Friday, February 18, 2011

Don’t ‘Check Your Brain at the Door’

It’s often difficult in large organizations to get people into the mindset of “How can I do this better?” People have a natural tendency to hold back because they believe they are just one small piece in a really large organization and ask, “How can I make any difference?”  But, the organizations that are truly ahead of the curve are the ones that figure out how to get people thinking, “This is how we did things yesterday, but how might we do things better today?”  The answer to this question is this – empowerment.
In 1995, when I was at Albany Medical Center in New York, I had this very conversation with a small group of people about how we can increase performance improvement throughout the organization.  A colleague of mine suggested I pay a visit to the new Hannaford Brothers food warehouse that was just built in New York. (Hannaford Brothers is a large chain of supermarkets in New York State and the Northern New England region.) A food warehouse, I thought? What does this have to do with improving the operations of a hospital? But, I suspended disbelief and visited this warehouse. When I called one of the warehouse managers to request the tour of the facility, he candidly said, “You don’t need to meet with me, you should meet with one of the warehouse staff.” He went on to explain to me that he’d been with the company for 20 years. He started in a store and later moved up to the ranks of manager. About the way in which the company valued the input of its people, he explained, “When this new organizational mindset took over, I realized I had been checking my brain at the door for the first 12 years.” He said it was like a new day when management started encouraging him, and all employees, to redesign the way the company was working.
So, instead of meeting with the warehouse manager, I met the guy driving the forklift who enthusiastically showed me around. And what he showed me were walls of run charts created by self directed work teams who were fixing the way things ran. It was the people who actually did the work, and who recognized what processes did or did not work, who were empowered to redesign the process to improve performance in the company. It was clear that he understood that part of his job was to make things better. And, all of these employees really were improving the system!
Several weeks after my visit to the Hannaford food warehouse, my wife came home one night from a new supermarket that had just opened up on the other side of town. She was truly amazed at what a wonderful experience she had there. She explained that upon walking in and making her way down the aisles about eight different employees asked how they could help her. And at the checkout, when the line grew to more than two customers, they opened up another check-out line. The new store was a Hannaford supermarket.  The very next day I called the manager of the food warehouse I had visited and told him about my wife’s terrific experience at one of their stores. I asked him, “What is your secret?” And you know what? He wouldn’t tell me. He said that the way they train their people is their strategic advantage.
But I did figure out the secret. How organizations truly thrive is by activating people and making sure that they get the company’s vision and are using continuous improvement in their work. Continuous improvement starts with:
1.       A focus on who it is that you are serving (patients and their families)
2.       Encouraging your people to design the systems to get ever better performance
3.       Measurement – it’s the only way you’ll know if you’re getting better performance
4.       Teamwork
5.       Empowerment
That’s the science of improvement and success. And it’s a course of action all of us at GBMC should continue to strive for. We must all have the mindset that we can make things better and feel that it is our job to create positive change.

How do you empower others to make a change? Have you felt empowered to make a difference? I’d love to hear your stories on actions you have taken, or would like to take, to improve the GBMC experience for our patients, as well as each other…


  1. There is one very important thing that I've noticed in the 2 plus years here at GBMC. While the staff for the most part are very pleasent, greeting everyone with a smile and a friendly hello. This of course shows their inner "Sunflower" as it were. On the flip side of this, I've noticed that the Doctors seem grumpy and rarely greet anyone except for other Doctors. Why is this? Are we not all to at least attempt to exemplify the hospitals core values or just the "little people"?
    Double standards exist everywhere, but in our lines of work, with all whom we come into contact with, we should ALL attempt to be a bit more friendly. Being at the top of the ladder is no excuse for poor people skills. Having said this, Smile more, greet everyone warmly as you would your own family, forget for just a second that you are a Doctor,and remember, your also human.

  2. Hey 1st Anonymous, you're a mind reader!! I see that all the time. Some do in fact greet with a smile, but there ARE those who you say hello to and are met with the ole' "Evil Eye".
    I guess Sunflowers are "Common" as in Commoners. Oh well, I'll stick with my routine and treat all as I wish for me and mine to be treated. Imagine how patients and visitors feel when they encounter these "Unhappy Docs"!!

    PS- I would sooo love to put my name on this, but the check comes in handy!!

  3. I think that we doctors can be pretty grumpy but I must say that I know many physicians at GBMC who smile and great everyone. I also must say that I also run into some non-physicians at GBMC who are also pretty grumpy.

    I think that we should all start by owning our own behaviors. Having said that, let me ask the Anonymous commentors and others: "What might we do to make grumpy people smile?"

  4. In answer to Dr. Chessares question, "What might we do to make grumpy people smile"? Some people will never smile, it's not in them. That does not mean that they are grumpy, rather it is just the way that they are. If Dr's don't smile and greet you back, maybe their having a bad day, maybe they have a serious conundrum that they are facing in their lives. I agree, there are alot of different people in this hospital who are NOT Doctors who can be more than grumpy.
    Don't dispair, be yourselves and keep a positive attitude. Happiness is contagious and the more we share it the more people will want to have it. EVERYONE!!


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