Project & Change Management

A Path to Process Improvement

• Past (Corporate World):

  • Money everywhere

  • “Yes” to everything

  • Excess & waste

• Change (Recession):

  • Shift to metrics, cost-cutting, downsizing

  • Focus moved away from customer/patient

• Key Realization:

  • “Where is the patient? Who am I helping?”

Lean Six Sigma (LSS)

• A method to improve processes by:

  • Reducing waste (Lean)

  • Reducing errors/variation (Six Sigma)

• Focuses on efficiency, quality, and consistency

• Uses data and metrics to improve performance

• Do things faster, better, and with fewer errors

What are the concerns/limitations of Lean Six Sigma (LSS) in practice?

• One-size-fits-all approach doesn’t work

• Can make work feel like an assembly line

• Focus on SOPs may:

  • Prioritize process over people/patient care

  • Justify reducing staff/resources

  • Limit basic needs (breaks, flexibility)

• Success measured by metrics, not real value

• Can lead to burnout (miserable, tired, “hangry” staff)

What key questions drive change and process improvement?

• What is in my control? How can I improve it?

• How can I increase team engagement?

• How do we build trust to support positive change?

Learning to be a Kind Manager

• Listening

• Supporting

• Direct and clear communication

• Standards

• Accountability

7 HR Management Basics

1. Recruitment & selection

2. Performance management

3. Learning & development

4. Succession planning

5. Compensation & benefits

6. HR information systems

7. HR data & analytics

Org Chart

• An org chart is a visual map of a company’s structure showing roles, hierarchy, and reporting relationships

  • Clarifies roles & responsibilities

  • Improves communication flow

  • Shows career paths & growth opportunities

  • Helps with planning and decision-making

What are the essential skills for building supervisor success?

• Supervisors must use fair, objective, and evidence-based approaches to manage employees effectively

• Rigorous fact-finding

  • Gather data, use 5 W’s → better decisions

• Neutrality & objectivity

  • Stay unbiased, listen to all sides → fair outcomes

• Eliminate bias

  • Focus on behavior, not personality → equitable treatment

• Precision documentation

  • Record facts and patterns → protects decisions & improves consistency

What is the progression of the ELR coaching, counseling, and discipline process?

• Informal stage → Formal disciplinary stage → Final stage

Informal Stage

• Coaching conversation

  • Private, supportive, NOT disciplinary

• Informal counseling

  • Discusses issues, clarifies expectations

Formal Disciplinary Stage

• Formal counseling

  • Written documentation (memo to employee + ELR)

• Notice of Discipline

  • Official charges, possible reprimand/fine

• Suspension or Demotion

  • Serious action (temporary or permanent role reduction)

Final Stage

• Termination

  • Employment ends (highest level of discipline)

What are the key principles of practicing kindness in change management?

• Think Kindly

  • Assume positive intent (don’t blame)

  • Take time to reflect and check your thinking

• Speak Kindly

  • Use respectful, human-centered language

  • People are not “resources” or “numbers”

• Act Kindly (Listen)

  • Give people time/space to respond honestly

  • Give full attention when others are speaking

What are common communication “Do Not Do” behaviors that lead to conversation dead ends?

• Multi-Tasker (Active Listening)

  • Doing other tasks while listening

    • Makes employee feel unimportant

• Fixer Mentality (Response Style)

  • Jumping in with quick solutions

    • Dismisses their perspective

• Interrogator (Questioning)

  • Asking “WHY did you…?”

    • Triggers defensiveness

• One-Upper (Validation)

  • Comparing or minimizing their struggle

    • Shifts focus away from them

• Barrier Builder (Non-Verbal)

  • Closed body language / physical barriers

    • Reduces openness and honesty

• “But” Eraser (Feedback Loop)

  • Praise followed by “but…”

    • Cancels out the positive feedback

• Clock Watcher (Presence)

  • Checking time frequently

    • Makes them feel rushed and not heard

What makes good listeners effective partners?

• Good listeners = supportive partners in conversation

• Start where they are (meet them at their level)

• Ask open-ended questions

  • “What’s on your mind?”

  • “And what else?”

• Create a safe space for honest conversation

• Respect their strengths and choices

  • Let them explore their own perspectives/option

• Support their growth

  • Acknowledge progress

  • Build on what they’ve already done to move forward

• Good listening = guiding, not controlling

What are the early warning signs and thoughts that indicate you’re becoming triggered (“internal thermostat”)?

