Sustained
R E S U L T S
Through

IDEAL BEHAVIORS

Testimonials

"The leadership education and training that I received from the Institute For Enterprise Excellence was the most helpful and most useful that I've ever participated in. "
    Tony Ogburn, MD, Professor and Founding Chair of the Department of Obstetrics and Gynecology, The University of Texas Rio Grande Valley School of Medicine

"Connecting systems with principles and having a mechanism to then create those aligned systems is very beneficial – and eye opening."
    Timothy Johnson, MD, CEO, La Crosse, WI

“Principle-based architecture knowledge encouraged us to view our work with a new set of lenses.  Applying the knowledge through building systems enabled us to see how key behaviors get key results.”
   Curt Wymer, General Manager of Toppling Goliath Brewing Co

“Max, Mike and Jake have helped leadership see the missing pieces in our lean journey and have taught us how we can enhance our ability to go beyond using tools to get results to focusing on ideal behaviors grounded by principles and adjusted by systems and tools.  It’s the key to cultural evolution!”
  Lori Pelletier, VP, Operational Excellence, UMass Memorial Health Care

“Moving past tools and raising my consciousness around the principles which govern the consequences of our work has forever changed how I look at healthcare. The enormity of change needed to transform healthcare into a healthy, sustainable industry for patients, families AND healthcare workers hasn’t shrunk, but the IEX framework for thinking about the systems, tools, and behaviors  around the aligning, enabling and improving principles offers me a viable construct for tackling this problem, each and every day.  The great thinkers at IEX have helped me ‘see.’ It gives me hope for the work we can achieve and the healing cultures we can cultivate.”
   Elizabeth J. Warner, MD FACP CPE, Medical Director of Continuous Improvement Support, Kalamazoo, MI

"Lean models and methodology helped us achieve breakthrough on technological process issues, but the enterprise excellence model and methodology helped us promote cultural evolution so that our teams can hardwire continuous improvement."
    Lorra Browne, RCP, MBA, Executive Director, Embedded Lean Fellow, MemorialCare Health System

"Respect for people relies on challenging others to increase awareness and capabilities. The institute for Enterprise Excellence is doing just that. Thanks to their principle based architecture, we are reaching a different level of thinking.”
   Didier Rabino, VP, Lean Sensei, HealthEast Care System

“Lean transformation is difficult to do and impossible to sustain without an associated culture change. The Enterprise Excellence model with its principles and behaviors as taught by Jake and Mike, helped inform the “why” behind the transformation. This approach  equipped us to identify, define and adopt new leadership behaviors in support of the necessary culture change across the organization.”
Dirk van Rossum, Lean Transformation Engineer, NCH Healthcare System

“IEX has been invaluable in our journey from changing our management system and culture to a principle based architecture where how we do the work matters in order to sustain and get our needed results.  They have exemplified the principles of humility and respecting every individual while being our teachers, coaches and mentors.  They didn’t just give us a “program” or “tool”.  They taught us the key principles and coached us to develop our management system based on our organizational needs.  They challenge us to continue learning and growing.  They truly care about our success.”
Jamie Silva-Steele, CEO; Yvette Sena, LQIP Senior Coach, Sandoval Regional Medical Center, Rio Rancho, NM

Impact   - Responses from IEX course participants 30, 60 and 90 days after each course.

Tell us how you have applied the knowledge in your organization:

