Good Leadership, Poor Leadership, Well Designed Systems and Random Behavior

I spend a lot of time thinking about how to move our health system faster towards its vision and I often reflect on incidents that happen to me in my life outside of GBMC and try to learn from them. I would like to share three episodes from my life over the past few days.

I do a lot of traveling on Southwest Airlines, I choose Southwest generally because they are the best at getting me to where I want to go safely and on time and they usually have the best price.  (This is the definition of value). They have been recognized historically for being very customer friendly, sharing GBMC’s value of respect, but I have been concerned lately that Southwest is losing its customer focus.

Last week I was waiting at the gate at BWI and sitting facing the Southwest Airlines counter and observed an employee who was talking on a cell phone obviously having a non-business related conversation. A woman came up to the counter, looking frantic standing in front of her, obviously trying to get the attention of this employee, who put her cell phone down.  The woman said, “Is this where Flight 396 is leaving from?” The employee turned, and pointed to the board that showed it indeed was the gate for flight 396, and the woman rushed off to get on the boarding line.  The Southwest employee then got back on her cell phone and complained to the person on the other end about the woman who asked if she was in the right place for her flight -  as if the customer was an annoyance.  Southwest, historically, has not operated like this. As I witnessed this I asked myself:  “What is the vision of Southwest Airlines?” “Does this employee know what Southwest’s vision is?” “Where is her supervisor? What would her supervisor say to her, if anything, if she witnessed this behavior?”

This past weekend, I was driving on the highway and I stopped at a rest stop to get something to eat. Ok, I must sheepishly admit I wanted a Nathan’s hot dog. The rest stop food concessions are all run by private companies. I was standing there waiting to order and there were several employees moving behind the counter and back and forth through a door that went to the kitchen. The line of customers was short, but it was taking a long time for anyone to get served. It wasn’t clear to me that there was any design to the work. It seemed almost that the people were working independent of each other and with no regard for meeting the needs of the people in line.  I then noticed two people who I later realized were the supervisors standing off to the side and chatting.  At one point they called one of the workers over and I heard them engage her in a conversation that was unrelated to the workflow. I finally ordered my hot dog and enjoyed it but the process to simply get something to eat was very challenging and by the time I left there was a long line of frustrated customers. Again, I started thinking: “Who is responsible for focusing on the customer in a business?” “What were the employees thinking?” “What was up with the two managers?” There did not appear to be a designed system for meeting the customers’ needs and leadership was truly lacking.

Compare these two situations with what I experienced earlier this week – taking my car for a required emissions test at the state facility in Owings Mills.

I looked online and saw that the wait time was just nine minutes and the on-line cameras validated that there were only a few customers waiting.  By the time I got there, there was actually zero wait, and I pulled in just behind a car that was leaving.  The young man took my sheet that I had received in the mail, checked my VIN number and hooked up the machine.  He asked how I wanted to pay, I swiped my card, I signed my name and he gave me the results sheet and credit card receipt, telling me I needed to come back in two years.  The whole thing took less than five minutes.

Not only was this system designed, but it looked like it had gone through multiple sequences of improvement to drive all the waste out of the process.  Through the eyes of this customer, the emissions inspection station performance surpassed my wildest expectation. There were no managers visible yet leadership was evident.

The characteristics that separated the two poorly functioning systems through the eyes of the customer from the one that delighted the customer were good leadership, true customer focus, and a well-designed system operated by a team of individuals who are empowered to make further changes to improve the system.

That is what we are striving for in our GBMC HealthCare System.

What can we do to get more customer-focused and design things better at GBMC? How can we use metrics better, get better teamwork, or make our staff more empowered?