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Lean Blog Audio

Lean Blog Audio

By Mark Graban

Mark Graban reads and expands upon selected posts from LeanBlog.org. Topics include Lean principles and leadership in healthcare, manufacturing, business, and the world around us.

Learn more at www.leanblog.org/audio
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GE's Larry Culp on Making it Safe for Bad News to Flow to the CEO (or Other Leaders)
GE's Larry Culp on Making it Safe for Bad News to Flow to the CEO (or Other Leaders)
Read the post for this episode Following up on my blog post about GE CEO Larry Culp's AME keynote speech, I wanted to share some of the discussion from his "fireside chat, absent the fire" (as Larry called it) with Katie Anderson (as we discussed in our podcast episode).
08:12
December 01, 2022
Highlights from GE CEO Larry Culp's Remarks at the AME Conference in Dallas
Highlights from GE CEO Larry Culp's Remarks at the AME Conference in Dallas
Blog post It was a real treat to hear Larry Culp, the CEO of General Electric and CEO of GE Aerospace, speak at the AME 2022 annual conference in Dallas. He recently reached the four-year mark of his tenure as GE's first-ever outsider CEO (read the 4-year update that Larry posted on LinkedIn). Below are some highlights and quotes from his 15-minute remarks, along with some of my commentary and thoughts.
14:28
November 28, 2022
Toyota Was Helped, not Hampered, by TPS During the Pandemic
Toyota Was Helped, not Hampered, by TPS During the Pandemic
Blog post  A culture of learning makes the difference, not "low inventory" Last year, I wrote a post that criticized those, including the Wall St Journal, who claimed that Toyota was "abandoning" the Toyota Production System or that strategically adding some inventory meant they were moving away from "Just in Time" approaches: Toyota leaders, including my friend Jamie Bonini, were quoted in this new article by HBS professor Willy Shih in HBR: What Really Makes Toyota's Production System Resilient Did TPS hurt Toyota during the pandemic? NO
07:55
November 22, 2022
Does Learning From Mistakes Mean It's OK to Try Any "Dumb Thing" - For Elon Musk or Any of Us?
Does Learning From Mistakes Mean It's OK to Try Any "Dumb Thing" - For Elon Musk or Any of Us?
Blog post - https://leanblog.org/audio321 Elon Musk tweeted this yesterday: "Please note that Twitter will do lots of dumb things in coming months. We will keep what works & change what doesn't."
04:03
November 10, 2022
Psychological Safety as a Pre-Condition for Lean
Psychological Safety as a Pre-Condition for Lean
Blog post: http://www.leanblog.org/audio320 Contact me to talk about psychological safety - measure, learn, improve “Simply put, we cannot get to zero harm without psychological safety.” I wrote that as part of this page on the Value Capture website: Psychological Safety and its Essential Link to Continuous Improvement I've come to understand that psychological safety is a precondition for “implementing #Lean” or however you might say. Toyota seems to strive for (if not have) a relatively high level of psychological safety.
03:31
November 10, 2022
Isn't It Ironic? Mistakes That Interrupted My Webinar About Mistakes
Isn't It Ironic? Mistakes That Interrupted My Webinar About Mistakes
Episode #319 -- read the blog post that contains video of the webinar A contractor unplugged my WiFi router. Or was there more to it than that? Instead of blaming somebody else, what mistakes did I make that led to the Q&A section of my webinar being knocked offline?
14:10
July 03, 2022
This WSJ Article About Lean Isn't Terrible (via GE and Larry Culp)
This WSJ Article About Lean Isn't Terrible (via GE and Larry Culp)
Blog post: https://www.leanblog.org/audio318 The Wall Street Journal has an epic track record when it comes to always getting it wrong when they write about Lean or the Toyota Production System. They always focus on just the “just in time” pillar, ignoring “jidoka” (built in quality) as the other pillar (per Toyota). They ignore many other aspects of TPS, like the culture and the management style. See some of that track record, including recent pandemic supply chain articles. You're normally better off reading about Lean from the source. But, they did better in this recent article about General Electric and CEO Larry Culp (who knows Lean very well from his time as CEO of Danaher): Larry Culp Rewired GE. Then He Unwound It.
12:15
January 04, 2022
Dolphins Are Also Smart Enough to Game the System to Get More
Dolphins Are Also Smart Enough to Game the System to Get More
Blog post: https://www.leanblog.org/audio317 Oh, how I enjoyed this article a month ago when it was sent to me. It's from 2003, but it was new to me: Why dolphins are deep thinkers
07:06
October 11, 2021
What Does Kaizen Suggest About How to Incentivize People to Submit Ideas?
What Does Kaizen Suggest About How to Incentivize People to Submit Ideas?