  • Teaching and educating others on the topic, trying to inspire to lead the initiative.  Promoting the idea of identifying "ideal behaviors" and my focus is now on the behavior, not the tool.
  • The organization seems to be benefiting from an outside entity 'bringing it to light'.  The initial sense is that it has been embraced and leadership has a better awareness.  The true test will be implementing and sustaining the knowledge gained.  Sustainment has been the challenge for any change.  Initial surges are great, but ingraining change, empowerment and acceptance in a culture is much more challenging.  Often times things are implemented ineffectively and then people revert to old ways of doing things. Hopefully there will be continued engagement from outside to identify and implement what is necessary for imbedding the IEX model.
  • I've applied the IEX model knowledge by actively using my lens for thinking about ideal behaviors and systems versus creating program after program. I've also been asking better questions.  We are using the framework in designing a session that will focus on leadership team development.
  • So far, I used the knowledge from the training to re-design our visual management system, starting with purpose, principles, and behaviors. We used the worksheets provided in the training as a general process. It was an excellent exercise and difficult to do, but changed the way we look at our VMS. I also am using what I learned to come up with better goals that link to principles for the purpose of driving ideal behaviors. After the training, I am noticing people's tendency to focus so much on the result, even some of the people who were in the training with me, and it is hard to get them to see the other side of the coin (backwards bicycle). Additionally, we have organization-wide initiatives that span numerous departments and silos and the training has helped me see this work in a new light. From a system perspective, we are focusing too much on the results and assuming that is we manage the parts well then the system will improve. NOT TRUE!
  • I have been teaching these concepts to leaders and managers.  We are making plans for how to deploy this thinking in the organization's strategy room.
  • I have applied the concepts to my work within the teams I support.  We have a small work group identifying "ideal behaviors."
  • We had an assessment that was mainly focused on the use of tools.  Since I learned the model, I have been focusing coaching leaders who are self-assessing to look at their behaviors first, rather than a tools focus.
  • The IEX model provided a comprehensive look at the gaps in our current environment, integrating systems, principles and behaviors that support effective work.  We already had tools that organized work groups and plans, but we did not realize the structural elements that are still needed.  I now understand the WHY behind things not moving or improving, and try to bring that observation forward.
  • Greater awareness about the importance of behaviors more so than tools.  Acknowledging and recognizing the behaviors more so than results.
  • We are now focusing on the Principles of Enterprise Excellence as our means for moving forward in Lean Thinking. We are attempting to learn an even deeper understanding of the principles, as well as create daily opportunities to focus on principles with our Directors and Managers, so that Managers can then in turn share with front line.
  • Assessing the presence and lack of essential systems that support desired outcomes. Assessing leadership behaviors and competencies that align with desired outcomes.
  • Focused coaching on alignment of purpose and thinking systemically.
  • I have been teaching leadership and some management these concepts. In addtion, we are making plans for how to deploy this thinking in the facility strategy room.
  • I have used the knowledge to guide my daily practices and shape my philosophy as a leader. I have shared this information with other leaders as well.  Using to ask better questions during Gemba, more probing questions during gemba walks and interacting with staff about problem solving
  • I am thinking more in lines of behaviors and reviewing that our process is promting the desired behavior.
  • I am changing my focus from tools and results to purpose, guiding priniciples and behaviors.
  • Transitioning from thought that implementing tools will be what moves process changes to reinforcing principles to accomplish the same.
  • Systems thinking (in particular system design in countermeasures development) has risen significantly as a mental model in my work.
  • Included more positive inquiry in gemba rounding.
  • Culture building and idenfitying "ideal behaviors with one leadership team. Explained systems to a 100+ patient financial services department working on developing a system.
  • Using Positive Inquiry, encouraging deeper understanding of variance.
  • Asking probing questions and being aware of what is going on the area aside from the white boards.
  • I shared with our Lean Steering Team and with our senior management team - velocity and transformation models, systems and principles.
  • I used the assessment training last week in our Medical Office Value Stream work. This assessment allowed the leaders to see what has changed, what strengths they have gained and where they see opportunities for next years breakthrough improvement work.
  • Increased my status rounding and Gemba schedules.
  • I recently completed an assessment in the ORs at our hospitals - use the learned assessment methodology to help identify where each entity is in their operational excellence journey.
  • Looking at systems and asking "Do we do this to get results or to drive behaviors?"
  • I have attempted to think of behaviors as the goal more than the numbers and work from that view when I coach staff.
  • The training provided an opportunity to make connections with the white papers - hands on learning helped tie it together.
  • I am developing a plan to infuse the behaviors at my department level.

Please provide any examples of outcomes in your organization (results, performance, behaviors) that you might attribute to the knowledge and training you received:

  • My behaviors have changed to be more focused on vital behaviors and less focused on tools.
  • Our team is talking more about behaviors and sharing ideas about how to incorportate what we've learned into our trainings and daily work.
  • The discussion at the senior leadership level is beginning to focus on behaviors we are expecting in addition to the results and tools.
  • I believe my questioning related to the training is starting to change people's mindsets at least when tey speak with me and we are talking about systems.
  • Discussions at senior leadership level is more about defining behaviors we are trying to change in addition to actual numeric result.
  • Directors are now able to verbalize the purpose of our work as "inspiring hope."
  • Focused strategic planning in Department and Group Practice. Common language developing. Narrowed priorities for this year to big three. Working on alignment now.
  • This training has sparked a deep interest in applying the model during senior leadership gemba walks.
  • System design is more that just SIPOC now.
  • Focus on align, improve, and enable. Creating metrics. Expanded going to the gemba questions. Doing Listening tours.
  • Reinforced how I lead the group to look at waste & continuously adapt/improve what we've already thought we fixed!
  • We explicitely discussed leadership behaviors to support key principles that will help us meet our goals this year at the Medical Center.
  • Changes in job descriptions and changes in hiring and interview questions.
  • Managers are learning how to communicate how the work on the front line aligns with system goals.
  • When we drive exclusively toward results, we negate the effort that may be going on to set the ground work and foundation that will support the culture, behaviors and integrated systems that support the learning environment where performance thrives and true results emerge.
  • Staff can identify the systems that drive behaviors - through aligning, enabling and improving.
  • Rather than driving the use of tools, we are more explicit in our introduction of tools and the importance of behaviors to ensure that tools and systems meet their stated purpose.
  • We recently had a kaizen report-out that was truly inspiring.  A long-term complicated problem related to fit testing employees with respirators was addressed.  This team did great work.  It is an example of our competency to solve problems is improving.
  • The biggest example is that ALL leadership can get behind these principles. It is a common language that begins with Senior Leadership, and will flow through all levels.
  • Performance with capacity management (LOS, Safety, Sat) is improving through the interdisciplinary team being aligned in the improvement cycle and through understanding the individual and collective behaviors that drive systems and outcomes. (through use of strategy room).
  • I believe leaders are starting to understand that the purpose is to provide value to the customer and KPI's just show us the results of that purpose and behavior.
  • Framing my thinking, impacting the interview process, implement standard work facility wide after review of work.
  • There was an awareness of transport job and safety and communication systems OFI's.
  • I have provided coaching and developed a process surrounding kaizen improvement form creation (1 per week) initiated by a leader in an engaged department. This form looks focus on continious improvement. A system has been developed to drive this behavior.
  • Able to speak to a team about what they really are looking for in terms of metrics, looking at behaviors not just data.
  • There is a significant pull from leadership to develop problem solvers.
  • Beginning to see better preparedness at the LDM Boards by frontline.  See more standard work developed and problem solving is deeper and less band-aide approach.
  • Reviewing subsets from list of principles at each managerial and leadership meeting to discuss and align work around these.
  • Deeper root cause problem solving in Security department related to lost and found belongings also in EVS on room cleanliness.
  • Feelings towards culture shift is being measured by ticks (like a Pareto chart).
  • PI dept revising metrics to focus on the processes that drive patient timely encounter vs the Outcomes data.
  • As a result, I believe we are getting closer to idenifying the root cause of problems.
  • I have seen a demonstrated shift in thinking with our senior management team. They agree that in 2017 we need to focus more on systems, alignment and enabling our management team versus just focusing on the tools. I don't have specific outcomes yet but hope to in 2017.
  • The leaders of this newer division in our organization are learning to focus on behaviors and performance not just results.
  • More cross departmental problem solving on shared processes.
  • Changing how we do care briefings daily.
  • Leaders are beginning to ask different kinds of questions to assess where an area is in their lean journey.
  • Thinking through the aligh, improve, enable - more consistently.

What did you DO to challenge how you achieve results when you Go and See in the organization?

  • I began to change my tactics.  I now understand the purpose of my actions, and the principle-based ideal behaviors which support the purpose in order to achieve results.
  • I proposed to our team that we share learnings from the Foundations Course and how each of use is facilitating the work.
  • We have created a means of aligning front line work, day to day results, with the strategic hospital goals and then up to Mission goals.
  • I edited the questions I asked based on the training. I advanced the process used in our strategy room huddles.
  • I focused on getting leaders to own the problem in their value streams and asking what is the real problem you're trying to solve.
  • I personally work to ensure I understand what lean priciples apply to each situation. Then work towards identifying ideal behaviors.
  • Ask more socratic questions. Seek to understand the "why" behind certain behaviors. Assess for culture in all levels of the organization and not just the artifacts.
  • I asked a lot of questions in regards of behaviors that they wanted to "see". In my role, more defining and adjusting a process to achieve improvement want to better scope out what the behavior the customer is trying to achieve not just the final result.
  • Refocus on problem solving through asking key questions, rather than just focusing on results.
  • More attune to the surroundings and more patience.  Asking better questions that seek accountability.
  • Positive inquiry, asking for standard work, requesting data.
  • Understand cutlure by observe meetings, communciation style, etc.
  • Ask questions, do you have the right information to understand the why, what did your 5 why lead to. have you trialed your new process. is there a standard work.
  • I have been using scripting based on what I learned in the course to find out more about the issues people are working on in their areas.
  • I utilized the types of questions we developed and practiced with front line team members when rounding on our current new process implementations. This helped prove that we are having a difficult time reaching front line team members that were not involved in the original lean team which will affect our ability to sustain improvements. We need to provide more why versus just the what.
  • I asked the leaders to see if they could identify how the area was doing for the day. Were they having a good or bad day?
  • I still ask leading questions, but am trying to ask more questions about conclusions and data use.
  • Better understanding culture by observing meetings and communication style.
  • Critically looking at what constitutes value in the eyes of the customer.
  • I have been working on thinking systematically, thinking if we have the right systems in place to support the ideal behaviors.
  • I feel like I have made time to be out in the work place, learning and asking questions.

