Recently, more and more hospitals are adopting tools and processes from other industries like Six Sigma, "Lean," or the Toyota Production System (“TPS”). Some hospitals are well-known for their success using Lean practices to reduce costs and improve the quality of care. Many, though, have invested time and money with limited success. Some try to implement Lean practices without considering important workforce cultural issues.
In our educational series a few years ago, Healthcare Goes Lean, we met too many HR professionals who knew little about the Lean efforts in their own hospitals. And of those who had been involved in the efforts, even fewer had given thought to how Lean concepts should drive hiring decisions. There are Lean experts who refuse to recognize that success is influenced by the quality of the leaders, managers, and front line workers who are implementing it. Michael Hoseus, co-author of the bestseller, Toyota Culture, The Heart and Soul of the Toyota Way, would obviously disagree:
“’Most companies miss seeing the blood flow of TPS – the human resource philosophies and strategies that make it work at Toyota.’ Toyota has always understood the importance of hiring and developing employees with the capacity to succeed.”
As an example, some hospitals start their Lean journey in the operating room because in many regards, the OR is similar to a manufacturing process environment. Samuel Agnew, M.D., is a renowned orthopedic trauma surgeon who has worked in some of the top academic and community medical centers in the country. He’s designed orthopedic trauma services around the world, including OR performance programs. He’s seen the futility of some of these Lean efforts. He doesn’t take issue with Lean practice, but with a failure to find, hire, and retain the type of people who can implement Lean. He says, “Processes like Lean require a specific personality to be truly efficient. Trying to mold or mandate people into the Toyota way is more problematic than one could possibly imagine.”
Healthcare education and development have traditionally been focused almost exclusively on clinical knowledge, technical skills, and autonomy. We’ve not emphasized the functional and behavioral competencies necessary for success in this new age. A decade ago, because of our extensive work with leading auto manufacturers, hospitals beginning their Lean journey started to call us. They wanted to understand how companies like Toyota consider Lean in their selection systems.
3 Ways HR can Support Lean Culture in Selection Systems
Just like HR should be part of every strategic initiative, HR needs to understand how Lean practice is being taught and implemented.
Lean changes the behavioral competency priorities. Place an emphasis on competencies like adaptability and the ability to collaborate and innovate.
Prioritize these competencies in the hiring process with both a structured behavioral interviewing program and with behavioral/personality assessments to evaluate candidates, similar to ones used by companies like Toyota.
The selection tools are just the starting point. HR should be using Lean principles to improve talent acquisition processes and effectiveness. An ideal process is effective, efficient, consistent (with standardization being a hallmark of Lean culture), enhances legal defensibility, and improves the candidate experience. These same principles can be applied to hiring the environmental services worker, nurses, managers, physicians, and leaders.
Want to learn more? See how an academic medical center incorporated lean concepts and reduced turnover at that same time!