• Physical Warning Signs (body reacts first):

  • Clinch → jaw, fists, or stomach tightening

  • Heat → sudden warmth in face/neck

  • Short-fuse → fast breathing or increased heart rate

  • Lean → moving into or away from someone’s space

• Cognitive “Red Flag” Thoughts:

  • “They are being disrespectful” → personalization

  • “I need to win this argument” → power struggle

  • “Here we go again” → labeling/generalizing

  • “I need to shut this down now” → urgency bias

What should you do when you feel triggered during a conversation?

• Goal: Reset and stop the fight/flight/freeze response

• Anchor Breath

  • Take a deep breath

  • Make the exhale longer than the inhale

    • Slows down your nervous system

• Grounding Technique

  • Press feet into the floor or feel your hands

    • Brings you out of your head and into the present

• Strategic Pause

  • Use a phrase to buy time

  • Example: “Let me take a second to process that.”

    • Prevents reactive responses

What is the difference between a triggered (escalating) supervisor and a regulated (de-escalating) supervisor?

• Triggered Supervisor (Escalates situation):

  • Goal: Control & compliance

  • Tone: Sharp, fast, condescending

  • Body: Rigid, pointing, “looming”

  • Language: “YOU” statements (“You need to…”)

  • Result: Fight, flight, or freeze response

• Regulated Supervisor (De-escalates situation):

  • Goal: Understanding & resolution

  • Tone: Calm, slow, steady

  • Body: Open, relaxed posture

  • Language: “I/We” statements (“Help me understand…”)

  • Actions:

    • Breathe slowly

    • Stay calm/focused

    • Use positive self-talk

    • Pause and regroup

E.A.R. Method

• Empathy → Ask → Respond

• E – Empathy

  • Acknowledge feelings

  • Example: “I understand, that’s a lot to manage.”

• A – Ask

  • Use open-ended questions

  • Example: “What’s going on? How can I help?”

• R – Respond

  • Collaborate on a solution

  • Example: “Let’s prioritize this first, then tackle the rest.”

Why does effective communication matter in workplace conversations?

• It’s all about TRUST

• If needs aren’t addressed → employees get louder, then withdraw and disengage

• There are only 2 response types:

  • Supportive → builds trust

  • Non-supportive → damages trust

• Key Risks:

  • Trying to “fix” things too quickly

  • Solving problems they didn’t ask about

    • Can make them feel incapable or unheard

• Example to Avoid:

  • “Let me fix this for you…” (implies they can’t do it themselves)

• Key Idea:

  • Support, don’t take over → builds trust and better outcomes

9 High-Trust Leadership Behaviors

1. Listening

2. Sharing

3. Celebrating

4. Hiring

5. Caring

6. Speaking

7. Developing

8. Inspiring

9. Thanking

Why do the 9 High-Trust Leadership Behaviors matter

• Employees are 4× more likely to stay

• 2× more likely to feel proud of their work

• 3× more likely to recommend the company

What are the five key characteristics of kind leaders?

• Actively model kind behavior

• Deliberately think, speak, and act kindly

• Consider others first

• Reflect deeply on their actions

• Focus on the means (how things are done, not just outcomes)

What do common “status quo” statements sound like in the workplace?

• “We can’t change this—we’ve never done it that way before”

• “We need to be careful who we put in that role”

• “We can’t train them—we might lose them elsewhere”

• “It can’t be done”

• “It’s never been done that way”

• “Why upset the status quo?”

  • These statements reflect fear of change, risk-aversion, and fixed thinking → barriers to innovation and growth

In pharmacy (and all of health care):

• Focus on quick fixes to solve problems immediately

• Strong attention to detail

• Preference for the status quo

• Reliance on literature/guidelines to solve problems

• But also:

  • Pharmacists = strong problem-solvers and scientists

What are the consequences of not adapting or improving processes in healthcare?

• Outdated practices

• Wasted effort

• Duplicate work

• Frustration

• Increased cost

  • There is a need for change and innovation

  • Continuous improvement is essential

  • Use project management + change management to improve systems

  • No change → inefficiency and frustration

  • Continuous improvement → better outcomes

What does this have to do with Management?

