5 LEAN Tips to Create a Culture of Continuous Improvement

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The 2015 Centers for Medicare & Medicaid Services (CMS) Quality Conference featured a series of Master Classes, including “LEAN 201: From Theory to Practice.” This session highlighted not only the Quality Improvement Organization (QIO) Program’s focus on innovation and care quality, but also CMS’ role in promoting LEAN adoption. Rocco Perla, Director of Improvement Dissemination and Model Expansion at the Center for Medicare and Medicaid Innovation (CMMI) was joined by Elijah Ditter,CMS Program Manager of the LEAN Transformation at CMMI, Maia Laing, a member of CMS’ LEAN Team, and Mindy Hangsleben, the Entrepreneur Fellow for CMS, to discuss the phases of LEAN transition and how to establish a sustainable change infrastructure.

The main question asked about LEAN at the 2015 CMS Quality Conference seemed to be, “Is your organization ready to implement LEAN management?” Below are five key takeaways from the Master Class for organizations looking to get LEAN and ensure the sustainability of new infrastructures:

  1. Be aware of the phases of transition, and prepare to address and overcome them. Phases include denial, resistance exploration and commitment. If an implementer can successfully move through these stages of transition, productivity will increase over time, and individuals will move forward independently.
     
  2. Create a sense of urgency to drive change.  Answer the question, “What’s in it for me?” Sell any problem with a solution depicted through visual aids and results from initial testing successes, and by engaging leadership.
     
  3. Establish a change infrastructure. Explain why the change was made and set expectations that clearly define the targets of the new process. Provide a supportive environment to use new skills, share feedback and coach a new performance level.
     
  4. Promote adoption with actions to support transition. Focus on the target innovators or early adopters who can help form success stories and create a pull toward adoption for those resistant to the transition.
     
  5. Sustain the change by making sure your metric is “SMART.” Each letter of the SMART acronym stands for a key aspect of sustainable change implementation: Specific, Measureable, Attainable, Relevant and Time-bound.