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Many organizations track their key performance indicators (KPIs) using a balanced scorecard approach. The collected feedback gives high-level leaders a way of monitoring the total health of an organization on a regular basis.

Operational excellence (OpEx) can be a mystery for some people. While OpEx doesn’t have a precise definition that is fully transferable from one organization to another, certain approaches for OpEx implementation are defined. The degree to which operational excellence is achieved varies and is not an exact comparison from one team to another, but it can be measured against various auditing checklists.

It’s best to establish a long-term strategy and stick with it rather than make frequent changes. After all, a strategy change can require additional resources and create confusion for both customers and employees. However, sometimes organizational strategy must change as a result of outside factors. Think of buggy whips after the invention of the car and photographic film after the invention of the digital camera.

I cringe to write bad advice in case someone misreads the headline and follows these suggestions. Oh well, here are Operational Excellence (OpEx) methods and actions people might suggest you follow, but you shouldn’t… Just don’t do it.

“Don’t worry about strategy. Just get started doing something.”

This has a couple kernels of substance; you do want to get engagement quickly and you can get started before every “t” is crossed and every “i” is dotted. However, the essence of the advice is contrary to operational excellence basics. Continuous improvement (CI) efforts must be aligned with strategy and must focus on delivering value. Have the strategy in mind rather than initiating teams willy-nilly just for the sake of saying you’re doing continuous improvement.

If you’re not familiar with continuous improvement (CI), it may sound like a soft goal — something nice to do, but not very clearly defined. Actually, CI is a very real and effective methodology for driving major long-term and sustainable improvements. Teams can initiate and achieve success in this area by abiding by the following specific principles of continuous improvement:

Do you know the story of the three blind men and an elephant? One man touches the trunk and imagines a snake. Another touches a leg and perceives it as the trunk of a tree. The third touches the ear and thinks it is a large fan. At first, each man distrusts the others because they assume they must be liars, but when they put their thoughts together, they begin to picture the elephant as it actually appears.

A critical component of operational excellence (OpEx) is gathering employee feedback. This feedback provides unique perspectives and insight into your organization that you can’t find elsewhere. It may include positive, negative, or neutral comments. Regardless of its leanings, use the information to make your organization better and more efficient.

As you begin a path to operational excellence, you’ll likely see the expression DMAIC. That’s simply an acronym that means:

Hoshin Kanri is a collaborative approach to driving toward long-term strategic goals in concert with completing the day-to-day work of the organization and achieving tactical objectives. "Catchball" describes the back-and-forth, up-and-down processes for sharing information, getting feedback, and building consensus that are used on an ongoing basis.

Process maps have tremendous value. Remember the adage: A picture is worth a thousand words. A process map is a valuable picture of your operations, helping to illustrate clearly how things work; it shows tasks, decisions, data collection, flow of materials and information, and the sequence of process steps. This picture is far better than verbal descriptions, which might be interpreted differently from one person to another. A process map becomes documentation of setup and changes, as well as an important teaching and troubleshooting tool.

The first thing to realize when looking for a continuous improvement model is that it is not just a collection of tools or a specific named and highly touted program that excludes other valuable methodologies. A continuous improvement model includes a mindset and approach that engages workers in understanding their customers and their processes and driving efforts toward sustainable changes for the better.

Do you remember Aesop’s story of the tortoise and the hare? The tortoise plods along slowly and steadily while the hare has an exciting start, racing off toward the finish line. Then the hare stops to rest, burns out, or hits some kind of obstacle. Meanwhile the slow and steady tortoise keeps chugging along and wins.

Just like anything shiny and new, implementing continuous improvement has a mystique and attraction when it first hits prime time. However, after a while the newness wears off and the CI process must stand on its own merits. At times, frankly, it doesn’t.

Imagine trying to do a critical, life-in-the-balance job under extreme time pressure while hundreds of random strangers wander around your workplace asking too many questions and getting underfoot. It would be disconcerting to say the least. That is a worst-case perspective of having visitors in a healthcare facility.

Doctor and patient communication has been ubiquitous in the American zeitgeist over many decades in the form of the empathetic bedside manner of television doctors. The likes of Marcus Welby (Marcus Welby, M.D.), J.D. Dorian (Scrubs) and Meredith Grey (Grey’s Anatomy) have modeled our ideal in their demonstration of care and communication with patients.

But what happens in the real world? A portion of doctor/patient communication comes from the personality of the physician or other healthcare provider. The larger part comes from the content of material that must be communicated and the trained skills of the communicator.

“For want of a nail…a kingdom was lost.” That proverb could certainly apply in the healthcare field: “For want of a working piece of equipment, a patient was lost.” Evidence-based studies indicate that in the United States, premature death related to preventable harm to patients may be as high as 400,000 per year. Tens of thousands of these deaths may result from equipment-related issues.

Imagine a defibrillator that doesn’t power up, an operating room laser that fails, a patient monitor that doesn’t alarm, a radiation device that shifts out of calibration, or a digital control system that just shuts down. When any of these situations occurs, it can lead to a bad outcome for a patient, even death. Hospital professionals rely on having working equipment to do their jobs well. Equipment maintenance is critical to make sure this happens.

While managing inventory of patients is a key requirement of healthcare facilities, managing distributed equipment inventory doesn’t fall far behind. Having the wrong equipment, too little equipment, contaminated equipment, or equipment in the wrong spot can mean problems for patients. On the other hand, holding more equipment than you actually need is very costly.

Fortunately, managing equipment inventory and distribution is not a new problem. Many industries have addressed and optimized inventory systems and developed methods to pursue continuous improvements. Let’s consider some of the distributed equipment needs in medical facilities and discuss best practices that might apply.

Do you remember the scene in Cool Hand Luke, where a “failure to communicate” brings pain and suffering to Paul Newman? It’s similar in a hospital, where miscommunications can have significant clinical repercussions. Beyond that, poor healthcare communication can result in poor non-clinical outcomes leading to low patient or staff satisfaction and higher costs.