What did you DO to identify how purpose and principles guide system design?

  • I have proposed further discussion with our team as well as integrating operational leaders into the conversation.
  • We are having daily discussions in the Gemba and focusing on one principles a week. Decisions on the right metrics, and alignment are actually happening now!
  • Leading open dialogue with leadership groups on what they thought the purpose and principles were and how to make it visible.
  • Senior leadership huddle to report value stream map findings and collaborate for changing the transport process.
  • In working through the strategy room, we are now developing systems which drive ideal behaviors on a weekly basis,
  • Seek to understand our organization's strategy deployment efforts and how they align with our desired KBI's. Prior to this training, I am able to connect how the "see" + "do" = our "get."
  • Asking different questions.
  • Re-read the training materials and notes taken to deepen my own understanding.
  • Exploring how to redesign our gemba walks, and sticking to my script and not step into problem-solving mode.
  • Use of VSM and focus on value to patients.
  • Debrief with leaders.
  • asking questions . what problem are you trying to solve, what are you hoping to accomplish, who do you need to partner with to take this to the next level or spread this.
  • Listen and observe. Are sytems being developed based on the principles? What happens when problems are identified? Is there a systematic approach to problem solving?
  • It is very obvious we do not have systems in place to support the changes we are trying to make throughout the organization. After sharing the models with our Green Belts and Senior Management Team, we worked on a strategic plan that would add more leadership development versus just deploying teams to solve problems.
  • I reviewed the purpose and principles identified by the team to see if they could link them to the system identified.
  • Bring the questions back to why we are tracking different items.
  • Debrief with leaders.
  • I asked the leaders to identify the purpose of the system we were looking at.
  • I have been reading/educating myself so that I may educate staff.
  • I am working on looking at the principle in our day to day as the end goal.

What did you DO to experiment with ideal behaviors to influence and elevate?

  • We are now beginning to develop what ideal behaviors mean to us at our organization.
  • We have four model cell areas with experiments happening in those areas.
  • Held internal gemba visit for system senior leadership.  This produced much excitement, and everyone wants to be involved again. We are having to be selective and prioritize the work so that we don't dilute our resources, and dilute the application of the principles. We are very intentionally trying to go that inch wide and mile deep.
  • I have a small group of leaders that are most engaged in testing these concepts.
  • Leading by example and hopefully asking effective questions.
  • I experimented with asking humble questions.
  • Working with leadership to develop what good looks like and also what a less than ideal behavior looks like. These are worked on every Friday as well.
  • Practice asking questions to really understand the problem- not think I already know and jump to solutions.
  • We made a list of different questions, posted at gemba start and try different questions to get deeper thinking and discussions.
  • Re-evaluated mtgs and non-value added time I ask leaders to commit to weekly and monthly.
  • Using "Caught Caring" and recognitions to highlight ideal behaviors.
  • Verbalize when we see ideal behaviors. Suggest more reflective questions when starting meetings to develop greater self-awareness.
  • List of questions, trying a different on on gemba each day.
  • The best experiment is to be visible, ask humble questions and understand the why of what others are working on in their areas.
  • I liked the idea of writing what behaviors we would expect to be demonstrated when the principles were utilized. I am working on my own behaviors as a Lean leader within our organization and the first experiment I have tried to going to speak to more front line team members versus just the process owners or Green Belts. This has already had a positive affect on several of our projects and has also uncovered problems I was unaware of that are now on my radar.
  • Asked the leadership team to call out the ideal behaviors they should see in each other and those they would see from those they manage.
  • Provided the defined operational excellence defined behaviors to the leaders to see if the leaders could connect these to the system being developed.
  • Adjusting my standard work.
  • I have shared and discussed white papers with staff. we are starting here with "respect all people."
  • I have been looking at the way I interact with my staff and how my staff interact with patient as the behaviors that get the best outcome.
  • I feel that I embrace the ideal behaviors - even prior to learning them - but how do we keep them top of mind for all.