Transition to Lean: A Personal Experience

By AshleyC

February 26, 2020

Once upon a time, I was a nurse. I began as a nurses’ aide, and while working as a nurses’ aide, I went to nursing school. During my tenure in healthcare, I worked with nurses who had been carrying the flame for forty years or more and newly licensed nurses. Like many nurses, I worked alongside other healthcare providers, administrators, executives, and board members. With many of them, I eagerly served the underserved and indigent populations, as well as the more affluent. Few other callings are so strong. Some may come to healthcare for the perks, but they stay because it’s their calling.

Throughout these experiences, the same thing ran true: direct care providers want to serve their patients despite an ever-changing landscape and increased bureaucracy.

However, this call to healing can be painful. I have seen many highly skilled, passionate healthcare providers burn-out from the increased pressure, staffing shortages and a population with ever-increasing complex needs. The world of healthcare has drastically become more complicated, but the processes did not reflect this new reality.

What is particularly distressing, nurses are leaving the profession either through attrition or because they have lost the desire to be in the field.

I was burnt-out and almost left healthcare entirely. I was tired from working long hours in a job that could at times be thankless. I saw my fellow nurses struggling with this same decision. For many who want to do the right thing for their patients, who want to fight for their patient, they find themselves fighting the system as well. It was a battle on all fronts with the patient at the center and healthcare providers swimming in a cultural sea of organized chaos. Much of their time is spent putting out fires, and this is exhausting.

I didn’t leave. Instead, I pursued a management-driven bachelor’s degree in healthcare administration. I couldn’t leave healthcare entirely. I love it. I love knowing that my work allows me to touch so many lives in so many ways. It’s my passion, and I couldn’t see myself not apart of the industry in some fashion. That’s when I began to seek roles in quality. One evening, I was watching 30 Rock, where Jack Donaghy (Alec Baldwin) was talking about Six Sigma. “Jack” got it wrong, but it was it was highly entertaining.

I had not heard of using Six Sigma in a healthcare setting (at the time, Six Sigma was not widely utilized in the healthcare world yet, it was used primarily in business and manufacturing), so I Googled it. From that initial Google search, I saw the value of Lean Six Sigma, and how its combined tools and mindsets could transform the processes and culture to help healthcare providers better serve patients and each other. This methodology was a beautiful complement to healthcare’s continuing quality improvement efforts.

My AHA moment came when I had the privilege of listening to Dr. Rishi Manchada, MD, MPH deliver a talk on the Upstreamist approach. For those who don’t know what Upstreamist is, you can learn about it here. His speech focused on using this approach in the realm of public health, but the points he made spoke to every aspect of the healthcare system. During this speech, he delivered the perfect story to sum up this approach. Three friends came upon a river where several people were drowning. Each used a different method to save them. The story hit me on a visceral level, circling in my brain and staying with me long after the presentation.

As I digested his words, I knew somewhere deep inside me that my path to making a difference was not in the downstream. This— I thought– this is what I’m meant to do. I’m meant to go upstream to help those further downstream, not by being a hero, but by working to improve the system as a whole systematically. Thus, I made the transition from practitioner to performance improvement and healthcare quality. I wanted to do more than fix the processes; I wanted to help others learn to see and empower them with the tools to do it themselves. I became a teacher, coach, mentor, and consultant.

When I thought about my favorite parts of the work I’d done in the past, the answer became overwhelmingly apparent. I love teaching. I love watching the moment when concepts click, and people could see how to apply it to their own life.

While I may not care for patients anymore, I still keep my footing firmly planted in my first love–healthcare.  My new calling is as teacher and change agent. And through my teaching, I have found that my work transcends industries. Many of my students come from a variety of backgrounds, and in my consulting life, I have been able to help people in both public and private sector across a range of industries. My Lean Six Sigma certification gave me transferable skills; my experience opened doors.

Now, my focus is on empowering the innovators and frontline heroes by providing them the help they need to help others further down the stream.

About AshleyC

Ashley Christman is a former nurse and Certified Lean Six Sigma Master Black Belt with a background in organizational change management and Lean. Her extensive experience in healthcare quality and performance improvement has transformed a number of organizations and led to better outcomes in patient care, reductions in wait times, and more. Her experience includes consulting for the CA Department of Public Health as well as multiple large hospital systems, including Santa Rosa Memorial and Petaluma Valley Hospital. Her passion for improvement and educating others led her to begin teaching in order to help entrepreneurs, professionals, and leaders create a sustainable culture change by empowering them to be change agents and champions of innovation. You can find her online at @learnlivelean on Twitter and on LinkedIn.

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