patient safety quality healthcare

November / December 2012
Lean Transformation

Key Characteristics of Successful Leaders

Replacing senior leaders in an organization is never easy. With a board of directors and other top executives having invested a lot of time and money in supporting the former leader, now they face the difficult task of replacing that knowledge and experience with a leader who will help advance the organization into the future. Finding effective leaders is different today than it might have been in the past, but there are certain, proven criteria organizations should consider using to find the right people.

In our work guiding healthcare organizations through Lean transformation journeys, we at Simpler have developed instructive criteria for senior leadership teams. The criteria are consistent with those exhibited by executives who have radically transformed their organizations.

Before focusing on the criteria, it helps to understand the reasons that drive healthcare organizations to become Lean. With hundreds of millions of dollars wasted in healthcare annually, coupled with pending reimbursement cuts, healthcare organizations are under pressure to maintain, and ideally, improve the quality of patient care in a cost-effective way. For organizations that are not satisfied with resorting to layoffs, Lean transformation teaches hospitals how to do more with less. Employees are taught how to define value in the eyes of the patient. Using that knowledge and perspective, every member of the staff learns to identify and eliminate wasteful steps from processes. The result is a more productive workforce delivering high quality care at a lower cost. Fundamental to the success of a Lean transformation is strong leadership to keep employees motivated and committed as they change how they work to reach the desired state.

What Makes a Good Leader?
Most often, organizations searching for a new leader are looking for someone to drive change rather than maintain the status quo, suggesting that the current strategies aren’t meeting the organization’s goals. A new leader is often tasked with revising the organization’s goals and proposing the best strategies, such as Lean thinking, to achieve them. Ultimately, redefining an organization’s mission and vision requires an organization to change the way it functions.

Driving change in an organization is not easy. The concept of doing something different does not appeal to many people because it is hard work. A strong leader is able to communicate effectively to employees why the hard work is necessary and reassure them that they will be supported on the journey.
Searching for a new executive involves more than focusing on resumes and credentials. The focus should also be placed on looking at the qualities potential executives possess and how their business philosophies and leadership style will work within an organization. It’s most important to gauge if the candidate will be able to help lead change. Characteristics that will help leaders successfully guide an organization through a Lean transformation include the ability to:

  • Develop and communicate the vision.
  • Hold people accountable.
  • Create a culture of continuous improvement.
  • Foster learning and mentoring across the organization, starting with themselves.

Develop and Communicate the Vision
Given the challenges of healthcare, it is important to find innovative leaders who have a clear vision for the future. These people are not stuck in the paradigms of today, but rather see the path for tomorrow.

In order to effectively sell the vision, leaders must have strong communication skills. They must be able to identify key messages that will resonate with each important audience and convey that important message with authority and confidence to the board of directors, shareholders, and community leaders. They must also convey the message to their partners, stakeholders, and customers, and they must communicate the message to all the people within the organization.

“As with any initiative, a leader needs to create the vision of where the organization needs to go,” says Dr. Patricia Gabow, former CEO of Denver Health. “The vision must be noble and a stretch. If it is not, the leader will look behind and see no one following.”   

Hold People Accountable
Holding people accountable begins with holding oneself accountable. Mistakes can and will happen, and when they do, there is an opportunity for true learning to occur. In order to capitalize on these pivotal moments that foster and lead to growth, employees must be taught to see mistakes as opportunities instead of failures.

The first step begins with making sure the proper people are put in place. Leaders cannot move the organization forward with staff members talking constantly about the good old days. That rhetoric is counterproductive, as past success does not guarantee anything for the future.

Second, leaders must have clear and measurable goals at all levels. Whether using strategy deployment, a systematic strategic planning methodology for defining breakthrough objectives, or another methodology to drive strategy and deliver on goals and objectives, a good leader must help people understand what success looks like.

Third, with the vision as a foundation, and clear measurable goals communicated to all levels, leaders must establish the values and supporting behaviors that will be required to create a culture of continuous improvement and learning. These behaviors, often described as core competencies, should be embedded into the organization’s training and human resources materials. From the employer branding statement to orientation, talent development and performance management, these core competencies must be reinforced and evaluated. Employees must know that it is no longer “just about results,” but equally necessary to exhibit the required behaviors, such as teamwork and knowledge sharing, in order to be successful.