Blog post: https://www.leanblog.org/audio316 I received a question from a healthcare leader who had read about the “idea card” format and method that Joe Swartz and I shared in our Healthcare Kaizen books. I read your post about the Idea Card. Amazing! Have a follow up question. What does Kaizen suggest about how to incentivize people to submit ideas? She's asking about the “Kaizen” style and approach to continuous improvement. I'll share some of my reply along with some relevant excerpts from the book.
12:08
October 08, 2021
Free Webinar: Applications of Lean Leadership Methods in Home-Based Care
Free Webinar: Applications of Lean Leadership Methods in Home-Based Care
Blog post: https://www.leanblog.org/audio315 I'm really excited to be hosting and moderating this webinar next week, the second in our new Value Capture Webinar series. The title is "Applications of Lean Leadership Methods in Home-Based Care."
03:15
October 07, 2021
Improvements to the Covid Vaccination Process -- Small and Large (and Hockey Hubs)
Improvements to the Covid Vaccination Process -- Small and Large (and Hockey Hubs)
Blog post: https://www.leanblog.org/audio314 In this era of Covid--19 vaccination, I'm still pretty much sidelined and not on site with any clients, although I did get to visit two mass vaccination sites (in addition to the one that vaccinated me). I have tried really hard to be a cheerleader for continuous improvement and, in particular, for sharing continuous improvement ideas through the free VacciNexus platform and through other channels. I believe, of course, in the power of many, many small improvements being driven by front line staff and their managers. That's the focus of my Healthcare Kaizen books. I also realize there's a time and a place for process re-design and for being innovative (thinking of it as step-change improvement. In this post, I share and discuss improvements large and small.
15:51
May 20, 2021
What Does Lean Mean to Healthcare Professionals? What Should it Mean?
What Does Lean Mean to Healthcare Professionals? What Should it Mean?
https://www.leanblog.org/audio313 tl;dr summary: Lean isn't just efficiency... it's safety, quality, delivery, cost, and morale. People often misunderstand that -- they don't know or they were taught the wrong things I often have the opportunity to teach a group of experienced healthcare professionals, from a wide range of disciplines, about Lean. My session is part of a longer professional development program that's framed as "clinical outcomes and patient safety." Lean has a lot to contribute to those outcomes, and you can see a collection of results here or here. Since my last session had to be virtual, due to the pandemic, I took advantage of the opportunity to use some interactive tools from Mentimeter.com. This is something I'll continue doing even when I have the chance to teach in person, as people can vote or give input from their phones, anonymously, while sitting in class. One question I asked the group was: What does "Lean" mean to you in terms of improvement?
08:03
March 18, 2021
Being Logical and Kind When a Mistake is Made
Being Logical and Kind When a Mistake is Made
https://www.leanblog.org/audio312 In this post, I'm going to share some reflections from one of my workplaces, some things that occurred last week. I'm going to be vague, so forgive me for that. It feels right to be less specific in this case, or at least that's the cautious (and maybe respectful) thing to do. When wearing one of my different "hats" with one of the organizations I work with, something went wrong. It wasn't something I did (or I would own up to that in specific ways). But the mistake affected me and the work I was doing. When a preventable process problem occurs, the engineer in me finds it relatively easy to be logical and think through "what happened?" instead of "who messed up?" A few deep calming breaths help, as well.
07:40
March 04, 2021
Will "Kaizen" Get the Buffalo Bills to Next Year's Super Bowl?
Will "Kaizen" Get the Buffalo Bills to Next Year's Super Bowl?
http://www.leanblog.org/audio311 I'm not a Buffalo Bills fan (a.k.a. "The Bills Mafia"), but I did attend one game at what was then called Rich Stadium in 1998 when I was a grad school intern at Kodak. Even without being a fan, I wish I could have written a headline for this post that said "Buffalo Bills Kaizen Their Way to a Super Bowl." Readers of this blog, of course, know that "Kaizen" is a Japanese word meaning "good change" and it's framed as an approach to engaging everybody in small improvements to the way they do their work. So what does this have to do with football? Football is a workplace, even if it's college. I blogged about my alma mater, Northwestern University, using the word "Kaizen" (and the mindset) within their football program. This article about the Bills isn't new, but I recently discovered it on Twitter: Sean McDermott, Bills use 'Kaizen' strategy to stress constant improvement From the article...
