The Leeds Teaching Hospitals NHS Trust

Leeds Improvement Method…

12 February 2018

Richard Corbridge is the Chief Digital and Information Officer for Leeds Teaching Hospitals NHS Trust.

I am about to embark on my Lean for Leaders training, and I have to say as I warm up that part of the brain associated to these new ideas I am excited to begin that evolution. I was lucky to be asked to be part of one of the report out sessions recently; I was able to understand how a group of infection control experts have applied some of the lean improvement methodology to save time and become a safer service delivery unit.

Three things struck me very quickly as part of this session; firstly the sheer brute force enthusiasm the team had for the benefit they were trying to make happen, secondly the selfless nature of the way they adopted the new ways of working delivering efficiencies to other departments and finally how much the team walked the walk. Clearly Lean for Leaders is going to be a challenge, to turn the tide on the way I do things and apply what will be new thinking to everything we do is going to be an exciting challenge.  

It is strange though, embarking on this discovery journey fills me with trepidation and yet I believe that what a digital team does best is consider improvement methods almost all the time; after all what we do has a less clear ‘means to an end’, what we do is try to help the ‘business’ adopt solutions that will enable improvement to be made.

If I think about the three lean characteristics of the infection control team I can see how that will become part of what we try to do.

Brute force enthusiasm is the new #LeedsDigitalWay that we have been trying to bring to all that we do since November. A reinvigorated will to try digital as the answer is part of our new team DNA and therefore I can’t wait to build up an understanding from the experiences that the Virginia Mason team have of digital health. We pride ourselves on lessons learnt and how to bring them to what we are trying to do here, our vision of a future with the Leeds Improvement Method twinned to our new way of working with digital will see us able to make change in a controlled and yet impactful way better than anywhere else trying to achieve what we have in mind.

A selfless nature to what we are trying to do is important to any digital team. Much has been written recently about the ‘back office’ elements of the NHS - we are here to support the delivery of care. We are ‘born’ with an understanding that what we do is not the celebrated success of the health system, in fact a successful digital team is one that goes unnoticed by the teams who deliver healthcare, because at that point the digital solutions are working as they should do, invisibly so, embedded in the way we work. If Lean for Leaders is going to give us as a team more ways to make this work then I am certain we are going to be able to embrace them.

The last of the three traits was the ability to walk the walk. A colleague in Ireland used to describe this a little more bluntly, he used to describe it as ‘eating your own dog food.’ As the digital part of the Leeds team we need to go about every day with the organisational goal in mind. We are no longer here to deliver IT, we are here to provide Leeds Teaching Hospitals Trust with a digital fabric that enables it to be the organisation that delivers the best possible care to every patient who needs our services. Walking the walk for digital also means being at the forefront of what digital can do as well as delivering a service and everyday striving to improve that service.

The idea of an inch wide and a mile deep permeates everything that we are asked to consider in the run up to Lean for Leaders. What is the most important button on a computer screen today, a button that enables you to learn to become lean? It’s the button shaped like a hook with an arrow on the end. It’s the undo button. With digital we can try things, we can see if they work, we can learn from them, tweak the edges and get it really right.

In getting ready for Lean for Leaders I wanted to understand how other digital professionals within my team had managed the transition; Matthew Watkins is our ‘poster boy’ for the Leeds Improvement Method and had these words to say about the different aspects of joining his cohort.

How I got involved: I became aware of the Leeds Improvement Method as soon as I joined LTHT and my interest was cemented when I sat next to Helen from the KPO at a senior leaders briefing and asked her ‘what do you do?’.

Why I got involved: A large part of my career has been spent working on service improvement (process improvement, effectiveness, getting digital right) and it was great to come into an organisation that had a clearly articulated and promoted approach to improvement.I applied, was accepted and started in cohort three on 27 February 2017

What I really liked: I enjoyed (nearly) every part of the learning. As with any learning certain areas grabbed me the most.  These were:

  • working with colleagues from across the Trust and getting to understand their Genba (it’s a Japanese term meaning "the real place." It refers to the place, such as a ward, where value is created)
  • understanding new concepts like ‘standard work’ and what we need to do within these concepts to really lace them into Leeds
  • bringing Leeds Improvement Method back into the places I work, sharing the learning with colleagues and being able to see tangible results; implementing 5S and the vocabulary of lean
  • building a network of new colleagues and problem solving with them.

Challenges: The commitment needed to undertake Lean for Leaders shouldn’t be underestimated and this requires your commitment and your teams support.For me the hardest parts of Lean for Leaders included:

  • managing my time well enough to meet the demands of the learning (I’d recommend blocking out time in your calendars to give yourself a chance to take the learning back to your Genba’s, and accept that a lot of the time you have blocked will be given over to other priorities but keep hold of some)
  • making enough time to share all of the knowledge and insights gained
  • having too wide a scope in some of the tasks I set myself.

What next? For me it’s about:

  • sustaining and spreading the method primarily in Digital and Informatics but also taking the opportunity to bring it to all the support work we do across the Trust
  • supporting colleagues that are just about to start
  • maintaining the network of contacts
  • building new relationships through Leeds Improvement Method - when I meet a new colleague I ask them if they use the method, are they doing Lean For Leaders and then help them start problem solving in that way.

Matthew puts forward a great vision of what the Leeds Improvement Method will bring for us all I think, and has helped me get ready for the experience to begin.

A digital fabric that is paired with the Leeds Improvement Method and the Leeds Way really is the most liberating of cultures we can hope to achieve. A liberating culture that will allow us to reach for the stars and achieve the goals we want to achieve. In the book Outliers by Malcolm Gladwell he encourages us to consider outliers, study them and understand why they exist and what we can learn from them. He asks if we want to walk on water, and goes on to say the only way to walk on water is to get out of the boat.

I believe that Lean for Leaders will give us more courage to do just that, to get out of the boat!