This is part of the series The CDPH Way—Becoming the best at getting better.
For background, here is an overview slide set and lean reporting templates.
At the California Department of Public Health (CDPH) we are on journey of lean transformation. Lean thinking and practice is “systematically developing people to solve problems and consuming the fewest possible resources while continuously improving processes to provide value to community members and prosperity to society”1 The value pillars of lean are “respect for people” and “continuous improvement.” These two pillars, along with four additional components, make up the lean operating sytem at the CDPH:
- Respect people
- Improve continuously
- Embrace scientific thinking
- Measure what matters (OKRs)
- Respond and adapt with speed and agility
- Eliminate waste and undesired variability
To be a lean organization, these six components are required, and if one is missing, organizational effectiveness and mission will suffer. Every health organization should strive to be a lean organization, and it starts with “respect for people.”
However, what does it mean to respect people? What does it mean to give respect and to feel respected?2
To be respectful, first we must understand the concept of “universal values.” Universal values are values that apply to everyone, everywhere and leaves no one behind, including our adversaries. I learned the concept of universal values from Dr. Monica Sharma, former director of leadership development at the United Nations, and author of Radical Transformational Leadership: Strategic Action for Change Agents [1].
In tackling complex public health problems around the world, Dr. Sharma discovered that universal values enabled stakeholders to transcend differences, find common ground, and solve problems together. The universal values she discovered to be the most effective and robust are dignity, equity, and compassion. To this short list I added humility. With authenticity and integrity, we should strive to embody and promote universal values in every interaction and in every conversation.
The first universal value is humility. To be humble is to believe genuinely that you are not better or more important than any person you are engaging with regardless of their social or occupational status, wealth, or ability.
The second universal value is compassion. To understand compassion, we must distinguish it from sympathy and empathy. With sympathy I care about your suffering. With empathy I feel your suffering. With compassion I want to relieve your suffering. Be aware and mindful: because of our implicit (nonconscious) biases we are more likely to empathize with people “like us” (eg, tribalism). Instead, we endeavor to have empathy for those unlike us, and to have compassion towards those who are vulnerable or suffering even if we do not share values.
The third universal value is equity; that is, to treat everyone with fairness regardless of their social or occupational status, wealth, or ability. Fairness does not mean everyone is treated equally, but rather we are responsive to their needs. When we are humble, compassionate, and fair with others, especially when we differ by social or occupational status, wealth, or ability, then they will feel dignity — “the quality or state of being worthy, honored, or esteemed.”3
The fourth universal value is dignity. When we engage others, and we embody and promote the universal values of humility, compassion, and equity (fairness), then they are more likely to experience dignity—and to feel respected. Dignity is also “the right of a person to be valued and respected for their own sake, and to be treated ethically.”4
The universal values of humility, compassion, equity (fairness), and dignity apply to everyone, everywhere, including your adversaries. Universal values apply where you live, learn, work, play, and pray.
I started with humility because it is a very deep and powerful concept. There are different types of humility we should cultivate.
General humility “is the noble choice to forgo your status, deploy your resources or use your influence for the good of others before yourself” [2].
Intellectual humility is a mindset5 that involves recognizing and owning our intellectual limitations in service of pursuing deeper knowledge, truth, and understanding [3].
Cultural humility is committing to lifelong learning and critical self-reflection; realizing our power, privilege, and biases; redressing power imbalances for respectful partnerships; and for promoting institutional accountability (learn more).
Discovering and cultivating your ability to be humble will supercharge your learning, your relationships, and your effectiveness.
ChatGPT query
To get a consensus view on respect for people in the lean health care context, I queried ChatGPT which provided a very reasonable answer.
For lean in the health care context, what is the best way to show respect for people?
“Showing respect for people is a fundamental value in lean quality improvement, and it can be demonstrated in various ways. Here are some best ways to show respect for people:
- Listen actively: Listening actively is an important part of showing respect for people. When someone is speaking, pay attention, show interest, and ask questions to clarify and better understand their perspective.
- Value diversity: Value the diversity of people’s backgrounds, experiences, and perspectives. Recognize that everyone brings unique knowledge and skills to the table.
- Encourage participation: Encourage everyone to participate and share their ideas. Create a safe and supportive environment where people feel comfortable expressing themselves.
- Provide training and development: Providing training and development opportunities shows that you value people’s knowledge, skills, and expertise. It also helps people grow and develop professionally.
- Recognize and appreciate contributions: Recognize and appreciate people’s contributions and successes. Celebrate achievements and milestones, and show gratitude for their hard work and dedication.
- Provide a healthy work environment: Provide a healthy work environment that promotes well-being and work-life balance. Recognize that employees have lives outside of work and respect their personal time.
By showing respect for people, organizations can create a culture of trust, collaboration, and continuous improvement. This can lead to better outcomes for patients, increased employee satisfaction, and improved overall performance.”
References
Footnotes
https://www.lean.org/the-lean-post/articles/public-service-leans-next-frontier/]↩︎
See Dr. James Womack’s take on “respect for people” in lean practice at https://www.lean.org/the-lean-post/articles/respect-for-people/↩︎
Source: https://www.merriam-webster.com/dictionary/dignity↩︎
Source: https://en.wikipedia.org/wiki/Dignity↩︎
Source: https://www.templeton.org/discoveries/intellectual-humility↩︎