• Project Management

  • Planning, executing, and overseeing tasks

  • Works within time, budget, and scope

• Change Management

  • Guiding people through change

  • Goal = achieve outcomes with minimal resistance

• Main Focus Areas

  • People

  • Processes

  • Culture

  • Communication

• How to do it well:

  • Use management tools

  • Apply Lean principles + Kind Leadership

What is Lean Project Management and what is its main goal?

• Identifies opportunities for improvement

• Focuses on:

  • Eliminating waste

  • Improving efficiency

  • Delivering value to the customer

What is the origin and purpose of Lean (Toyota Production System)?

• Developed by Toyota after WWII

• Needed to produce cars efficiently with limited resources

• Mass production (like Henry Ford) didn’t fit their needs

• Challenges:

  • Limited resources

  • Customers wanted variety, not just one standard product

• Toyota’s Goal:

  • Build a self-sufficient, long-term company by:

    • Understanding customer needs deeply

    • Continuously improving production (efficiency + effectiveness)

• Key Difference from Ford:

  • Ford: standardization (“any color as long as it’s black”)

  • Toyota: flexibility + continuous improvement

Lean

• Continuous effort to deliver exactly what each customer wants

• At the right time

• Right the first time

• In Services (Healthcare):

  • Processes are harder to see → Lean helps visualize them

  • Every person (patient/staff) has unique, evolving needs

Traditional vs. Lean Management

• Traditional Management:

  • Focuses mainly on financial results

  • Less focus on how results are created

  • Internally focused

• Lean Management:

  • Focuses on both process AND results

  • Emphasizes how results are created

  • Focuses on customers AND the company

• Goal of Lean:

  • Continuously find better ways to:

    • Satisfy customers

    • Improve effectiveness & efficiency

    • Support long-term growth

• Traditional = results only
  Lean = process + results + customer value

In Lean Project Management, what does the customer want?

• Customer wants = VALUE (no waste)

• Value must meet ALL 3:

  • Customer is willing to pay for it

  • Done right the first time (no rework)

  • Transforms the product/service

• Avoid WASTE (TIMWOOD):

  • Transportation

  • Inventory

  • Motion

  • Waiting

  • Overprocessing

  • Overproduction

  • Defects

What are the 7 wastes in Lean (TIMWOOD) and why do they matter?

• Transportation

• Inventory

• Motion

• Waiting

• Overprocessing

• Overproduction

• Defects

Why is having the right process important in Lean management?

• Right process → right results

• For Customers:

  • Get exactly what they want

  • When they want it

  • Done right the first time

• For the Business:

  • Long-term growth

  • Financial success

• Key Principle:

  • Results don’t just happen → they come from a well-designed process

What defines the “right process” in Lean management?

• Right Process = EFFECTIVE + EFFICIENT

• Effective:

  • Delivers exactly what the customer wants

  • When they want it

  • Right the first time

• Efficient:

  • Right cost for both customer & company

  • Hassle-free and easy process

• Why it matters:

• For the Company:

  • Time = money (rework = waste + extra cost)

  • Poor processes → employee frustration

• For Customers:

  • Defects + waiting → unhappy customers

Why is it important to refer to customers (patients) as humans in healthcare?

• Problem:

  • We often refer to patients as objects or tasks instead of people

• Examples:

  • “Tube that dose to station 200”

  • “Bed 34 needs norepinephrine”

  • “Drive-thru is waiting on that antibiotic”

• Why this matters:

  • Dehumanizes patients

  • Reduces empathy and connection

  • Can negatively impact care and communication

• Key Idea:

  • Patients are people, not tasks → human-centered language improves care and trust

What is 5S in Lean?

• 5S = a method to organize and improve the workplace

  1. Sort → Remove unnecessary items (get rid of clutter)

  2. Straighten (Set in Order) → Organize items (everything has a place)

  3. Shine → Clean the workspace

  4. Standardize → Create consistent processes/rules

  5. Sustain → Maintain and regularly check the system

How does Lean apply to project and change management?

