Before beginning any implementation of Lean Six Sigma in health care, it is important to get support and buy-in from management. Health care is a very conservative industry filled with professionals that maintain a traditional school of thought. Even though the health care industry has grown accustomed to change, the uneasiness of implementing a process improvement initiative like Lean Six Sigma is not well received. Those entrenched in the field find it difficult to understand the application of a manufacturing technique to the human element. Therefore, a great deal of effort is spent trying to encourage staff to embrace and adopt the Lean Six Sigma way of life.

With the amount of time that is spent trying to establish and maintain buy-in from those working at the forefront of health care, little thought is every put in to how much buy-in must be gained from the management staff. It is because of this, that a good number of Lean Six Sigma implementations, in health care, are unable to sustain. A mistake that myself, as well as fellow implementers, have made is assuming that the project champions have spent the time necessary communicating the impending changes to the management staff, as well as establishing buy-in from them. Likewise, the project champions have mistakenly assumed that the initial buy-in from the management staff has been established by the implementer. As a result, management is often left looking for answers on how to sustain after the Kaizen event or the implementation. While they are able to, as innovative leaders in the organization, see the big picture of what Lean Six Sigma is trying to accomplish, they are not equipped with the necessary tools to sustain the way of life that successful companies like Toyota have withheld. Therefore, it is critical that proper project management be in place to ensure that management is able to maintain this new, radical, culture in health care. When creating a project charter and defining the scope of the project, it is essential that one of the deliverables of a successful implementation be to have unwavering support from the mid-level management. This should include intense training that is apart from the necessary training that the staff receives prior to starting any kaizen event. Further, at some level, it is extremely important to keep the management staff involved in whatever type of kaizen event that is occurring. Doing this will allow the management to follow the progression of a Lean Six Sigma implementation and develop a formula for accountability and sustainability.

It has been widely accepted that the middle managers are the key innovators of the organization. As such, the managers of an innovative process such as Lean Six Sigma must be allowed to understand and embrace the process as they help to ensure that it becomes a way of life and not just the “flavor of the month.”