11:00
February 21, 2021
Blaming “Human Error” Isn’t an Excuse for Wasting 500 Doses of Covid Vaccine
Blaming “Human Error” Isn’t an Excuse for Wasting 500 Doses of Covid Vaccine
https://www.leanblog.org/audio310 During this "let's try to get people vaccinated" phase of the Covid-19 pandemic, almost every article that I've seen about the vaccine and its distribution mentions the need to not waste precious doses. There are many opportunities for error with the different vaccines. If some of them aren't stored properly at the correct temperature, the vaccine degrades and gets wasted (or worse, gets injected and gives a false promise of effectiveness). Good process design (lessons I learned as an engineer) means being proactive and thinking about what could go wrong -- and then designing the process in a way that prevents errors or mistakes. The ideal would be "error proofing" that makes it impossible to make a mistake. Or, we could make it more apparent that a mistake has been made (for example, a temperature-sensitive label on a vaccine bottle that would let you know if it's been out of the correct storage temperature too long). A countermeasure like this might prevent the mistake of using expired vaccine. But how can we prevent the storage problem (and the waste of the vaccine) to begin with? I wasn't planning on blogging over the holidays, but this article caught my attention: Wisconsin hospital tosses 500 doses of COVID-19 vaccine due to 'human error' (See the full post at the link https://www.leanblog.org/audio310)
13:12
December 30, 2020
Announcing a New Podcast Series: “My Favorite Mistake: Reflections From Business Leaders”
Announcing a New Podcast Series: “My Favorite Mistake: Reflections From Business Leaders”
https://www.leanblog.org/audio309  Subscribe now to "My Favorite Mistake"
07:38
August 27, 2020
Why I'm "Handing Over" My Blog for the Week to #RootCauseRacism
Why I'm "Handing Over" My Blog for the Week to #RootCauseRacism
http://www.leanblog.org/audio308 You might have heard of a "social media takeover" where a brand with a large following gives control of their social media feed to somebody who is promoting a cause or a social message. One person I've followed on LinkedIn is Deondra Wardelle. She is a Lean practitioner (like me) and she's a Black woman (unlike me). So, thinking back to the idea of a "social media takeover." I was inspired by Deondra, so I asked her to accept a "blog handover" as I'm calling it. My initial thought was to give a platform for her to write and talk about anything she wanted, to give more exposure to her voice.
08:22
August 08, 2020
Great Piece: "Health Care Workers Protect Us. It's Time to Protect Them."
Great Piece: "Health Care Workers Protect Us. It's Time to Protect Them."
http://www.leanblog.org/audio307 Today, I wanted to share an excellent article written by Dr. John Toussaint (of Catalysis) and Ken Segel (of Value Capture)...
04:19
June 22, 2020
The “Practicing Lean” Audiobook is Available Through Audible
The “Practicing Lean” Audiobook is Available Through Audible
http://www.leanblog.org/audio306 I'm excited to announce that our book Practicing Lean is now available as an audiobook through Audible. As we did with the paperback and Kindle versions of the book, 100% of royalties will be donated to the Louise Batz Patient Safety Foundation (it's been almost $5000 so far). You can buy or subscribe through Audible.
02:25
June 11, 2020
Standard Work for Being as Safe as Possible When Refueling Your Vehicle
Standard Work for Being as Safe as Possible When Refueling Your Vehicle
http://www.leanblog.org/audio305 It's possible that I could start traveling again for my healthcare consulting work next month... or maybe in July. My colleagues at Value Capture aren't sure yet how this will work out, but clients are sharing their current plans for starting to re-open -- to a new normal, not the old normal. As I mentioned (if not buried) in a post last week, my wife and I relocated from Orlando to Los Angeles last week because she is starting a new job (we will still have our permanent home in Texas). Anyway, as the consultants start to think about traveling again, I have compiled some thoughts from my own research and experience since I'm the only one who has flown or stayed in hotels over the past two months, due to the relocation.
06:19
May 19, 2020
Remembering a Great Leader, Paul O'Neill (1935-2020)
Remembering a Great Leader, Paul O'Neill (1935-2020)
http://www.leanblog.org/audio304 It was a sad weekend, hearing about the passing of Paul H O'Neill, Sr. on Saturday. He was 84. I had the good fortune to meet and spend time with Mr. O'Neill on a few occasions and I'll share some reflections in this post. My condolences go out to his family and friends, and especially to my Value Capture colleagues who worked with him at Alcoa or at the firm over the past 15 years. Here are his obituaries from the WSJ, the New York Times, and the Pittsburgh Post-Gazette. You can also read more about his life on a memorial page that his family set up and people are sharing memories there.
13:36
April 22, 2020
What my Book "Lean Hospitals"​ Says About Inventory Planning
What my Book "Lean Hospitals"​ Says About Inventory Planning
http://leanblog.org/audio303 This is from the 3rd edition of my book Lean Hospitals. I've copied and pasted from the book with no additional edits, although I'll bold italic some parts for emphasis. I'll some closing thoughts at the end. For a more complete PDF excerpt, click here (requires Dropbox access).
