Seven Leadership Leverage Points

Seven Leadership Leverage Points: for Organization-Level Improvement in Health Care by James L. Reinertsen, MD; Michael D. Pugh and Maureen Bisognano.

If leaders are to bring about system-level performance improvement, they must channel attention to and take action regarding several, if not all, of these leverage points. In other words, this set of leverage points is not offered as a tried-and-true method, but as a theory-one that we hope will be useful for individual leaders in planning their work and for us in organizing a support and learning system to share best leadership practices and results across organizations; and from which all of us can learn about what works, and what doesn't, in bringing about large-system change in health care.

Once again the Institute for Healthcare Improvement (IHI) is doing a great job. This white paper does an excellent job of collecting knowledge and suggesting a way forward. And they are having an impact by getting people to participate in improvement efforts.

They have the courage to say one of the 3 sources for there hypothesis as "Hunches, Intuition, and Collective Experience." While attempting to base plans on data and not hunches is good. Often you must make decisions without data. It is why Dr. Deming was so concerned with mobility of top management: that mobility means many managers don't really understand what they are managing. Lean thinkers understand the value of having managers with deep knowledge of the areas they manage.

The leverage points are not a substitute for a coherent quality method such as the Toyota Production System or the Model for Improvement. In fact, the organizations in which the leverage points would be applied are assumed to have adopted a coherent quality framework.

You can see why I like IHI. They don't try to sell quick fixes. The are interested in achieving extremely significant results that continue into the future.

While this white paper is very focused on health care I find the IHI material is also great for those not working in health care. The material shows how management improvement concepts can be applied to address large systems and it is thoughtful and presented well.

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