An important health care blog, NOT RUNNING A HOSPITAL, is written by Paul Levy, former CEO of Beth Israel Deaconess Medical Center in Boston. Recently, he wrote about a dynamic presentation given at the Saskatchewan Health Care Quality Summit by Sarah Patterson, Virginia Mason executive vice president and chief operating officer.

Sarah Patterson, Executive Vice President & Chief Operating Officer

Sarah’s presentation, Levy wrote, was “a masterpiece of description and discussion of the Lean philosophy,” and he noted dozens of her major points in his blog.

One of the first things Sarah said during her presentation was that at Virginia Mason, “we understand the important role of leadership, throughout the organization.”

This simple statement represents years of work and learning within Virginia Mason – learning that started a decade ago when Sarah Patterson, Dr. Gary Kaplan, Virginia Mason chairman and CEO, and other team members visited a Toyota production facility in Japan. She watched the production line of Toyota vehicles moving along and observed a technician on the line who had difficulty with part of the assembly. The worker pulled a cord and the entire production line shut down.

Sarah was amazed that the line worker – every line worker, she discovered – was empowered to shut down the entire production line to prevent a defective product from getting to a customer.

What Sarah saw next is an image that remains a vivid guide for her work with leaders at Virginia Mason. She watched as a manager suddenly appeared at the worker’s side to help solve the problem. The manager was stationed on the shop floor – adjacent to the assembly line – for exactly this reason: to help solve problems as they happen.

“When I saw this, it was so clear that this is exactly the kind of leadership we need in health care,” she says. “I thought that if we could set up a similar system at Virginia Mason, then every staff member would know that their manager is right there to help fix any problem. And we’ve worked to make that a reality over the past 10 years. Our managers have been developing and trialing methods and tools, such as production boards and daily huddles, to help connect every team member to the work and to create stability in our daily operations. It is only when you have a work environment that is stable that you can make improvements in how you do your work. By creating stability, we will move away from spending our time as leaders managing crises to spending our time helping our team members transform how we deliver health care. Our managers want to do the real work of helping staff members fix real problems as they happen.”

Sarah continued: “There’s a huge difference between leaders who are tucked away in an office far removed from the front lines of care and leaders who are physically present, working shoulder-to-shoulder with their teams. When leaders are on the genba they are teaching, inspiring, solving problems – they are leading. Leadership to me is active; it’s vibrant, not a concept or theory. It’s getting the real work of patient care done safely and efficiently. When leaders are close to the work, it provides the kind of focus, direction and support our front line workers deserve.”

“When leaders are on the front lines they are teaching, inspiring, solving problems … Leadership to me is active; it’s vibrant, not a concept or theory.”

- Sarah Patterson

Leading at the front lines, Sarah notes, has an enormous additional benefit: “Dealing with problems in the moment is far more effective and patient-centered than doing so days or weeks later, which has too often been the typical course in health care. When issues are dealt with downstream, it is much more difficult to understand why it happened let alone fix it.”

How is your organization “leading from the front lines?” If it isn’t, what’s keeping it from happening?