I've long admired the work of Dr. Richard (Rick) Shannon, who is currently the Chief Quality Officer for Duke Health (an organization that I and others at Value Capture have worked with).

I had the opportunity to interview Rick back in 2011 as part of my Lean podcast series. 

Rick was deeply and directly influenced by the late Paul O'Neill, Sr. when Rick was at Allegheny General Hospital in Pittsburgh.

You can read about this relationship and this learning in our free eBook Lasting Impact: Leaders Share Lessons from Paul H. O'Neill, Sr.

An excerpt:

"Richard Shannon, MD, Chief Quality Officer at Duke Health, met O’Neill in 1998 as “a typical academic physician, leading a large clinical department, but also running my research lab, doing what I call fundamental discovery research into human heart failure.”

He eventually became involved with PRHI and O’Neill, and says he admires him more than any of the great minds he encountered in his 35 years of medicine as well as 17 years at Harvard Medical School and seven years at the University of Pennsylvania.

Dr. Shannon was so overwhelmed by O’Neill’s approach that he gave up his research career “because he taught me that discovery didn’t have to be confined to a lab. It was a daily exercise in human behavior and in leadership. So I literally gave up what was 40 percent of my effort and began to think along the lines of developing quality platforms in healthcare.

By 2003 or 2004, I was a completely different person.”  

As a senior leader in healthcare, Dr. Shannon says he has built everything in his organizations around the principles of quality and safety.

“Yes, we do have budgets, but I pay no attention to the budgets. I believe that if we do it right, the economics will follow. That is an O’Neill lesson.

I don’t want to be misleading. There are people in the organization that spend a lot of time on the budget, but not me. Everything begins with quality, doing the right thing the first time, no defect, no error, no waste is the ‘economically good thing,’ the term that Paul coined of perfect patient care.

And so I lead with an agenda of quality, not mergers and acquisition, not growth, not cost cutting, but the idea that building better clinical outcomes, making our patients better by delivering perfect care the first time, is the economic secret sauce of healthcare. And that was an O’Neill-ism. That was something that emanated from Paul.” 

You can read more about their learning and collaboration in the eBook.

You can also read more about Rick in the 2004 Wall Street Journal article that's titled "To Fix Health Care, Hospitals Take Tips From Factory Floor."

"In the factories of Toyota Motor Corp., any worker who spots a serious problem can pull a cord and stop the assembly line. Richard Shannon, chairman of medicine at Allegheny General Hospital, is applying the Toyota technique to an intensive-care unit here."

What Does Rick Shannon Say in 2022?

Rick is very busy, but he takes time to share thoughts on LinkedIn

In one post, he shares three things he learned last week. I think that's a fantastic habit for a leader and it sets a great example for the rest of the organization. None of us know it all, including senior leaders. We all have something to learn.

Rick mentions learning from our friend and colleague Meghan Scanlon, who last year left Value Capture to take a leadership role at Duke Health:

From Meghan Scanlon, Duke VP Performance Excellence:

”Our answers lie within our organization. Our charge as leaders is to unlock the potential of everyone, everyday. There are no shortcuts to this work. No magic wands to wave. The resolve and courage to lead our way to the results our patients deserve and our people are capable of can only come from leadership, armed with and ready to execute on a plan of action."

Everyone, everyday improvement -- that's Kaizen (continuous improvement). Creating a culture of continuous improvement is possible, but it takes work and diligence. "There is no instant pudding," as W. Edwards Deming would say.

Rick also shared this learning "from Hannah and Sarah, two nurse managers":

”Stop feeding me and patting me on the head. Instead, teach me, help me to see and solve my problems."

When people are stressed and overwhelmed by the system, no number of pizza parties will really help solve that. When people are overburdened -- when there is too much waste and they're not properly supported by the system -- leaders need to help people see problems, solve problems, and share what they've done.

Rick also shared this:

”This is not a data problem. It is not solved by measurement. It is a work process problem, only solved by observing and understanding the work and granting voice and agency to those who do the work. We are long on data and short on improvement.”

Data matters. We have to measure our progress in directions such as "zero harm" (something that Rick and Duke Health are deeply committed to). 

I agree with Rick that measurement alone solves nothing. Again, you have to do the work. You have to engage everybody to get their voices and their participation in improving the system in a way that better supports everybody.

Rick shared another post last week with some direct reflections (and sharing reflections is another great habit for leaders). 


That's a great Toyota Production System lesson -- the three actuals:

  • The actual place ("gemba")
  • The actual team members
  • The actual work

There's no substitute for the direct observation of work. You can see the flow (or lack thereof). You can see the waste, you can see the lack of standardized work. You can see the opportunities for improvement. 

Instead of sitting in a conference, stewing about (or just talking calmly about) the performance measures doesn't drive improvement. Setting a goal doesn't drive improvement. Leaders do.

What are your thoughts or reflections based on what Dr. Richard Shannon has shared? You can scroll down to leave a comment on the post.

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