Chapter 17

Develop a Communication Plan with a High Degree of Visual Management to Support Branding

The single biggest problem in communication is the illusion that it has taken place.

—George Bernard Shaw

Based on several studies conducted on nonverbal communication by Dr. Albert Mehrabian, 7% of any message is conveyed through words, 38% through certain vocal elements, and 55% through nonverbal elements (visual appeal, facial expressions, gestures, posture, etc.). Therefore, in a transformational journey it is important to strategize with all three communication methods (verbal, nonverbal, and vocal) to engage people at all levels.

As a first step, understand your target audience and plan your communication strategy to meet their need. Use a stakeholder analysis grid to plot all of your key stakeholders (Figure 17.1).

Use the template (Table 17.1) to develop your communication plan.

In their book, Made to Stick, Dan and Chip Heath share six principles (SUCCESs) that can be applied as a template or checklist to shape or test any idea/message for stickiness (Figure 17.2). A sticky idea/message is one that is understandable, memorable, effective, and actually changes perspectives or behaviors. Not all ideas are “stick-worthy,” though it is possible to systematically create sticky ideas/messages. Develop a communication strategy that sticks with your target audience.

A recent survey conducted by Innovisor revealed that 3% of employees (the “key influencers”) drive organizational conversations with 90% of the other employees. When incoming CEO Jack Rowe launched a turnaround journey at Aetna Inc., he kept in direct personal contact with nearly one hundred leaders in multiple levels and functions. These informal networks not only brought him up to speed on the way people thought about their work and the practices they followed, but became viral spreaders of the culture he wanted to evolve.

Sensei Gyaan: In your transformational journey, find the 3% who are most frequently identified as influential by their peers and leverage them to engage people at all levels using social networking.

Now, let us continue to learn from the real case example of More Time to Care at Hospital Heal. Some of the strategies implemented at Hospital Heal, as a part of their multilevel communication plan to engage the frontline, managers, directors, senior team, and physicians, included the following:

Leaders demonstrated living the new behavior to support the excellence journey (Figure 17.3)

More Time to Care added as a standing agenda item on the monthly physician leadership meeting, weekly director meeting, weekly senior team meeting, and monthly quality committee of the board meeting

More Time to Care Council with representation from different departments established

Weekly meetings between the communications department and transformation office regularized

More Time to Care branding created and incorporated as a part of all standard work templates and presentations (Figure 17.4)

More Time to Care portal created on the intranet

Lean overview included as part of new employee orientation

Lean education made mandatory as part of employees’ professional development

Live skits and videos on standard work created

Blogs posted on intranet

More Time to Care education fair held annually to share management system elements implemented in pilot areas. The fair included booths for creating awareness on Lean tools and poster presentations to showcase the projects implemented (Figure 17.5)

8 × 4-foot visual whiteboards displaying department performance scorecard metrics facilitated team huddles (Figure 17.6 shows the actual board)

“Traveling roadshows” conducted quarterly or as needed by the value stream coaches to answer any questions, provide quick updates, and impart education on standard work

Individuals and teams recognized monthly during improvement project report-out events in the auditorium

Project priority validation sessions held quarterly with directors, physicians, and senior team

Biweekly meetings held between the transformation leader and chief of staff

Portable “huddle boards” rolled in during physician meetings to discuss quick wins and other challenges experienced by the clinical departments

While all the above strategies were very effective, I would like to make a special mention of two: (1)members of the leadership team acting as role models to influence change and (2) the huddle/scorecard board. These two strategies were not time or event based. They were visible to both staff and patients at all times and therefore became instrumental in impacting behavior change across the organization.

Let me first share the innovative and highly visual layout of the performance scorecard board. While the left side of the board had the provision to display area-specific metrics and monitor performance on a monthly basis, the right side of the board allowed the team to conduct their daily/weekly huddles and see the linkage of the projects/initiatives with the metrics at all times (Figure 17.6). All eighty performance scorecard boards were installed across the hospital in areas that were accessible to patients and families. Patients were encouraged to attend huddles along with staff and learn about the work being done to positively impact their health outcomes. To promote standardization, the design of the performance scorecard board mirrored the concept of the four walls of the visual strategy room.

Before procuring the porcelain magnetic whiteboard, eighty paper versions of the scorecards, 8 × 4 feet, were professionally printed, in a standard template and tested in all areas across the hospital for its layout, content, and location for a trial period of ninety days (Figure 17.7). In addition, standard work definitions (refer to the template below) were created for interpreting the contents of the board. Education was provided to all staff for reviewing their performance scorecard/huddle board on a set frequency.

Many senior leaders ask why in the age of Big Data you would want to install giant whiteboards and expect people to update them manually. They fear that after some time the boards will become expensive wallpaper occupying premium wall space that no one will use. My response is that I am not against the use of technology, provided it does not take an opportunity away from teams to huddle, share problems, and leverage the strength of their team members to solve problems collectively; limit access to information to a select few; curtail transparency and open communication within and among staff, patients, and customers; and prevent staff from relating their work to organizational strategy.

In my view, use technology to extract data on metrics but do not substitute it for a visual board. It is too big a price to pay if the excellence journey fails. Instead, establish standard work, integrate the new way of working into employees’ daily work, motivate and recognize staff, and invest in professional development, all of which will give the best return on your investment. You will be glad you made that investment in procuring the visual boards.

Sensei Gyaan: The purpose of the visual management is to make the abnormal obvious. In case of daily visual management, first focus on the management (what you want to do), then on the visual (how), followed by the daily (when) (Figures 17.8 and 17.9).

Now let’s talk about the second strategy of leadership as a role model in influencing organizational change. In Chapter 3, we learned that leadership commitment and systems and structures in the CAP model are pre-requisites for any change effort and they support all the other five categories of the CAP model throughout the course of the excellence journey. The two have to work hand in glove to inspire culture change in the organization. In successful companies, culture doesn’t happen by accident. It occurs because leaders are modeling behaviors that lead to success.

The hospital report card, the performance scorecards, the strategy room, the Go See Learn, and the huddle boards are all examples of providing an environment, but the critical component is how leadership takes personal responsibility to be a role model for staff in demonstrating the new way of working in the organization. In his book The Company that Solved Health Care, John Torinus, CEO of Serigraph, says, “We do not have leader standard work and that is the biggest barrier why we can’t go as fast as we want in this continuous improvement journey.”

The leadership presence around the visual board is a good example of setting the tone of behavior expected from the staff and demonstrating commitment to several of the sustenance elements shared earlier, including the performance scorecard, visual management, team huddles, no-meeting zone, Go See Learn, team-based creative problem solving, coaching, leader standard work, recognition, scorecard review, and reflection. For that reason, I have highlighted the importance of having a visual huddle board in every area of the organization.