08:34
April 12, 2020
Thoughts From Lean Thinkers on Coping with the Coronavirus Crisis
Thoughts From Lean Thinkers on Coping with the Coronavirus Crisis
http://www.leanblog.org/audio302  Thanks to Elisabeth and the team at GoLeanSixSigma.com for inviting me to contribute some thoughts in this piece: How Lean Six Sigma Can Help Fight the Coronavirus Pandemic
04:23
April 11, 2020
See? Lean is About Flexibility, Not Low Inventory
See? Lean is About Flexibility, Not Low Inventory
http://leanblog.org/audio301 It's great to see examples of manufacturing companies being flexible and adaptive in these challenging times. Lean methods are often providing a huge boost in what can be life-saving efforts. Lean often gets mislabeled as a “low inventory” system (or “zero inventories”) but that misses the point. We don't just lower inventory at all costs (anybody can make that mistake without Lean) — we have to create systems and supply chains that might possibly allow for low inventory. ..... But back to the one manufacturing company that inspired this post. It was great to see this article (hat tip to Brad Miller): How to pivot an entire company in a week–and remain profitable See more in the blog post (link at top)
07:25
April 10, 2020
One Doctor's Troubling Experiences in the Emergency Department [Covid-19]
One Doctor's Troubling Experiences in the Emergency Department [Covid-19]
http://www.leanblog.org/audio300 I had a phone conversation yesterday with an emergency medicine physician after her shift at an unnamed hospital in an undisclosed state. She had a number of frustrations to share and she doesn't really have an outlet (and doesn't want her name out there for fear of retaliation). More importantly, this isn't about one institution. She works in a well respected system. So this lack of preparedness and leadership could be widespread. When I posted my concerns about hospital preparedness for Covid-19, I guess they weren't unfounded. I'm sharing these concerns in a public way because I think it's important to try to inspire other healthcare professionals and improvement specialists who CAN be on site to drive improvements. I also hope it serves as a reminder to the public to NOT GO to the hospital unless it's a life-or-death emergency right now.  "When should I go to the hospital?" and more questions were be covered in a webinar that was done on Wednesday. Listen, watch, or read a synopsis here.
12:04
March 20, 2020
Covid-19: Don't Blame Toyota or "Just in Time" for Your Risky Supply Chain Strategy
Covid-19: Don't Blame Toyota or "Just in Time" for Your Risky Supply Chain Strategy
http://www.leanblog.org/audio299 I normally love the public radio program "Marketplace" and have listened to it (on radio or as a podcast) for 15 years or so. But, I was very disappointed with this recent piece, which you can read here: "Just-in-time" manufacturing model challenged by COVID-19 Yes, many factories have been shut down in China, which disrupts global supply chains. However, if you're a company that decided to move all of your production to China (to then ship out to customers around the world), that wasn't a "Lean" strategy. It's really difficult to support "just in time" delivery over such long distances. If it were a "Lean" approach to move all of your production to China, then Toyota would have done that. But, Toyota didn't.
11:09
March 17, 2020
For Covid-19 Preparedness, Hospitals Need More Than Written Protocols
For Covid-19 Preparedness, Hospitals Need More Than Written Protocols
http://www.leanblog.org/audio298 I've been thinking a lot about hospitals and how they're preparing for the expected tsunami of Covid-19 patients who will need ICU beds and ventilators (when it's expected that there won't be enough of either). There have also been recent preparations (and ongoing actions) to screen patients who arrive at emergency rooms and outpatient clinics. I was at one organization last week that was in the process of installing new protocols and procedures in an outpatient clinic setting and I was able to have a tiny amount of input into that. Now, I'm home and trying to help remotely with the situation. I hope this blog post helps more broadly.
15:17
March 16, 2020
Jumping to Solutions: A Hard Habit to Break
Jumping to Solutions: A Hard Habit to Break
http://www.leanblog.org/audio297 Looking back at a blog post and an article from 2012 and 2014...
05:22
March 03, 2020
My “Measures of Success” Workshop at the Shingo Conference 2020 in Orlando
My “Measures of Success” Workshop at the Shingo Conference 2020 in Orlando
http://www.leanblog.org/shingo2020 Thanks to the Shingo Institute for inviting me to facilitate a half-day workshop at the Shingo Conference, being held this year in Orlando, April 16 and 17. The workshop covers concepts and methods from my book Measures of Success: React Less, Lead Better, Improve More. I hope you can join us for the conference, as this is an event I have enjoyed in the past — and if you're going to be there, please say hi and, better yet, come to my session. My workshop will be a concurrent session on Friday at 8:30 AM. Here is a video they asked me to make where I share a little bit about the workshop:
05:16
February 12, 2020
GE's CEO Larry Culp Goes to the Gemba, Looks to Understand the Real Reality
GE's CEO Larry Culp Goes to the Gemba, Looks to Understand the Real Reality
http://www.leanblog.org/audio295 Here's an article from Bloomberg BusinessWeek: GE's Larry Culp Faces Ultimate CEO Test in Trying to Save a Once-Great Company Very early on, the article mentions Culp's advocacy for "Toyota-style lean manufacturing." Or is he pushing "Danaher-style lean manufacturing" and is that different? And does that matter? Culp was "in his element" visiting a GE factory in Pensacola -- can that be said about most CEOs?
