The 5P Pyramid--Up to Levels 4 and 5

“Here we are on Level 3, Curmudge, where we stopped last week. The climb up here wasn’t nearly as difficult as it was the first time.”

“Practice makes perfect, Jaded Julie. Soon we’ll have it hardwired.”

“I see a sign over there. Can we talk about that before we go higher?”

“Of course. It’s a Communication Board, sometimes called a Performance Indicator Board. Among other department goals, it displays the brand goals and metrics that the team has chosen to indicate their progress toward achieving the Affinity promise of personalized care.”

“Metrics? That’s like meters and kilograms, right?”

“In ‘Leanspeak,’ a metric is something that is measured, such as patient satisfaction scores.”

“I remember, Curmudge. Something that is not measured tends not to get done. The communication board needs to be kept up to date so that a problem becomes immediately evident and can be tackled ASAP.”

“Are you ready to go up to the higher levels, Julie? It’s windy up there today, but we won’t stay long.”

“You’re right about the wind, but the view of downtown is pretty good. The most distinctive features are the 222 Building, Appleton Center, the old Zuelke Building, and the County Jail. But here on the pyramid things look pretty much as Liker depicted them in The Toyota Way. (1)”

“That must mean that the Toyota concepts of People and Partners (Level 4) and Problem Solving (Level 5) are enduring. We discussed those back in January of 2008. Fortunately, the application of these Toyota concepts to hospitals has been addressed by Studer (2) and Stubblefield (3) (the People concept, Level 4), and by Graban (4) (Problem Solving, Level 5). We may devote a whole discussion to these people in the future.”

“I recall your mentioning that all these books are must reading for health care leaders. Is there anything in them that bears upon our Affinity promise of personalized care?”

“Almost everything, Julie. Both Studer and Stubblefield agree that satisfaction of patients is directly related to satisfaction of employees. We achieve that by providing employees a place to work where they feel they have a purpose, are doing worthwhile work, and can make a difference. The authors emphasize that continuous leadership development is absolutely essential. Graban’s discussion of problem solving reinforces what we already know about going to gemba and getting to the root cause of errors, which can be serious patient dissatisfiers and the most critical problems in a hospital.”

“Thanks for bringing me up here, Curmudge. Maybe the image of a pyramid will help me retain what I have learned for a few thousand years.”

“Lots of luck, Julie. Let’s hike down the back trail. It’s not nearly as steep as the way we came up.”

“So what are we going to talk about next week, Curmudge?”

“It’s a secret.”

“A secret! I bet that just means you haven’t thought of anything yet.”

“Not true, Julie. I planned next week’s conversation a couple of weeks ago. When I can’t think of anything for us to talk about, that will mean that the synapses in my brain are getting lost and senility is setting in.”

“Oh? You mean that isn’t already happening?”

Affinity’s Kaizen Curmudgeon

(1) Liker, Jeffrey K. The Toyota Way. (McGraw-Hill, 2004)
(2) Studer, Quint. Hardwiring Excellence. (Fire Starter Publishing, 2003)
(3) Stubblefield, Al. The Baptist Health Care Journey to Excellence. (John Wiley, 2005)
(4) Graban, Mark. Lean Hospitals. (Productivity Press, 2008)