3 lean leadership concepts to revisit during a crisis and beyond

Lean leadership is (and remains) fundamentally about one thing: respect for people. In health care, lean leaders exist to serve the next level closer to the patient and maximize value for both employees and those we care for. It goes without saying that now more than ever, amid the current pandemic, everyone deserves a great leader.

A little while ago, I found myself thinking about three important leadership concepts that have truly been placed under a microscope over the past six months: time, agility, and permission. All three are critical to the overall health, well-being, and performance of individuals and organizations. Yet each can get easily forgotten or become an afterthought during the urgency of our current situation.

I thought about the ways in which lean methodologies can and are equipping leaders with the right emotive tools to effectively guide and care for our people during this time — and challenged myself to reflect upon how we can continue to lead by example.

Health care leaders, here are some of the questions I asked myself, and I encourage you to think about them.


How are we explicitly acknowledging that some work needs to be deferred? When the pandemic came, there was a lot of great work that had to be put on hold. But how explicit were you with your teams that this important work needed to be deferred or tabled for a later date? An increasingly tired team needs to know that they didn't have to keep adding to their weekly workload to finish anything and everything — we know that things are going to get delayed. Don't assume that this is understood, and make sure it's communicated effectively.

How are we optimizing our escalation process to remove waiting from our management process? It can be difficult at times to get the right information that can be helpful to our organizations into the hands and the heads of those who can actually help make those changes. There are ways around it, though. Here's an example: If I go to a morning huddle in one of our departments at Stanford Children's Health, I may hear about a concern; and then, as a leader, I can coach the team — or, if necessary, facilitate escalation. It's about making sure that, as leaders, we're physically (or virtually) present during certain times so that our staff are able to get fast resolutions.

Do I recognize that both calm and panic are contagious? It's easy to forget, but one of our roles as leaders is to make sure that we're bringing calm into the organization and our people. So, one of the important questions I ask is, are you taking time to reflect? There's an old saying: If you don't have time to meditate for five minutes a day, then meditate for 20 minutes. Short on time? Take 30 seconds to draw four deep breaths before embarking on a task for the day. Think about being present with your teams, and remember what you're trying to accomplish. Calm is contagious.


Are we spending more or less time admiring problems? I think we are now spending less time admiring problems — but it's still something we could be better at. A great place to begin is with the assumption that the current way is not the best way (probably always a safe assumption). So really be thinking about what it is that you need in your organization to help you get through the next crisis we face, and how to proactively prevent problems. You'll find that when the time comes, there will be less admiration and more action.

How quickly are we implementing corrected decisions? So you've solved for a problem, but how quickly are you going about implementing change? Agility is important, and leaders need a very quick process for implementing corrected decisions and making sure teams understand that things are going to be very fluid. Part of this leadership skill is a willingness to understand that decisions could have been made better—and a willingness to ask for forgiveness. Failing forward will serve us all better than being indecisive.


Have you focused your team on the present? I think that, in general, we're becoming different leaders as we've gone through the pandemic, largely due to the need to keep people focused on the present. I think about it like this: If your people are focused on the past, they're going to exhibit feelings of depression; and if your people are too focused on the future, they're going to show signs of anxiety. One of the questions that leaders should be asking themselves is, how do we keep people in the present?

Have you given yourself permission to try new things? The pandemic has led to our trying a lot of new things and, naturally, failing at a lot of new things. I think we figured out how to work differently to have things happen much more quickly. An example at Stanford Children's Health: It wasn't until we went from 20 digital visits a day to 800 digital visits a day that we truly understood the capacity and means we had to serve many more people virtually. That challenged prior beliefs and reinforced the positives in our organization, which have both led to continued digital health innovation and leadership. Leaders should challenge themselves to explicitly reset goals and challenge the status quo based on what we've learned is possible over the past six months.

Are we showing up differently and managing resilience? We are certainly much more human — and as we go through this pandemic, leaders should continue to ask their people different questions. Something as simple as not asking, “How are you today?” but asking, “Where are you working today?” The latter opens up the door to a whole different answer and gives leaders the information to better manage our teams' resiliency. With added detail and information comes the power to be able to make sure we're really taking care of our teams in a different way (through internal and external resources). Again, we are focusing on showing that respect for people and the current challenges they face.

I've found this time to be an incredible period of personal and professional growth. I'm very proud of the work we've done, and will continue to do, at Stanford Children's Health as we put lean leadership methodologies into practice for the betterment of our team, our patients, and their families. As the health care industry continues to solve for the pandemic and care for patients, I'm encouraged by the advancements and experiences in our leadership approach — enabled, in part, by lean management techniques.

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