Lean and mean: getting things done (Proceedings)


A lean and mean guide to getting things done.


   • Veterinary Medicine has been owner centric, not systems centric.

   • We have been buoyed by demand for services (human animal bond, low cost care and a thriving economy).

   • Our "product" is now better understood by the client so we have to do better at getting it right. Solid execution of our services will maintain our place in the industry.

   • 4 out of 5 veterinary employees view their practice as "weak" or "inept" at execution and getting things done.

Psychology of non performance

   • Detachment from the practice

   • A "not my job" attitude

   • Decreased performance

   • Culture of blame and fear


   • "Getting things done right by acting according to the information you have and your own self interests."

   • Building Blocks that Influence Execution:

   • Clarifying decision rights

   • Designing information flows

   • Aligning motivators

   • Making changes to structure

A quick fix

   • Most practices move right to structural changes because moving lines on an organization chart often seems like something very tangible.

          o Short term rewards of increased efficiencies

          o Improved employee morale

We fail to address the causes and only look at symptoms.

   • Focus on improving execution of service

          o So people have a clear sense of their roles and responsibilities?

          o Do they intuitively understand what decisions are theirs to make?

          o Is their a strong link between reward and performance?

          o Are you long on micro-managing and short on accountability?

          o Is more time spent justifying and reporting upward or questioning tactical decisions of reports?

Strategy execution

   • Information

   • Decision Rights

   • Motivators

   • Structure

          o These elements build on one another. Structure is often the result of good information, clear decision making authority and the right motivators.

Traits of organizational effectiveness

   • (81%) Everyone has a good idea of the decisions or actions for which he or she is responsible.

   • Young organizations are generally to busy to get other things done and define roles.

   • (68%) Important information about the competitive environment gets to decision makers quickly.

   • (58%) Once made, decisions are rarely second guessed.

   • Traits of Organizational Effectiveness

   • (58%) Information flows freely across all levels of the organization.

   • Traits of Organizational Effectiveness

   • (55%) Front line employees have the information they need and the ability to understand the bottom line effect of their decisions.

   • (48%) Managers have access to the metrics they need to measure the key drives of the business.

   • (32%) Conflicting messages are rarely sent to the public.

   • (32%) Performance appraisal process differentiates high, mid and low level performers.

   • (32%) The ability to deliver on performance commitments strongly influences career advancement and compensation.

   • (29%) It is more accurate to describe this culture as "persuade and cajole" rather than "command and control."

   • (29%) The primary role of the administrative staff is to support the business rather than audit the business.

   • (29%) Lateral moves can be viewed as promotions.

   • (23%) Fast track employees can expect promotions more frequently than every 3 years.

   • (19%) On average, middle managers have 5 or more direct reports.

   • (13%) The business has a bad year but a high performing unit of the business still gets a bonus.

   • (10%) Besides pay many other things motivated individuals to do a good job.

Transforming the practice

   • www.simulator-orgeffectiveness.com

   • Get a score and follow the course of action suggested

   • Mapping Improvements

   • Decision Rights

          o Focus administration on their role of supporting the care providers.

          o Clarify and streamline decision making at each level.

          o Focus management team on important strategic decisions.

          o Create excellence divisions or centers whereby we consolidate certain functions into a single unit.

Mapping improvements

    • Information

          o Assign "process owners" to coordinate activities that span all functions.

          o Define and distribute daily operating metrics to the front line.

          o Create cross functional teams.

    • Motivators

          o Establish individual performance measures.

.           o Expand nonmonetary rewards to recognize exceptional performers.

          o Structure

          o Decrease layers of management

          o Institute lateral moves and rotations

          o Broaden spans of control

The challenge

   • Execution is always difficult

   • Only ⅔ of employees "on board" is still a good place to start.

   • Sacrifice short term gain for long term results.

The right order for change

   • Decision rights

   • Information

   • Motivators

   • Structure

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Aaron Smiley, DVM
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