Deming's 14 Points Stand the Test of Time

I've been on a personal leadership journey for 25+ years now and I've definitely hit some bumps along the way.  And I have much yet to learn as the journey continues!  That learning comes more from the bumps than it has from successes I've enjoyed - and I've had the privilege of working with a few great teams in my healthcare career.  Those teams have taught me a lot about leadership and basic human values over the years and I owe them a great debt of gratitude.

One of the things that I have come to believe is that you cannot discover leadership lessons if you lack humility, a commitment to ongoing learning, and a sincere willingness to always being open to hearing what others have to say about our leadership capabilities.  An unwillingness to be that open or honest can at best reflect unfortunate naivety and at worst pure arrogance.  We must be prepared as leaders to objectively and critically assess our areas for personal improvement on an ongoing basis. 

Objectivity - and sometimes distance from a leadership experience - is crucial in drawing the right conclusions from our current and past positions.  In addition, if we can have the courage to build relationships with some strong confidantes who will help us assess our experience so much the better.  I recall now with more than a little trepidation my first leadership role at the beginning of my career.  That first role was very challenging to my ego as I learned the on-the-job realities of healthcare.  Most importantly I experienced the key aspect of healthcare management - the experience of working with people and managing relationships.

The first and most immediate lessons I took away from that leadership experience were the wrong ones.  Of course, they were discovered immediately on the heels of leaving the role and were arrived at without benefit of external validation.  At the end of this first role, I truly believed that in order to be as successful as I thought my peers were I would have to adopt a tougher, more unyielding leadership style.  Maybe that's not what my more experienced peers thought they were modeling to me as their leadership style but that's what I initially took away from my formative experience - be tough, demand performance, get respect through fear, be distant from your staff, be above your staff.

I am very grateful that immediately following this experience that I had an opportunity to reflect on my formative experience in the course of my master's degree, including an internship in another healthcare organization.  It gave me time, distance and other people to learn from before I set myself down the wrong path of leadership.  Through my studies and internship - an opportunity to learn from two healthcare organizations implementing total quality management - I became exposed to the work of Dr. W. E. Deming.  I further explored his teachings through my master's thesis on total quality management.  It was eye-opening and his principles really struck a chord with me at the time.  Over the succeeding years I have come back to his basic principles time and again.  I have learned from other leadership guru's as well, but Deming's perspective has continued value for me.  I want to touch on only a few of his 14 Points with the belief that these have much to inspire those in leadership positions - or those looking for good leadership.

Point Seven - Institute Leadership. 

Dr. Deming calls upon management to lead rather than manage.  Simple statement but what does it really mean for us as leaders?  Well I'm pretty confident that if you were to talk to many of our frontline staff and management personnel outside of the executive suite they would provide you with countless examples of where they felt they were being "managed", not "led".  This bias towards "management" is without doubt enhanced by the immense pressure the health system is under to perform and achieve better results.  A typical management response is to exercise greater control and oversight to make sure results get better.  More often than not in these circumstances efforts of this nature only seem to put more barriers in the way of getting good work done - more reports to generate, more signatures to get, more unreasonable timelines to meet, multiple and conflicting demands, and failure to hear and act upon input and recommendations from staff. 

Point Eight - Drive Out Fear.

I've already made my confession in regards to violating this particular principle, at least insofar as thinking that fear might be an effective tool of leadership.  And maybe it can be in the short-term but not if you are trying to create a high-performing organization for the long-term.  With fear in an organization there cannot be open communication, innovation, and teamwork - and these are all required for an organization to achieve the full measure of its potential.  Leadership of any organization - and at all levels of the organization - must actively model open communication, encourage appropriate risk taking and innovation, and promote teamwork from the executive suite through to the front lines of operations.  With fear in place an organization shall continue to squander the full potential of its people and the organization to the detriment of the people it purports to serve.

Point Ten - Eliminate Slogans, Exhortations and Targets for the Workforce.

Everybody needs to measure performance.  Deming did not intend, nor do I suggest, that system performance not be evaluated on an ongoing basis.  Rather, what Point Ten addresses is the notion of trying to assess an individual's performance without reference to understanding of the system in which that individual works.  If an individual is prevented from achieving higher levels of performance by a system (that management has created or allowed to be created) then performance managing an employee, setting new targets for them to achieve, and giving them "motivational" speeches will have little impact on performance.  It is far more likely that such efforts will actually cause frustration, demoralization and reduced performance.  Deming's red bead experiment is a great illustration of this principle - given an equal number of red and white beads, an employee is tasked with collecting only white beads with an employer-provided scoop or paddle.  Inevitably, the employee collects some red beads in their assigned task.  As a result of "failing" in their assigned task, the employee may be given further direction by their supervisor, there may be encouragement to do better, they may be applauded if their red bead count has gone down, or they may be chastised if their red bead count goes up.  Regardless, their individual effort and various interventions at the personal level will have no impact on actual outcome.  It's like expecting employee engagement scores in an organization to go up simply by saying that the target is 10 out of 10 on the next engagement survey.  Only by changing the system and the organizational environment will better, more consistent results be achieved.  I see a strong correlation between Point Ten and the need to Drive Out Fear from an organization as noted earlier.  In fact, I believe that what leaders often create by exhortations to do better is an environment in which results and information are hidden through fear of rather than discovered.  And only by discovery can we improve.

Point Twelve - Remove Barriers to Pride of Workmanship.

In this Point, Deming was referring to unclear expectations, lack of timely feedback (or any feedback), lack of training and support, and systems that focused on short-term results rather than long-term goals.  Staff and front-line managers are often frustrated by multiple tasks or changing priorities (see Point Seven) as leaders change focus or react to external stimuli without, it seems, due regard to long-term objectives or stated core values.  And unfortunately, more than one of us can relate to the fear that the performance evaluation process creates in us - either as provider or receiver of the experience.  Too often this is because we establish the evaluation process as a one-time event, not as a continual process of discussion, engagement and opportunity.  There is a need too to ensure that the evaluation process becomes an opportunity for leaders and staff alike to identify and invest in skills and intellect.  It is also a great opportunity for leaders to model desired behaviours and reinforce common goals.  On this latter point, I firmly believe that there must be a high degree of visibility and sincere engagement with internal audiences on par with leadership visibility and engagement with external audiences.  Without the kind of internal alignment that I believe comes from such effort the ability to deliver on commitments to external audiences and customers stands on shaky ground.

As the title of this blog implies, I will continue to come back to this theme of Leadership over and over again.  Moreover, I will focus on a particular style of Leadership that I think is the right and crucial one for us to achieve our desired goals for a better healthcare system.  We need to invest more in our leaders and place just as great a value in that development and those people as we do in the bricks and mortar of our healthcare system.

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Greg Hadubiak, MHSA, FACHE, CEC, PCC
Executive Coach/Consultant
BreakPoint Solutions
gregh@breakpoint.solutions
780-250-2543

Helping leaders realize their strengths and enabling organizations to achieve their potential through the application of my leadership experience and coaching skills. I act as a point of leverage for my clients. I AM their Force Multiplier.