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Lean Explained

Lean Leadership

The focus of work is on changing our systems and processes but we also need to change the informal culture (behaviours, beliefs and attitudes) of the organisation to empower staff to make the changes in the best interest of our patients.

Best possible care through Lean thinking is not a project; it is a fundamental change to the way in which the hospital delivers its services to patients.

Lead clinicians, senior and middle managers were asked the following two questions at the Chief Executive conference on the 25th May 2012:

Question 1:
Discuss what are the current attitudes, beliefs and behaviours within the RUH which prevent change?

Question 2:
Discuss what you want the attitudes, beliefs and behaviours to be at the RUH to encourage change? What does good look like?

The table below details a summary of their responses:

Question 1:
Current behaviours, beliefs and attitudes within the RUH which prevent change

Question 2:
What good behaviours, beliefs and attitudes look like

Target driven and not about quality

Patient focused - treating staff and patients as we would want to be cared for

Lack of planning/thinking time

Good, clear communication

Conflicting priorities

Positive performance management – celebrate the good

A lack of visible senior leadership

Knowing what is expected of our job and delivering it - support not direct

Very difficult to get things done – timescales, bureaucracy, red tape

Finish what we started

Lack of consultation and involvement – decisions are pushed to staff

Clear direction and heartfelt engagement from outset

Learned helplessness (behaviour)


Blame culture – don't allow failure (behaviour)

Permission to fail

Clinical and Non Clinical split

Feeling valued and respected by staff and 'our clients'

Lack of trust (micromanagement)

Everyone's opinion matters

Lack of investment in innovation

Rewarding success and share good ideas

Feeling of numbed and dumbed

Integrity and commitment to deliver plan – even when it's challenging

Divergence of goals

'One team one goal'

Defensive responses

Improved customer service skills – 'smile, can I help'


Collective responsibility

Scared of change and impact on working life

Engagement at all levels

Entrenched views – we have always done it this way (behaviour)

Integrity and commitment

Crisis mentality

'Can do' culture

Silo mentality

All to all of the time

No guarantee that you'll find support for your idea

Courage to speak up at all levels

Burnt in the past

Give it a go, try it again attitude

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