Holding employees accountable is not done with an iron fist; it’s done through communicating expectations clearly, setting local goals collectively, and making sure people live up to the commitments they have made to their job and the organization. For example, during a Lean transformation, roles and responsibilities at all levels will change as a result of process improvements. Employees will have an opportunity to provide input and design these changes through their participation on event teams. It is critical that all impacted employees understand the changes through frequent communications and open forums during which they can voice concerns and seek clarification.

Changing behaviors and learning new skills requires time, practice, and feedback. Leaders and managers must be willing to provide feedback and coaching to reinforce the new behaviors as well as address unacceptable behaviors aligned to the old culture. Employees should be actively involved in setting goals specific to their area of influence, thereby creating buy-in and ownership of the results.  

Create a Culture of Continuous Improvement
Leaders must have a passion for continuous improvement. Given the ever changing healthcare landscape, organizations must improve each day or they will not be in business. The level of transparency will continue to increase in healthcare, giving patients and families more knowledge about which provider to select.

One way to motivate executives and staff is by sharing data and further demonstrating that change is working. Leaders, too, must be data-driven. They must strive for perfection. They must foster a culture that candidly admits imperfections. Historically, healthcare has done a good job measuring how well they are doing on certain metrics. However, high-performing organizations also measure what they are not doing well. They analyze every type of error and are relentless in finding the root cause to problems and improving quality every hour, every day. With the ultimate goal to achieve perfection, improving processes and outcomes becomes the cultural norm.

Through Lean, new leaders have the tools to encourage formal continuous improvement strategies that involve staff and members of the medical team and allow everyone to operate at the top of their license. For example, ThedaCare Health System in Appleton, Wisconsin, worked with Simpler to develop a Collaborative Care Unit where caregivers are empowered to coordinate the delivery of treatment plans to patients. By developing a new treatment plan where a nurse, pharmacist, and physician meet with the patient as a team within 90 minutes following admission, and redesigning the unit to reduce the amount of paperwork and steps to find supplies, ThedaCare was able to dramatically reduce the amount of time caregivers spend on administrative tasks and increase the time they spend on patient care. Through this process, ThedaCare has experienced a 25% reduction in total cost of care, and patient and nursing satisfaction is ranked at 100%. In addition, they have not had a medication error in more than three years.

It’s not enough to say you do continuous improvement. You must have a formal, systematic approach to improvement. It should be part of an overall business system that drives financial, operational, and cultural performance.

Foster Learning and Mentoring Across the Organization, Starting with Themselves
Leaders must have a drive for continuing to develop their own skill sets as well as fostering a culture that provides opportunities for employees to do the same. Being a visionary doesn’t mean you must have all the answers. Effective leaders understand this and consult with others to contribute to the overall success of the business. I’ve learned from many great teachers. They all helped me to learn and allowed me opportunities to fail. We know we learn from our mistakes, but it’s what we do when they occur that makes us great.

Leaders must first learn to be good students. They must be willing to learn new ideas that will advance the organization and ensure its long-term success. Humility is sometimes looked at as soft, but strong leaders are willing to admit they don’t have every answer and will publicly admit their mistakes.
Mentoring is a leader’s most important skill; it is the ability to develop other leaders. A leader can’t expect people automatically to know everything expected of them. A leader must be willing to spend time with the staff and coach them.

“Since the inception of our Lean journey, we have encouraged our senior leaders to alter their allocation of time to ensure they spend enough time to observe and participate in performance improvement activities throughout the practice,” said Dr. Gene Lindsey, CEO of Atrius Health and Harvard Vanguard. “By ‘going to the gemba’ and personally getting involved with those who do the work, we strengthen our ability to make breakthroughs and improvements.”

In summary, when you need to replace a leader, find someone capable of taking your organization to the next level. If they exist within the organization, that’s great. If you need to look outside, that works too. Either way, they should be viewed through a similar lens and judged on their ability to challenge employees to embrace change and realize a better future. ?

Mike Chamberlain is president of Simpler North America, and a key player in the formation of Simpler’s healthcare practice, which has led more than 150 healthcare systems across the world in the application of Lean concepts and management to improve the overall quality and delivery of healthcare. Chamberlain may be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. .


ABQAURP American Society for Quality American Society for Quality Healthcare Division Consumers Advancing Patient Safety
EMPSF Institute for Safe Medical Practices
Medically Induced Trauma Support Services (MITSS) Medication Safety Officers Society NPSF Partnership for Patient Safety Society to Improve Diagnosis in Medicine