• Addressing the Cultural Impact of Changes Driven by Lean Six Sigma Projects


Addressing the Cultural Impact of Changes Driven by Lean Six Sigma Projects


Tim O’Hanlon, PhD MBA CQP FCQI, Principal, GE Healthcare Partners, United Kingdom


Culture-Change, Change-Management, Culture and Change





The Dubai Health Authority (DHA) has the mission of “Transforming Dubai into a leading healthcare destination by fostering innovative and integrated care models and by enhancing community engagement”. Its values are focused on consumer concentricity, efficiency, engagement of the workforce, creating accountability and transparency, whilst embracing innovation to achieve the highest standards of excellence. This generates a program of improvement projects changing systems, infrastructures and the culture.

Projects involve changes to processes, patient experience, safety and quality, systems and structures as well as the to the very culture of the DHA.

In terms of systems and because of the linkage between business context, leadership, risk management, planning and leading change - the transformation framework provides an ideal foundation for identifying, planning, implementing, communicating, validating and sustaining changes that enhance the quality management system and customer satisfaction (currently at 95%). In relation to LSS, the transformation framework deals not only with the technical nature of the change but the people impact, the cultural impact, the role of leaders and the management of change through participation and focus on the end-game.

Each project involves a change but it was important to ensure that every change resulted in an improvement. A Transformation Office (TO) and a Project Management Office were established through the vision of His Excellency Humaid Al Qutami, the Director General of DHA. The mandate was to use a structured and systematic approach to achieve the strategic objectives of DHA whilst aligning with the mission and values. The DHA team of 8, worked with GE Healthcare Partners to train more than 50 change agents to support the delivery of transformational projects across DHA and its 12000 staff.

A Transformation Framework was co-designed by the TO with the consultants and the change agents using global research.

The premise of the Framework is to maintain momentum for change and to experiment through design thinking, being prepared to pivot, based on learning from experimenting with change options. The work was aligned with a leadership charter that was developed by the most senior leaders of DHA and defined the role model behaviors at the time of transformation. The leaders also outlined their expectations for the future culture and this was cross-matched with an employee survey. The baseline of the current state of the culture was established through another survey and thus a gap analysis was possible. The transformation projects to close the gap between the current and future states were thus prioritized and resourced.

This paper explains how the Transformation Framework enables the delivery of beneficial and sustainable change using more than 30 tools that help teams move from planning, through transition and implementation to sustaining the change. Changes include transformation of processes, structures and systems. The baseline examines the business context, the stakeholders and interested parties, defining the projects and planning resources. The focus on customers and their engagement in co-design, measuring customer satisfaction and managing the customers’ responses to change are integral to the framework.

Aspirational change and all the plans in the world need to be implemented, their impact validated, ongoing improvement, handover to operational personnel and sustainability are consistent with the most common improvement approaches such as PDSA or DMAIC. In this model, we also remember to celebrate success.