Jaded Julie starts learning how to go from bad to great.

“Don’t you mean ‘good to great’, Curmudge?”

“No, Julie. Good to Great is Jim Collins’s book. We’re going to start by considering organizations that are farther in the hole than those that he studied. Recall our February 18 posting where we listed a lot of aspects of a command-and-control culture? That’s our starting point.”

“And I suppose that our end point is an organization with all those great attributes that we listed on February 25. So all one has to do is read the books you recommended in January and do what they say. Pretty easy! Case closed! So what are we going to talk about next?”

“Julie, you are beset by grandiose visions.”

“I think you are saying that it’s not going to happen, right?”

“What have we been talking about since last May? Lean and how difficult it is to achieve and maintain, that’s what. We’ve been using a fairly broad brush and talking about the organizational aspects of Lean. Now we are going to bore a bit deeper and look at Lean from its personal side. Let’s call our topic Personal Aspects of Lean. We’ll cover the CEO, middle management, nurses, and maybe even volunteers. Are you with me?”

“How can I object? Those are your fingers on the keys.”

“Before we weigh anchor, there’s one more book to add to your reading list. It’s The Baptist Health Care Journey to Excellence by Al Stubblefield.”

“Thanks, Curmudge. I’ll read it on my next flight to Paris.”

“Shall we start at the top of the organization and talk about the CEO? Then gravity will carry us downward to the rest of the staff.”

“I’m for that. It’s going to be a lot easier than climbing up Liker’s ‘4P’ Toyota Way pyramid, especially in the winter.”

“Okay, Julie. So what qualities should the CEO of a Lean organization possess?”

“I suspect that she should look like a CEO and be able to walk on water.”

“I doubt that either of those qualities is in his job description. By the way, what’s this she stuff? Aren’t most CEOs in health care men? For ease of reading, let’s use ‘he’ for top management and ‘she’ for nursing management even though we are really thinking ‘he or she.’ That should look better than having a lot of ‘he/she’s’ cluttering up our text.”

“That’s okay, Curmudge. I used ‘she’ just to see if your hearing aid was working.”

“Now about your ‘walk on water’ response: Think back to our postings on October 29 and November 12. Remember John Kotter’s and Mitch McCrimmon’s definitions of management and leadership?”

“Of course I do. And Father Hesburgh’s admonition to CEOs that they not blow an uncertain trumpet.”

“So here is a critical difference between the role of the CEO in a Lean organization vs. command-and-control. Under command-and-control, the CEO is the big boss manager. In a Lean organization, the CEO is the main leader. As Kotter said, the leader ‘defines what the future should look like, aligns people with that vision, and inspires them to make it happen.’ We’ll talk more about how he—and sometimes she—does that in our next couple of conversations.”

“Okay. Lead on, Curmudge.”

“Yes, boss.”

Affinity’s Kaizen Curmudgeon