The Virginia Mason Medical Center Discovers Its True Customer

I found this great article by Michael McBride over on the DARK Daily website about the Virginia Mason Medical Center (VMMC) and its Lean journey. Other than the important financial turnaround that VMMC achieved, the medical center appears to have learned the most crucial lesson: "...that the patient, and not VMMC itself, was the true customer."

The article includes some quotes and insights from chairman and CEO
Gary Kaplan, MD, who leads the Lean initiative, which began 10 years ago. He interestingly reaffirmed the pivotal role IT plays in process redesign: "You have to redesign your work first. The data comes first; and IT can help eliminate manually based errors." In addition, although it is is not detailed in the article, Kaplan achieved what can sometimes be one of the hardest early hurdles by "securing buy-in of all senior leadership at the hospital."

Are any of the readers of this blog familiar with the Virginia Mason Medical Center? Do you think it has set the right example for other medical facilities to follow? Are there areas that still lack improvement?

The story of the Virginia Mason Medical Center's Lean odyssey has been revealed in book titled
Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience authored by Charles Kenney.


Creating Productive Conversations Among Conflicting Employees

During a recent conversation with Steve Dinkin, president of the National Conflict Resolution Center and co-author of the recently published book The Exchange: A Bold and Proven Approach to Resolving Workplace Conflict, I asked him if he had any tips on how one can transform a meeting with conflicting employees into a productive conversation. Steve had quite a detailed answer, so I thought I'd include his complete response in this blog post:

Start with an icebreaker. Most people will be ready to complain, debate, or argue at the beginning of any conflict-based conversation. They have marshaled their most compelling arguments and are ready for battle. If you go straight to the topic of controversy, most people will quickly get stuck in defending their positions and attacking their opponents.

That’s why you need to do something different.
ou should begin with an icebreaker, but this is not just a light introductory activity. It is a way to non-confrontationally initiate a conversation about difficult issues. An ideal icebreaker asks for a person’s own take on something that’s both work-related and positive. For example, if the conflict involves two employees involved in the same project, you might break the ice by asking each of them how they became involved in the project and what they hoped to achieve.

It is important to listen. Conflict resolution is tricky because too many managers ignore the fact that sometimes what they aren’t saying is more important than what they are saying. Often the best resolutions come from listening carefully to what the other person has to say. Being an active listener sends the message that you are genuinely concerned about him or her and the dispute. Put plain and simply, it’s the best way to get good information.

Ask an open-ended question. It can be as simple as, ‘So, tell me, what’s going on?’ Then listen carefully to that person’s side of the story. You’ll know it’s time to insert yourself into the conversation when the discussion turns negative.

You can acknowledge someone’s emotions without seeming like you are taking his or her side. Especially at the beginning of talking about a conflict, you’re building rapport, even if it’s with an employee you’ve spoken with millions of times before. When there’s a conflict, you’re treading on new ground, and showing that person you are willing to see his or her side of the story is how you will set the foundation for working toward a solution.

Use and encourage positive language. This one might seem like a no-brainer, but any frustrated manager knows how easy it can be to slip into negativity after a conflict has affected a work group. Always think before you speak. Use positive, easy-to-understand language. Don’t fall into repeating, verbatim, paragraphs from your company’s HR manual.

Remember, you’re having a conversation, not a trial. If you keep the language positive, whoever you’re addressing will likely mirror what you’re doing. Even referring to the department’s needs can be stated in very positive terms, which will lead to a more collaborative (rather than punitive) tone in the discussion. For example, if the manager says, ‘This has increasingly affected the entire team, and we need to address it so we can get everyone focused back on the project goals and having a comfortable working environment. I am looking forward to establishing a good working relationship between the two of you and improving morale for everyone on the team,’ it will set a constructive atmosphere. When you keep things positive, you can work toward great solutions efficiently and effectively.

Work toward SMART solutions. Sustainable solutions are SMART solutions. That means they’re:

Specific -- Be clear about who will do what, when, where, and how.

Measurable -- Be clear about how you will all be able to tell that something has been done, achieved, or completed.
Achievable -- Make sure that whatever solution you agree on fits the situation; that it complies with both the law and organizational policy; that everyone involved has the ability and opportunity to do what is required of them. Don’t set up anyone to fail.
Realistic -- Check calendar dates for holidays and vacations; look at past performance to predict future actions; allow extra time for glitches and delays; don’t assume that the best-case scenarios will come true.
Timed -- Create reasonable deadlines or target dates; include a few ideas about what to do if something unexpected occurs; be willing to set new dates if necessary.

Once you have your SMART solutions in place, immediately put them in writing. Putting solutions in writing is very important, and not just for legal reasons (and for covering your back). It’s a way to honor the work that you and your employees have accomplished. It’s also a way to keep people’s memories from diverging from the agreed-upon solutions. Verbal agreements have a way of being remembered very differently by different people—and then becoming the subject of another conflict. It’s safer and easier for everyone to have the solutions written down, in order to be able to easily verify them later.

Do you agree with Steve's advice? Have you ever been in a meeting that's turned unproductive because the focus has been on bickering instead of achieving goals? Do you have any suggestions to add to Steve's response?