Lee, Connor, and others have written before about our progress in implementing a daily management system (DMS) across our healthcare organization (for example,  http://dailykaizen.org/2010/05/23/).   While we have made lots of progress, we are still working toward achieving our vision of having a strong daily management system in place across the organization.  Still, enough time has passed to be able to assess how well our strategies worked; we now have a great opportunity to reflect on and learn from our experience. I recently spent some time doing this and would like to share some of the lessons learned. The following suggestions may be helpful to both individuals implementing your own system for your own team and to those of you who may be responsible for spreading daily management more broadly.

1) Daily management is improvement management

We have relied heavily on David Mann’s excellent book, “Creating a Lean Culture” to guide our DMS implementation. Mann states that “a lean management system sustains and extends the gains from implementing lean production.” 

I believe we focused too much on “sustaining the gains” and too little on “extending the gains.”  I would suggest that it is more helpful to think of driving continuous improvement as the singular purpose of daily management.   This will help avoid the trap of focusing too much or only on compliance to current standards rather than engaging your people in identifying the next set of improvements.  And yet this purpose does implicitly incorporate “sustaining the gains;” achieving higher levels of performance can’t practically occur unless the previous gains are sustained.

So, remember to ask yourself: Is the DMS supporting improvement? If not, what do I need to change?

2) Daily management is not easy – plan accordingly

It has been our experience that implementing a DMS that is truly useful and sustained is plenty challenging for a single team.  So clearly it’s exponentially more difficult to implement across the hundreds of teams in a large organization, each with its own unique characteristics.  

Implementing a DMS is difficult because (a) there isn’t yet a guide book available that details what a DMS should look like or how to implement it in an industry like healthcare and (b) it requires leaders to learn and consistently apply new skills and behaviors. Looking back, not fully realizing the difficulty of our task as well as believing we understood more than we actually did about the “target condition” were major causes of many of our missteps. 

So what to do? Here are some specific suggestions:

  • Learn as much as you can. Read books (e.g., Mann’s book and Martyn and Crowell’s “Own the Gap”), take classes (e.g.,ThedacareCenter for Healthcare Value’s “Creating a Lean Management System”), and visit other companies.  
  • Frame the development of your DMS as a series of experiments. Doing this will help you evolve it to the point where it is useful and sustainable.  And keep in mind that the flip side of there not being a guide book is that there is not (yet) a right way; whatever is useful in your context is the right way.If you are charged with spreading DMS more broadly, use a pilot to develop your understanding of what daily management looks like and how it can be effectively implemented in your organization.  Next, assure that the implementation approach accounts for the difficulty of the task. This could translate to something like an intensive 3 month plan which includes training, lots of hands on practice, and one-to-one coaching.  And, if you can manage it, wait to spread to other areas until you are certain that the DMS will sustain itself because of its value to the leaders and in teams in that area.
  • Adjust your expectations. Developing an effective DMS is not “one and done.” It will take ongoing work and some time.  Remember you will be in many cases changing long held habits!

3) Focus on what matters

It is very easy to get focused on the “trappings” of daily management such as the visual displays posted on walls.  After all, daily management involves making status visible. So doesn’t it make sense that we should expect that everyone should make certain types of information visible? We thought so too. The flaw in this is that visuals are a means to an end; they are only useful when they support teams in performing their work or leaders and their teams in improving their work. Visual displays without the processes that use them are wasteful “wallpaper.”

And yet implementing DMS requires change. How do you define the needed changes which don’t lead to “wallpaper” or people “going through the motions?” I would suggest asking yourself – or if appropriate, asking your leaders – the following two questions. These will help keep the focus on the purpose of DMS and experimentation as a key method to developing a useful system.

  • Do I have multiple improvements underway with my team to improve business results?
  • Am I regularly working with my team on improving my management system to increase its value to me and my team?

And to assess whether you are making progress in your DMS journey, ask: would anyone be upset if I took it away? If the answer is no, you have more experiments to run.

4) Look inward

Finally, our observation is that leaders who held accountability with their teams, maintained discipline in following their new management processes, and were open and committed to learning lean principles deeply were the most successful in establishing and sustaining an effective daily management system.  Assessing yourself against these attributes may suggest an area that needs more attention.

I hope you are able to take something from this reflection on our experience and apply it to your next daily management experiment. Good luck!

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