I have always wondered why process improvement often correlates to layoffs in the minds of staff, as well as, administrators. In one instance, while serving on an Operations Council, I was attending a meeting and the COO indicated he needed our support to do ‘the hardest thing.’ This difficult task was linked to reimbursement changes in the psychiatric areas which had decreased significantly the previous day and would not come back in the near future. He wanted our support in laying off 20-30 individuals from those departments. Keep in mind, this was a medium sized hospital that had operated for over 100 years without ever having a layoff. See example of how Adept approaches staffing simulations..
He went around the conference room to each person and asked “Would you do ‘the hardest thing’ and support him?” Each person answered “yes.” He then came to me, ironically the last person to ask, and asked me the same question. Everyone was certain I would answer the same but instead I waited a few seconds before answering, which you could tell seemed an eternity to those in the room. Then I simply asked, “Why are you doing this?” You could have heard a pin drop in the room. I then proceeded to point out that we had 2,000-3,000 employees in the system of which 20-30 left every month for new jobs, retirement or other reasons. Before the ensuing conversation ended, HR was tasked with finding similar or higher-paying jobs for each of the affected individuals. Within days, instead of layoffs, each was offered a similar grade level position or higher grade position to stay with the health system. The “hard thing’ was not to have a layoff. The hard thing was to keep them gainfully employed with us, being valued for their skills they brought to the table and their experience and loyalty. It also helps to improve all staff’s moral and satisfaction with the health system, knowing the organization cherished and valued them.
This same is true with Lean Six Sigma and other productivity improvement methods, programs and cultures. It is important to get in front of the issue.In John Toussaint’s book titled Management on the Mend (MOM), at ThedaCare (where John used to work) there is a policy for Lean facilitators, prior to a rapid-improvement event that reviews whether the possibility of FTE’s could be reduced as part of the improvement area. If so, the facilitator and leaders from the affected area review and explore possible redeployment’s and explain this to potentially affected employees long before the high emotion of a rapid-improvement event begins. They asked whether there might be people interested in moving to a different unit or learning a new job. Sometimes volunteers raise a hand immediately but most people wait until private meetings that are held later. John also says elsewhere in his book that they guarantee people will not be laid off due to process improvements. Another promise of lean is that leaders will work hard to make jobs meaningful. We each need to make these guarantees to our people. For me, this goes back to Deming’s 14 points specifically number eight, “Drive out fear, so that everyone may work effectively for the company.” Lean Six Sigma or any other process improvement program/culture will never be successful when based upon fear and disrespect.
David Ferrin is a Lean Six Sigma Master Black Belt and has worked with hundreds of healthcare organizations specializing in the identification, evaluation, and implementation of process/systems improvements. He has significant experience with organizations in transition including growth, aggressive reorganization and downsizing. Strengths include in-depth knowledge of operations, facilitation to closure, and analytical expertise that fosters the identification and implementation of attractive improvement opportunities.