Lean Healthcare relies not only on tools and methodologies, but on people. People are the engine of Lean Healthcare. They provide innovation, skills and process knowledge that enable the continuous improvements to a lean organization. Without people, lean would be merely a tool sitting on a shelf waiting to be used. It takes people to use the tools of lean. Lean can not be automated.

One of the most important steps in lean implementation is developing teams of people working together to use the tools and methodologies at their disposal. Through team work; innovation, skills and knowledge are leveraged to maximize the benefits of lean tools and methodologies. It is important to remember that a team of people is different from a group of individuals. A group of individuals can work on multiple tasks that are independent from one another. It takes a team of people to work on one task that can not be accomplished on a group or individual basis.

Take the analogy of trying to move a rock. One person can move a rock of limited size over a limited distance. Eventually the person tires and abandons the task or requires rest. The result is a rock that has only moved a little or not at all and one tired individual. A group of people can sustain the effort and move the rock over a greater distance. However, the direction of movement and effort varies between individuals and may even result in the rock ending up where it began. Through communication, organization and direction; a team of people can move a rock in one direction and sustain the effort over longer distances. The result is that a team works more efficiently than a group or even an individual and is able to accomplish more in shorter time.

In Lean Healthcare, a team building tool known as “SPACER” is used to give organization, communication and direction to a group of individuals brought together to work on a common task. SPACER is an anagram that stands for Scope, Purpose, Agenda, Communication, Expectations and Roles. It is a simple tool that only takes a few minutes to implement during the initial meeting of a team.

The “S”, or Scope, is a short description of the task and its parameters on which the team is to accomplish. It states what the team is supposed to deliver. It is best to phrase the scope in terms that can be measured. Here is one example. “The Registration Team is to design new registration processes by which patient encounter time is decreased by 8 minutes from initial presentation to exit from the registration area.”

The “P”, or Purpose, is similar to the Scope, but has one specific difference. It is used to describe the current state of a process that is necessitating the need for a change and the formation of the team. It states why the team is being formed. Related to the above example, here is the congruent statement. “The current Registration process is averaging 20 minutes and resulting in decreased patient and employee satisfaction.”

The “A”, or Agenda, is initially developed by the facilitator or person responsible for inviting the individuals to the first meeting. The first meeting can last an hour or over a period of days. During this step of SPACER, the initial meeting times and content are discussed with the team and clarified. At each subsequent meeting of the team, a new agenda should be developed and clarified.

The “C”, or Communication, step of SPACER is begun by collecting the names, departments, phone numbers, E-mail addresses and other means of communication for each team member. This is best accomplished by sending around a sheet of paper with the fields to be filled in by each individual. Once the information is collected it is then given to a person selected by the team to be the voice of the team. This person is called the Communicator and is responsible for making sure all updates, information and documentation is distributed to team members and outside entities as necessary.

The “E”, or Expectations, step of SPACER is important. Each team member tells the expected benefit of their participation on the team. Each expectation should be documented and referred back to as the team progresses. By working the expectations into the eventual deliverable of the team, individuals and the departments they represent gain value out of their efforts. Thus, they have a vested interest in the success of the team’s work.

The “R”, or Roles, step of SPACER gives the team the organizational foundation going forward. Team members are selected to accomplish specific duties. As a minimum, each team should have the following roles.

  1. Communicator – as described above.
  2. Team Leader – provides the drive for accomplishing time lines, calling for subsequent team meetings and providing leadership.
  3. Scribe – writes down minutes of the meeting and provides historical references for future meetings.
  4. Log Person – writes down the action items, responsible person, due dates and sends out a status update to the Communicator for distribution.
  5. Time Keeper – this person is responsible for preventing the team from going off on tangents during discussions and for keeping the meeting schedule. During breaks, the Time Keeper should let the team know when the break is over. Also, they should make sure team members arrive on time for the next meeting.
  6. Champion – this is the only role that may not be a team member. Some organizations have standing Champions at the executive level. All team members should be aware of who is their team’s champion. The Champion is responsible for breaking down organizational barriers to success and to provide resources that are beyond control of the team.

Other roles can be developed by the team as they progress. If the number of team members is larger than the number of roles, it is best that no one serves in more than one role.  Also, roles can switch between team members from meeting to meeting. Changes in roles should be thoroughly communicated to all interested entities.

Using the above simple steps, SPACER, provides the catalyst for basic team building. It gives the members an understanding that they are not just attending a meeting. The end product of this Lean Healthcare tool is a Team working together in a common direction to accomplish a task instead of a group of individuals.

David Pickens is the author of this week’s article. David is an HPP Lean Healthcare facilitator, consultant, trainer, and certified lean six-sigma Master Black Belt. Dave has a B.A in Statistics and M.B.A., and is currently working on his DBA. Dave has worked with HPP healthcare clients throughout the USA by assisting them with their Lean transformations. Dave has years of industry experience from his time in the automotive and consumer goods industry, including time with Panasonic, Allied Signal and BOSCH. He has trained with Matsushita in Hong Kong, Japan and Singapore in Japanese Manufacturing Management.