Debbie McAllister of Hansei Coaching helps healthcare leaders through the heart and mind transformation of becoming a teacher so that they can develop their people into engaged problem solvers using the Plan Do Study Act (PDSA) cycle to eliminate patient harm. She uses the Lean foundation of respect for people, servant leadership, and intuition to integrate processes and people. She also has a background in John Maxwell training and coaching which was the topic of our conversation. If you are not familiar with the Maxwell philosophy, take a look at the 10th-anniversary edition: The 21 Irrefutable Laws of Leadership. 
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Transcription of Interview
Joe Dager: Welcome everyone. This is Joe Dager, the host of the Business901 podcast. With me today is Debbie McAllister. She is a leadership coach, speaker, workshop facilitator, teacher, and Lean process change professional. She is driven to improve the quality of healthcare outcomes primarily. Debbie, I would like to welcome you. Let’s just start out and tell me, are you a lifelong resident of Pocatello or do you venture there from somewhere else?
Debbie McAllister: Thanks Joe for having me on today. I really appreciate the opportunity to share my passion for leadership. And to address your first question, no, I am actually a new resident of Idaho. I’ve only been there a few months. I’m actually a Bay Area girl, Northern California. I grew up in the high-tech industry.
Joe: How did you get connected with healthcare?
Debbie: If we go back 5 years, I was in high-tech. I was working for an organization where I was boots on the ground traveling throughout Asia, doing Lean implementation and the transactional and the manufacturing arena, and my dad had some health concerns. My mom asked me to help step in and be part of that process. As we went through gaps in the processes, and he was misdiagnosed, and by the time they were able to change the diagnosis, the outcome was not going to be favorable. As I spent time with him, I stopped my travels to Asia, and I became his caregiver, along with my mother for the last 6 months. As we would sit in the hospital bed, he asked me to go stop fixing whatever I was fixing in high-tech and go fix healthcare. Fast forward 6 months after he passed away, I was able to join a healthcare organization, and that’s how I jumped into making a change in healthcare.
Joe: That’s a very touching story, and I can’t think of finding a profession and better way actually, though, I compliment you on that. What caught my eye originally about your background was not the Lean side, but being a John Maxwell coach. Tell me about that experience in training. What is a John Maxwell coach, I guess? Let’s start there.
Debbie: A John Maxwell coach is for independent coaches, teachers, and speakers who have been blessed to have access to John Maxwell. And using the fundamentals of his philosophy which was based upon his bestseller book, ‘The 21 Irrefutable Laws of Leadership’ which has his basic philosophy that everything and rises and falls on leadership. We need to think about making any type of change, whether it’s Lean Six Sigma, TWI, PDSA Cycle, you’re always looking at the leadership. I had the opportunity back in the 90’s as I was being developed as a leader myself to read this book and it has always stuck with me, and I’ve tried living these principles and so as my career progressed into the Lean Six Sigma world, it just became intertwined in how I practice.
Joe: Putting them into practice, has there been challenges? I mean are other people receptive to being coached in these principles?
Debbie: Joe, I have always approached any type of change… When I look at Lean and how to intersect, there’s the tools and the behaviors. And when you look on the principle, how everything rises and falls on leadership, over 70% of change failed because the behaviors don’t change with leaders. As you work through and walk hand in hand with the leader, we ask a lot of them. We ask them to change what has made them successful, is you’re stepping back and becoming a curious leader, a teacher so that they can empower and develop their own people because truly a leader is somebody who understands that you have to develop somebody else. What I have found in applying these practices is that I may not call out that I’m working on law number 3 for example, which is the law of process, which is in essence developing leaders on a day to day basis and not in a day. And so that really goes very well with the whole Lean philosophy of developing the leaders, that is a journey. You’re not going to become a leader, a Lean leader in a day. It’s not a microwave it’s more of the crock-pot, as John likes to say.
Joe: With the Maxwell coaching, it’s very compatible to Lean. Is it a supporting role that you play; a facilitating and teaching role.
Debbie: Correct. Our roles are to develop and in essence, how I feel in a leader is that they are a servant leader. It goes very well with Deming’s 14 principles, Covey’s 7 habits, Toyota’s 14 principles, John Maxwell’s 21 laws of leadership, with developing leaders and they’re all common is that they all have the same underlining principles. And a leader has to learn how to develop someone and so that hooks through their own personal a journey of change in developing themselves. And so very powerful, they just might take different paths to get there.
Joe: When we talk about the 21 laws, is there any of them that really conflict with lean thinking? Have you found one that is kind of like, it doesn’t quite fit or anything?
Debbie: One that I find quite interesting and I mentioned because it’s the Law of Intuition, which is really talking about a natural gifted born leader which some of us like to think, oh well they were just born that way. They’re just a better leaders. We’ve all worked for leaders who just seem to have been born leading the group. There was always somebody when you were going up who was chosen to lead the pack. And so that one is a little bit harder for me myself, to understand, and so I focus on those that are more compatible. And what John shares with us is that we don’t have to be experts in all the 21 laws, but we do have to surround ourselves with those. So if I’m weak on the Law of Intuition as being a natural born leader, but I can learn, then I’m going to surround myself as somebody who naturally has that strength for them so that my team as a leader is well-rounded and able to support the organization.
Joe: I don’t work in healthcare, so I’m not sure if that is true or not, but do they have servant leadership mindset? Is that natural or is that something that really needs to be taught in healthcare?
