In 2007 this large teaching hospital was going through a difficult time, with a number of serious incidents that had caused negative publicity and necessitated a formal inquiry. Morale had sunk so low that staff would hide their uniforms in public to avoid being associated with the hospital.
With a large budget deficit, angry, hostile staff and a constantly changing executive team, change was clearly needed to improve performance and revitalize the workplace culture.
Sue Shilbury, the new CEO/General Manager, was conscious that she was the latest in a long line of leaders. She set out to bring much-needed stability within the executive team, empower staff to make changes and create a positive environment through a common vision. It was important to have visible signs that the CEO and other senior figures were living the new values, displaying appropriate styles of behavior and managing performance in a consistent manner.
As part of this cultural transformation, RNSH embraced Lean techniques to improve performance, with specialized coaching from KPMG to give staff the skills and confidence to come up with their own practical solutions.
The team applied classic Lean principles, stripping out non-value-added components to simplify and standardize processes for clinical practice and remove variations, which had the added bonus of freeing up staff to spend more time on strategically important work.
As Sue Shilbury comments: “This was not about imposing solutions; it was about energizing people to come up with answers themselves, using Lean thinking. And we did not develop projects in isolation, so were able to achieve synergies between interdependent pieces of work, giving us a quantum improvement.”
The positive new culture has led to a dramatic turnaround, with RNSH significantly improving staff turnover, costs, and length of stay through initiatives implemented during 2011-2012.
Staff now truly believe they have the power and capacity to effect change and as CEO, Sue Shilbury remains the overall Lean sponsor. But there is no room for complacency: “We are definitely not sitting back and basking in our success,” she says, “We are continually up skilling and empowering staff to make sure we build on our gains.”
The early achievements of applying Lean principles to healthcare have been useful.