08:53
January 30, 2020
When Should We Lower a Target and When Should We Try Harder to Figure Out How to Reach It?
When Should We Lower a Target and When Should We Try Harder to Figure Out How to Reach It?
http://www.leanblog.org/audio294 Today, I'm sharing a question from a reader who started their career at Toyota and now works at another company. See previous posts with reader questions. The reader has given me permission to share this -- to get your input -- and there are no identifying details included: I came across something interesting at work around goals that I wanted to share with you and perhaps get your thoughts. At the beginning of the fiscal year, our manufacturing sites submitted their cost savings targets to me. I looked them over to make sure they both seem reasonable yet challenging and asked questions as needed. From there, I submitted them to the operations VP for final approval. The VP accepted them without question. We're at the end of the first quarter, and 3 of the 9 sites are not meeting their run rate target...
10:12
January 30, 2020
Our Toyota Tour Guide's Kaizen
Our Toyota Tour Guide's Kaizen
From 2014 -- http://www.leanblog.org/audio293 We had an excellent English-speaking tour guide for our visit (she lived in Hawaii at one point). As we talked through the facility (up in a "catwalk" that gave good visibility down into the process), she would occasionally stop at pre-determined points to explain something about the process or about the Toyota Production System and its elements. At each stop, there was a box with a microphone and other audio/visual equipment and speakers. She didn't have to carry a microphone with her. The guide was carrying a bag, something between a briefcase and a large purse. One of our sharp-eyed tour attendees, a Chief Medical Officer from a Canadian hospital, noticed a hook that she would hang her bag on while stopped and talking. He asked her about the hook. Sure enough, it was a Kaizen improvement! And, it was her idea.
06:25
November 23, 2019
A Japanese Hospital CEO on Kaizen, Innovation & Breakthrough
A Japanese Hospital CEO on Kaizen, Innovation & Breakthrough
From 2012: http://www.leanblog.org/audio292 Dr. Iida talked about the connections between "Kaizen" (small improvements) and innovation (larger improvements) and how, together, they lead to breakthroughs. He also talked about how one is absolutely necessary for the other to occur. Dr. Iida has been the CEO for just over 20 years and his hospital receives visitors from around the world, including Europe and Africa. They were on the verge of bankruptcy when he took the job in 1991 and they are now "in the black" and had the money to build a new hospital, while most Japanese hospitals are losing money today, he said.
04:28
November 23, 2019
Jess Orr on What She Learned by Leaving Toyota
Jess Orr on What She Learned by Leaving Toyota
http://www.leanblog.org/audio291 Last week was our fifth annual KaiNexus User Conference (or "KaiNexicon" as we now call it). One of our keynote speakers was Jess Orr, a former Toyota engineer who shared perspectives on what it was like to now lead continuous improvement in another company. Jess has previously presented three webinars for us at KaiNexus (see links at the end of the post) and she always has something insightful to say. I took a lot of notes during her talk, so here are some of the highlights as I captured them.
07:25
October 11, 2019
Maybe "Just Do Its" Should be Called "Just PDSA Its"?
Maybe "Just Do Its" Should be Called "Just PDSA Its"?
http://www.leanblog.org/audio290 So, upon some reflection, it seems like "Just Do It" isn't really the right phrase to use. A classic suggestion box system has cards that start with listing a suggestion. That's, in a way, jumping to solutions. Kaizen isn't a suggestion box model. Maybe "Just PDSA It" is a more accurate phrase to use?
07:32
October 08, 2019
When Problems are Hidden in Kudos: From Celebrations to Root Cause Countermeasures
When Problems are Hidden in Kudos: From Celebrations to Root Cause Countermeasures
http://www.leanblog.org/audio289 In the huddles, the manager and team talk about problems, issues, or opportunities for improvement. In some huddles, the team might say, "We can't think of anything that came up yesterday." But, then, as the huddle progressed, the team was asked if anybody should get recognition or kudos for something they did.
03:40
October 07, 2019
Previewing Mark Valenti's Webinar on "Motivational Interviewing" for the Workplace
Previewing Mark Valenti's Webinar on "Motivational Interviewing" for the Workplace
http://www.leanblog.org/audio288 http://www.kainexus.com/webinars Today, I'll be hosting and moderating the latest in our KaiNexus Continuous Improvement Webinar series. I'm really excited that the presenter will be Mark Valenti -- he's been a bit of a mentor and coach for me on the topic of "Motivational Interviewing," something I've really found helpful these past few years. Click here to register for the webinar, which is intended to provide tips for leaders and managers (and a transcript can be found at the end of this post): From Ambivalence to Action: Leadership Lessons from Motivational Interviewing The webinar is today at 1 pm ET. If you can't attend live, please register anyway and you'll be sent a link to the recording.