Debbie: What I have found in my experience in working in healthcare is that it’s not natural. Most organizations, healthcare really is driven a lot by management by objective for short term goals. Healthcare is in a crisis; I think we can all agree on that, and it’s a very complicated industry. It’s not a simple and the payment changes, the regulations, and now we’re asking them to change. How can they make more value added to the patients and still be able to improve the quality outcome with wherever your rate in the world is fairly low, it’s not the most rewarded, the way the structures are set up in healthcare. It’s not necessarily the behavior that gets rewarded when you’re running by management by objective.
Joe: You talk about the people side of Lean the most. How is that reflected in healthcare and you working in healthcare? I mean do people pick up or they think Lean’s a bunch of a set of tools initially? How do you get that people side across to them?
Debbie: What I found recently is that the hospital that I’m currently working in is inaccurate care, and it’s more than role setting, and there had been a Lean consultant there prior to myself. When I first start out, I go into any organization while I am learning about their organization, about where they are, where can I meet them at to help figure out where do I need to take them and what’s going to work for this person. It’s how I had run my whole career, long before I met Lean, was I always one or two developed people.
I see Lean as that tool to be able to do that, in conjunction with the John Maxwell stuff to help develop. But what I found is that we have an enormous amount of very brilliant people working with the tools, and they’re working with some of the execs, but in the between, between the base or the ground which is where I generally am working in the Gemba, working with the leaders who are actually doing the operational or the clinical support for our patients is that sometimes they get missed. People think, well I got to do this and do that and change I actually from within. We have to remember John Conner’s information about first we have to change through the heart versus the mind. Otherwise, you’re not really engaging, and it won’t change the behavior to sustain. I’m naturally focused more on the people. You have to first have a relationship before you can ask somebody to do something.
Joe: You always think of the leaders having the answers; they’re the most experienced. Can they really be servant leaders? I mean don’t they have to take the bull by the horns and lead? Isn’t that what they’re about?
Debbie: Well, I think that’s what they used to be. The managers have been trained. They, in fact, could have been trained on the more traditional flow method of command and control. What happened most recently in the acute care setting is we did a value stream mapping event in the emergency department. At the end of every day, the CEO would come and check and see where we were. We would share the comments and the learnings of the team. This was a 4-day event and on the first day, she was just shocked at what was being discovered through the observations of simply being in the Gemba of what was coming through this cross-functional chain of a team and just so honored that they were seeing what the staff was putting through. She really saw herself as the leader to remove these obstacles so that our patients could have the right care at the right time, be comfortable, and that our staff is taken care of. Getting out to the Gemba and letting the leaders see what the staff goes through, the heroic efforts that happen every single day in healthcare is the one way that I’ve seen over and over the growth, the ‘aha’ moments that happen to our execs when they’re able to go out and do that and not try to fix.
Joe: Did they participate as one of the members of the value stream mapping session or did they just look on?
Debbie: The CEO checked in at the end of every day. She wasn’t on that particular event, but I did have two other execs of the hospital who were there every day; who put their titles out the door, they were a team member. One wanted to jump in and help fix the problems and then she realized that her role was to just see and the power behind just seeing and understanding that this was just a regular busy day, was very powerful. So they were able to then share that with the rest of the executive team, and their whole executive team is really embracing the changes. They’re open. They want to change. They want to show their intention to all of the employees in the hospital and come together and let them know that they are there to help improve this for our patients, so we can figure the outcomes to make it a better working environment for them.
Joe: That sounds like a great lesson in itself. That’s about worth the event in itself, right?
Debbie: It was. I mean, we go through fantastic training with the hospital that we’re at. They’re going through some of 8 days of didactic training, and they come back, and they say, okay, that makes sense. Well, we all know, if we take an instance where we have had to learn, you can learn through a book, you can watch it on YouTube, but until you actually start practicing it and feeling what this feels like, it’s pretty simple, it doesn’t mean it’s easy. Change is simple. It’s not easy. Having them watch their ‘aha’s’ and realize it’s on a journey, just for them to really be able to see that it is really a very successful beginning foundation of the changes that can occur at this particular hospital. It’s very exciting.
Joe: What’s the most rewarding thing for you as a Lean coach?
Debbie: When you’re working with a leader, a staff member and they realize that they can make a difference, that their ideas, their voice makes a difference, that together as a team, we can all come together, using the tools, changing our behaviors every day and that it’s not boiling the ocean. If we just bite a small piece of that elephant, bite by bite, that we’re together collectively and working collaboratively across healthcare, that we can make those changes happen. That’s very, very rewarding when you see a group, whether it’s on a Kaizen event or value stream mapping, in the first day until they’re sharing their results, the changes that come over them, the excitement, the joy that comes back through when they understand how their strategy falls into the work that we’re doing, how their dashboard measurements can be influenced and changed through empowering their employees. That’s just very, very powerful and it gives me hope. It makes me feel blessed to be doing this work and knowing that I’m honoring my dad.
Joe: That’s a very kind thought. What’s in the future for Debbie? What’s next for you?
Debbie: I am stepping out on my own. I’m going to do doing more coaching, presenting some workshops. I have an upcoming master going class that had launched in June and then at September I’m launching into providing some more workshops.
Joe: Will you still be located in Pocatello?
Debbie: I will be, yes and traveling. I have a couple trips, a couple activities built around in the Bay Area, and in Florida, and in Oregon so far over the next couple of months that I’m really looking forward to.
Joe: And would it stay in healthcare primarily?
Debbie: I am dedicated to healthcare. I need to focus. There’s a lot of work to be done, and there’s a lot of leaders who want to make the change and be supported. That’s where I’d like to focus my attention primarily is in healthcare.
Joe: What’s the best way to connect with Debbie right now and maybe even 30 days from now?
Debbie: The best way would be to send me an email. You could reach me at ProcessTeamBuilder@gmail.com