• Focus on Value

  • Lean emphasizes delivering what the customer truly values

  • In project management, this means clarifying stakeholder requirements and ensuring the project aligns with those needs throughout its lifecycle

• Eliminate Waste (Muda)

  • Lean identifies and removes non-value-adding activities (e.g., waiting, overproduction, unnecessary processes)

  • Projects become leaner, with streamlined tasks, fewer delays, and better use of resources

• Continuous Improvement (Kaizen)

  • Teams are encouraged to regularly evaluate and improve processes

  • In project management, this leads to adaptive planning, learning from past projects, and improving future performance

• Empowered Teams

  • Lean promotes decentralized decision-making and team autonomy

  • Project teams under Lean principles are more collaborative, take ownership of tasks, and adapt more quickly to changes

• Flow Efficiency

  • Lean focuses on creating a smooth flow of work and minimizing bottlenecks

  • In projects, this can translate into better scheduling, faster task completion, and reduced cycle times

• Visual Management

  • Tools like Kanban boards make work visible and trackable

  • This enhances transparency, accountability, and status communication within projects

What does a real-life Lean (5S) improvement project look like in pharmacy?

• Problem (Current State):

  • Cluttered workspace, materials on floor

  • No defined locations for meds/materials

  • Poor organization & no visual management

  • Inefficient workflow (items not at point of use)

• Goal (Future State):

  • Improve flow by eliminating waste

  • Better communication & organization

  • Reduce errors/defects

  • Use 5S methodology

What does 5S look like in real life (pharmacy example)?

• Before (NO 5S):

  • Clutter everywhere (boxes, meds, supplies)

  • No set location for items

  • Hard to find things → wastes time

  • More errors + frustration

• After (WITH 5S):

  • Everything has a labeled place

  • Clean, organized shelves

  • Easy to find items quickly

  • Less movement, less searching

  • Fewer errors + faster workflow

What does “Don’t stop” mean in Lean / continuous improvement?

• Always keep improving by:

  • Finding problems in current processes

  • Questioning the status quo

  • Identifying inefficiencies (waste)

  • Creating/improving standards

  • Holding people accountable to follow standards

• Continuous improvement = never-ending cycle (PDCA)
  (Not just one-time fix!)

Respect for People

• Treat people as valuable contributors by:

  • Listening to them

  • Providing education & training

  • Developing them to their full potential

  • Supporting teamwork (patients, coworkers, suppliers)

• Goal: Help people improve processes and succeed

Bottom Line

• Project Management is successful when you grow employees who live the philosophy of teamwork and respect

What does “Culture drives performance” mean?

• Leadership behaviors → shape employee experience → create culture → drive performance

• Leadership (listening, developing, caring)
  ⬇

• Employee Experience (trust, pride, teamwork)
  ⬇

• Culture (collaboration, innovation, belonging)
  ⬇

• Performance (productivity, efficiency, customer satisfaction, retention)

How do kindness and Lean work together to create change?

• Combining Lean + kindness:

  • Improves how teams work together

  • Improves interactions with patients

  • Increases teamwork and cooperation

  • Encourages participation in continuous improvement

• Result: Better culture + better outcomes

What does a Lean + Kind team look like?

• Motivated team that respects and helps each other

• Employees generate ideas and take ownership

• Team continuously reviews and improves work (PDCA)

• People are excited and engaged in improvement

• Managers can have honest, difficult conversations

What did we DO to implement Lean?

• Started with visual management

• Built a tiered huddle system + structured project/change management

• Focused on creating a culture of continuous improvement

• Most importantly: just start somewhere

Tiered Huddle System Levels

• Level 1 Huddle (All staff)

• Level 2 Huddle (Leadership)

• Level 3 Huddle (Director)

Level 1 Huddle (All staff)

• Frontline Staff (DAILY)

• “What’s happening right now?”

• Everyone (techs, pharmacists)

• Talk about:

  • Daily operations

  • Safety/quality issues

  • Education

  • Recognition (kudos)

• Pull ideas from staff

Level 2 Huddle (Leadership)

• Leadership (2x/week)

• “What needs support or escalation?”

• Managers/supervisors

• Take info from Level 1 and:

  • Discuss issues

  • Help ongoing projects

• Push info across departments

Level 3 Huddle (Director)

• Every other week

• “Big picture decisions”

• Directors/executives

• Look at:

  • Trends across all areas

  • Major issues

• Make strategic decisions

More Effective and Efficient Department

• More effective and efficient department

• Increased trust and communication

• Better ability to handle challenges

• More flexibility and innovation

• Higher employee satisfaction

• Improved patient care (meeting patient needs)

Where do I Start?

• Ask questions about current processes

• Identify waste and inconsistencies

• Define the target (goal)

• Build trust with the team

• Use available tools (5S, PDCA, huddles)

• Involve everyone in improvement