08:51
September 10, 2019
General Jim Mattis on Leadership, Mistakes, and Defining Problems
General Jim Mattis on Leadership, Mistakes, and Defining Problems
http://www.leanblog.org/audio287 General Jim Mattis has been making the rounds to talk about his new book that is out today: Call Sign Chaos: Learning to Lead. "Learning to Lead" sounds like it could be the title of a book about Lean management. We're learning how to lead people, to lead improvement, to lead organizations. You might say we're "practicing leadership," myself included. A few things jumped out from an article and an NPR interview with Mattis that made me think about Lean and the challenges we face in various workplaces. 
08:25
September 03, 2019
Third Time's the Charm for the Iced Tea -- On Errors, Blame, and Process
Third Time's the Charm for the Iced Tea -- On Errors, Blame, and Process
http://www.leanblog.org/audio286 This past weekend, an old friend came down from Michigan to spend two days in the Dallas area. Amongst the activities and catching up, we went bowling -- something I did a lot of as a kid and something my friend and I usually do when we get together. I ordered a drink -- not a Lean whiskey, perhaps surprisingly -- but this: "An UN-sweetened iced tea, please"
05:14
September 02, 2019
Mark Graban Interviewed by KOGO Radio, San Diego
Mark Graban Interviewed by KOGO Radio, San Diego
http://www.leanblog.org/audio285 This is a radio segment from the KOGO morning news on August 23rd, 2019. LaDona Harvey: When it comes to your career path, your family’s financial future, or even a weight loss journey, focusing on little setbacks can throw a real wrench in your progress. Ted Garcia: Joining us on the KOGO news live, the author of, “Measures of Success. React Less, Lead Better, Improve More,” Mark Graban. Good morning, Mark. Mark Graban: Good morning.
04:15
September 02, 2019
Embracing and Helping Surgeons Accept Change -- Instead of Blaming & Labeling Them
Embracing and Helping Surgeons Accept Change -- Instead of Blaming & Labeling Them
http://www.leanblog.org/audio284 Here is an article that caught my eye recently, from HBR: "How One Health System Overcame Resistance to a Surgical Checklist"
04:12
August 23, 2019
What Chefs and Restauranteurs Say About Learning From Failures & Mistakes
What Chefs and Restauranteurs Say About Learning From Failures & Mistakes
http://www.leanblog.org/audio283 Anyway, this article caught my eye the other day: Top Chefs and Restaurateurs on the Best Lessons They Learned from Failures Check out the article for the detail, but here are the five lessons and I think they apply to Lean and other things we practice, with my commentary…
04:02
August 20, 2019
Bob Lutz on Tesla, Threats, & Communication About Quality - and Implications for Healthcare
Bob Lutz on Tesla, Threats, & Communication About Quality - and Implications for Healthcare
http://www.leanblog.org/audio282 Hat tip to Stan Feingold from StoreSMART (a Lean Blog sponsor) for sending me this article: Bob Lutz Talks Panel Gaps, Tesla, and Why Every Detail Matters -- Getting it right starts at the top.
04:55
August 18, 2019
Lean: A Combination of "Why?" and "Why Not?"
Lean: A Combination of "Why?" and "Why Not?"
http://www.leanblog.org/audio281 When we have really sticky, complicated problems (like the widespread healthcare patient safety and quality problems), I think it's interesting to think about problems in the following terms... for a particular problem, which is true? It can't be solved (in general) That organization can't solve it (don't know how?) They won't solve it They don't need to solve it When we look at patient safety, there are many examples that show improvement is possible. So, it comes down to a question of "can't, won't, or don't need to?"
07:34
August 16, 2019
When Having a Process Improvement Idea Means You're Weak?
When Having a Process Improvement Idea Means You're Weak?
http://leanblog.org/audio280 I guess I'm wired for improvement. Or, it's just become a habit. Or, it's both. I celebrate moments when I can identify an opportunity for improvement in my work. I tend to be pretty transparent about problems and even mistakes (like forgetting my socks).  The Toyota-ism of "No problems is a problem" resonates with me. Identifying a problem shouldn't bring blame and shame... it's the first step in improving the way work is done. I'm fortunate that we've built a culture at KaiNexus where problems and opportunities are celebrated. It's safe for people to speak up and problems lead to improvement, not punishment. Our book Healthcare Kaizen shares stories and examples from organizations that have built a strong and sustained culture of continuous improvement. I almost take it for granted that improvement is a positive thing.
07:02
June 24, 2019
Come See a Culture of Continuous Improvement at Franciscan Health This October!
