I was going to name this blog post, Why Toyota should visit Virginia Mason? However, since I have never been to Virginia Mason (a Leader in Lean Healthcare) or Toyota, it would be pure conjecture on my part. Instead, I decided to base my blog post on a discussion that I had with Dr. John Toussaint, CEO of Thedacare, in the Business901 podcast Transforming Healthcare through Lean.
What brought me back to this discussion was my recent work in Systems Thinking. A long story short, my introduction to Lean and Six Sigma was through Peter Senge’s work and most specifically the book The Fifth Discipline. I eventually found Eliyahu M. Goldratt and Dr. Deming and my journey was on. I waffled back and forth between all of them spending several years of study on each until Lean came to the forefront and stuck. This past fall, I have experienced a renewed interest in Brian Joiner, Peter Scholtes and Dr. Deming. This has brought me a full circle back to Systems Thinking.
One of the things that I discovered is the use of Outcome Mapping which I introduced in the blog post, Lean Sales and Marketing: Outcome-Based Mapping. The advantage to the Outcome Mapping approach is that it uniquely identifies what they term as boundary partners. Boundary partners are described as “those individuals, groups, or organizations with whom the program interacts directly and with whom the program can anticipate opportunities for influence.” This approach is very aligned with my efforts on how to discover and influence the participants in our customer’s networks and organization.
However, one of the intermediate steps before we get to the customer is convincing the salesperson about Lean. Within an organization, the salesperson’s behavior will be the hardest to change. Trying to find an analogy, I found the introduction of Lean into Healthcare and the resulting interaction with Doctors may be considered similar to what I have experienced with salespeople.
I have solicited several quotes from my discussion with Dr. Toussaint. Since these quotes are used out of context, if you question anything, I encourage you to read the entire transcript or listen to the podcast. I have used these only to serve my purpose of demonstrating the similarities between doctors and salespeople when it comes to the introduction of Lean.
Dr. Toussaint: This autocratic nature of medicine does not allow for any sharing of good ideas and of improvement ideas. So you end up with, like I said: you’ve got 19 different doctors; you’ve got 19 different processes, none of which are able to be studied to determine, which is delivering the best result.
When you think of your sales processes, how often do you have different types of salespeople, all handling customers in a different way? We attribute to the fact everyone has a different style or all customers are different. So how is the best result determined? Who are your star performers? Is the person or the territory and clients they are assigned?
Dr. Toussaint: Typically, you’ll hear of a doctor say, “Well, that’s just cookbook medicine, and that’s no good.” The reality about cookbook medicine is that there’s been a lot of work done around using protocols for certain things. We know that about 80 percent of the time, standard protocol works for delivering reliable patient outcomes. The other 20 percent of the time it doesn’t, and that’s when judgment and experience, and other things come into play.
You would be surprised that standards do exist. I am not going to elaborate on these but not standards such as scripts (though they have a place) but standards on how you manage and train your workforce to deliver what your customers want.
Dr. Toussaint: Yes, we had very little standard work for anything. You had 19 doctors doing their things 19 different ways. There wasn’t any way to figure out ? when there was a defect ? which process was causing it, because the processes were in chaos. That’s what we were doing, is trying to get to a standard work process and then standard work for each of these areas.
Most measurements that exist, salespeople have little control over the outcome. In lieu of this, these metrics should be much closer to the way a startup would view them. For example, The Lean Startup encourages you to stay away from vanity metrics and instead look at metrics that are actionable (demonstrate clear cause and effect), accessible (do not create additional work) and auditable (testable by human interaction).
We need to stop rewarding the lone wolf that is breaking all the rules. If you scrutinized these efforts, you may find many problems with the orders they take and the margins they obtain. It is not their fault; they typically are working the system the organization has created to the fullest. Sales performances are seldom judged by accurate metrics.
Dr. Toussaint: We’re asked to ask questions without a team. This is about me asking questions to the patient. It’s about my knowledge. It’s about my control of that knowledge and my control of the people who then, once I make a decision… Lean is much more about, “OK, let’s get the team together to actually ask the questions.” What’s happened at ThedaCare is instead of the doctor going in and meeting with the patient, the doctor, the nurse, the pharmacist, the discharge planner, all go in at the same time within the first 90 minutes of admission and do a history and an examination together.
One of the detriments to implementing Lean into Sales and Marketing is the lack of the team concept. Most people will agree with the concepts of having inside inbound and outbound sales agents but developing a true team concept for sales is very unusual and seldom addressed. What would happen if your sales team went into a customer’s place of work together? Would you walk out with a different approach?
Lean has made some great inroads in healthcare and one of the leaders of this has been Dr. John Toussaint and the Thedacare network. It is a good starting point for healthcare professionals. If you are looking for a starting point in Lean in sales and marketing, you could do worse than purchasing the Marketing with Lean Book Series and receiving access to the online Lean Sales and Marketing Training at no additional charge.