Going through the motions

Managers play a critical role in process improvement. However, research has found that many improvement efforts fail due to insufficient management involvement. Less is known, however, about mechanisms to foster managers' involvement and their impact on organizational climate, which predicts successful outcomes. We addressed this gap with a field experiment suggested by Toyota's problem-solving process. We tested three related process improvement activities: (1) interacting with workers to learn about problems, (2) ensuring that action is taken to address the problems, and (3) communicating about actions taken. Sixty-nine randomly selected hospitals, 20 of which were randomly selected to engage in the three activities for 18-months, participated in the experiment. Survey results showed that identifying problems had a negative impact on organizational climate while taking action had a positive impact. Results suggest that solving problems as they arise (e.g. Toyota's approach) with intense and substantive actions is more productive than gathering information about large numbers of potential problems to solve (e.g. incident reporting systems). Providing feedback about actions taken negatively impacted frontline workers' perceptions. Qualitative results suggest that communication can backfire when managers go through the motions of process improvement activities without making a sincere effort to resolve staff concerns.