Come See a Culture of Continuous Improvement at Franciscan Health This October!
http://www.leanblog,org/audio279 Registration is open for "Kaizen Live!" -- the 2019 edition. Joe Swartz and I are excited to announce that we are hosting the fourth site visit to his organization, Franciscan St. Francis Health, in Indianapolis. It's being held October 3 and 4, with an optional workshop on October 2nd.  Click here to learn more. You'll find links to the registration page and be sure to check out the early registration and group rate discounts that are available.
04:30
June 24, 2019
Inside Toyota's Takaoka #2 Line - Flexibility and Kaizen
Inside Toyota's Takaoka #2 Line - Flexibility and Kaizen
This is an interesting article: Inside Toyota's Takaoka #2 Line: The Most Flexible Line In The World I had a chance to visit the 'Takaoka #1" line in February 2018 as part of my tour with Kaizen Institute. This article makes me wish we had been able to see Takaoka #2, but that sounds like a somewhat rare and special opportunity (even more special than visiting Toyota is normally).
08:31
June 11, 2019
Toyota, Respect for People (or "Humanity") and Lean
Toyota, Respect for People (or "Humanity") and Lean
From 2013 -- http://www.leanblog.org/audio277 A principle that has been often discussed (and hopefully practiced) in the Lean community over the past few years is usually described as “respect for people.” A certain British rabble rouser recently said the following at a Lean conference: “All this respect for people stuff is horse sh*t,” and it is a “conventional Western management interpretation.” He mocked the idea of “respect for people programs,” although I'm not sure where such a standalone program has ever been attempted. That sounds like a strawman, the idea that a company would have a “respect for people” program. Let me explain why he's wrong — “respect for people” is not horse sh*t” — and we can explore some great links on “respect for people” in this post.
09:11
May 25, 2019
How PBCs (Process Behavior Charts) Can Enhance the Practice of OKRs (Objectives & Key Results)
How PBCs (Process Behavior Charts) Can Enhance the Practice of OKRs (Objectives & Key Results)
https://leanblog.org/audio276 "Over the past year, I've heard about the “OKRs” methodology that is used in tech companies like Google. OKRs stands for Objectives & Key Results.  The approach (along with examples and case studies) are laid out in the book by venture capitalist John Doerr, Measure What Matters: How Google, Bono, and the Gates Foundation Rock the World with OKRs."  There are things I like about this model... and it reminds me of the Lean "Strategy deployment" practice... but I think it would be better with "Process Behavior Charts." #okrs #OKR #leanstartup #leanmanagement #business 
17:57
May 20, 2019
My Talk: When Being Right is the Wrong Strategy for Change
My Talk: When Being Right is the Wrong Strategy for Change
I always enjoy the KaiNexus User Conference (now called KaiNexicon starting this year) and they ask me to give a talk each year. Last year, I gave a talk called “When Being Right is the Wrong Strategy for Change” and KaiNexus recently shared a nicely-shot video of that talk on YouTube. So. I'm sharing that here... and the blog post has a transcript I had done, annotated with some slides and links. You can also read a shorter summary via the KaiNexus blog. http://www.leanblog.org/audio275
36:45
May 17, 2019
When Old Habits and Old Science No Longer Make Sense - Evidence vs. Habit in Medicine and #Lean
When Old Habits and Old Science No Longer Make Sense - Evidence vs. Habit in Medicine and #Lean
http://www.leanblog.org/audio274 I find it really interesting when scientific facts and truth get superseded by new evidence. Science isn't supposed to be stubborn… it's OK to cast aside the old status quo when we learn something new (pay attention, “flat Earth” crowd). There are a lot of these themes, also, in a book I've been reading, The Case Against Sugar, by Gary Taubes. Some of the established science about low-fat diets being good for us might not really be true. How does this all apply in medicine and our practice of Lean?
14:11
May 16, 2019
Family Guy Skewers Marie Kondo (and 5S and Lean too?)
Family Guy Skewers Marie Kondo (and 5S and Lean too?)
I haven't read it, but Marie Kondo's book The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing has been a pop-culture phenomenon the past few years. I've seen some compare her process to the Lean practice of “5S.” Kondo says you should only keep an item if it “sparks joy.”
06:37
May 13, 2019
A Hospital CEO Who Wants Other CEOs to “Give a Damn” About Their People
A Hospital CEO Who Wants Other CEOs to “Give a Damn” About Their People
Here's an interesting column from Becker's Hospital Review, written by Michael Dowling, President and CEO, Northwell Health. I'm guessing he created the headline, since the phrase “give a damn” doesn't appear in the article: "Michael Dowling: CEOs — Give a damn about your people" Who are the CEOs he is speaking to who do NOT give a damn? What inspired him to write this?
08:00
May 01, 2019
On Boeing, GM, and Hospitals… and Epic Battles Between Reality and Spokespeople?
On Boeing, GM, and Hospitals… and Epic Battles Between Reality and Spokespeople?
