a supply chain project in their Lafayette facility. In his own words: “We were considering doing color coding [of materials bins]. There was a nurse that sat in the front row in the event, and I noticed she had color coded highlighters. She was highlighting all her notes. I turned to her and I said, "Hey, I see you like color coding. Would you be willing to think through a set of color codes for our supplies?" She said sure, and she worked with her other nurses. They came up with color coding system, and it was good. It was really obvious, like urinary tract items were yellow. We put it in place, and it worked really well. That system is now spreading throughout our systems, slowly, but spreading throughout our system.” Joe also remembered a Champion of Change – the manager of materials in Indianapolis – who was involved in the conversion to a two-bin Kanban system. As Joe explained: “She was resistant at first, but after she saw the benefit, the value of two bin, she was on board. She shifted. That's a Champion of Change, someone that can shift their perspective, that's not just stuck in a way of thinking. They're willing to look at a different approach and try it, because that's risky. Someone willing to step out of their comfort zone and take a risk is a Champion of Change. I remember going through a cost justification exercise for the two bin system. We really couldn't cost justify it. It would lower inventory levels, so our holding costs would be lower, but when I calculated it out, we're going to do ten more units, it was only $3,000 a year that it would save us. It would cost us about $3,000 per nursing unit to put in a two bin system. You had to change the shelving. You had to change all the little bins, so that you had one bin behind another. Even when you considered outdated supplies, stock outs, the search time for nurses, and even the supply tech – we needed less of a supply tech – it wasn't a whole person. It was just a partial, so it was one of those windfall to the bottom line today. [A nursing leader] had an opportunity when we were going to consolidate campuses. They were going to redo all the supply rooms. He approached me. He said, "Joe, I think the timing is now." He's now our director of nursing operations there. He just took it on to convert all the nursing units to two bin systems. One of the things he used was simulation, a little game they played that showed nurses the difference. The nurses got to actually play this game with real supplies to show them the difference between a PAR level system and a two bin system. They could see the difference before they even had to make the change, so they bought in. That really helped accelerate that. That nursing leader was a Champion of Change who said, "You know it's not the most important, highest leveraged thing to focus on, but it is a really important practice to put in place. So, I'll step up and I'll make sure it gets put in place throughout Indy." Now that system is being spread throughout our system.” Franciscan has a powerful culture where every leader encourages every employee and manager to be a Champion of Change. Many organizations emphasize huge projects that require a lot of time and money. At Franciscan, they have emphasized the power of thousands of small ideas, the “just do its” that are less risky and have a quicker impact. Starting with small improvements reduces fear and encourages participation, which leads to increased confidence, which then allows staff to bravely take on larger change initiatives. Franciscan is a great example for other healthcare organizations who are trying to get everyone to embrace and lead change. When leaders are Champions of Change, it doesn’t mean they do everything themselves. It means they create an environment that allows everybody to participate in change, to lead change and to personally benefit from change.