Yesterday's blog post was about a situation (with my podcast hosting service) that triggered memories of my time at General Motors in 1995. Today's post is about a recent article on Boeing that definitely caused me to think of that broken, dysfunctional “pre-Lean” culture that I suffered through (and learned from) in my first year at GM. In 1995, nobody claimed GM was Lean so the expectations were low. They were who they were and my new plant manager in 1996 started to change things. Boeing is a company that has been pointed at as a great example of Lean Manufacturing, so it's troubling to read reports that suggest otherwise. From the New York Times: Claims of Shoddy Production Draw Scrutiny to a Second Boeing Jet Workers at a 787 Dreamliner plant in South Carolina have complained of defective manufacturing, debris left on planes and pressure to not report violations.
16:60
April 30, 2019
On Podcast Server Downtime, Scars from General Motors, and Taking Ownership of My Situation
On Podcast Server Downtime, Scars from General Motors, and Taking Ownership of My Situation
Episode #270 Ever since I started podcasting in 2006, I've been using a company called “Hipcast” to be the “hosting” company for the podcast audio files and feeds. For those of you not familiar with podcasting, that's the website where I upload podcast audio files… and they then serve those files when requested by services like Apple Podcasts or Spotify. This has been an aggravating week or so, since Hipcast has been having a lot of technical issues going back to last Tuesday or so. Their website has been down, the podcast feeds (RSS feeds) have been broken. People haven't been able to listen to my podcasts unless they had already downloaded the episodes through their app.
12:46
April 29, 2019
Is "Kaizen" a Slogan or a Methodology for the Seattle Marine
Is "Kaizen" a Slogan or a Methodology for the Seattle Marine
Is "Kaizen" a Slogan or a Methodology for the Seattle Mariners? Here is an interesting article that a few people pointed me toward the other day about the Seattle Mariners team: Mariners Sunday mailbag: Explaining the Japanese origin of the team's new slogan “Manager Scott Servais does have a mantra each year for the team, which is supposed to serve as a reminder of their purpose and responsibility… This year, Servais chose a Japanese word: Kaizen. An avid reader, Servais got it from a book by Masaaki Imai called Kaizen: The key to Japan's competitive success.”
04:55
April 22, 2019
The CEO Leading the Culture Change at ZSFGH
The CEO Leading the Culture Change at ZSFGH
Today, I'm writing about another view, from an article co-authored by our friend Dr. John Toussaint and the CEO of ZSFGH, Dr. Susan Ehrlich: Changing Leadership Behavior Gets Real Results As I blogged about yesterday, new leadership behaviors (sometimes as the result of getting a new leader) can make a huge difference for an organization — this was true during my time at General Motors and I've seen it in healthcare.
09:22
April 16, 2019
A Lean Guy Reads "Health Leaders" on Nursing Retention
A Lean Guy Reads "Health Leaders" on Nursing Retention
Today, I'm reading the latest issue of Health Leaders magazine (March/April 2019) whose cover features a number of stories about nursing retention. The lead article shares some data about recruitment and retention. The article says that 17% of “newly licensed RNs” leave their first nursing job “within the first year.” 33% leave within two years. Instead of blaming nurses for leaving, better organizations are looking in the mirror to see what they can do to improve the work environment. That's always been one of my primary motivations for Lean in any workplace — providing a better, more fulfilling work setting.
08:45
April 15, 2019
WSJ News Flash: Developing Better Leaders Makes a Difference
WSJ News Flash: Developing Better Leaders Makes a Difference
Here's an interesting recent article from the Wall Street Journal (you might require a subscription to read it): The Economy's Last Best Hope: Superstar Middle Managers Anemic growth, millennial malaise, you name it–blame a lack of inspiring bosses I'll comment first that organizations that have high aspirations of “Lean Transformation” need to have “transformational leaders.” Sadly, those transformational leaders seem to be few and far between. How many organizations have “bureaucrats” at the helm?
05:02
April 10, 2019
Lean Should be Solution to Hospital Overwork or Understaffing
Lean Should be Solution to Hospital Overwork or Understaffing
Lean Should be the Solution to Hospital Overwork or Understaffing
14:24
January 30, 2019
Toyota as a "People Development Company"
Toyota as a "People Development Company"
When I had the chance to go back to Japan last October with Honsha, there was a big focus on what the former Toyota people kept referring to as "a development company." The meaning was that Toyota (and companies with similar performance) focus first and foremost on developing people.
12:31
January 14, 2019
Value is Defined by the Customer...
Value is Defined by the Customer...
Value is Defined by the Customer (and not all Customers are the Same) http://www.leanblog.org/audio263 It's said in the Lean methodology that “value is defined by the customer.” Value can be defined as, in most cases, “Something the customer is willing to pay for.” In healthcare, this gets complicated when patients aren't the ones paying and when patients need care instead of wanting it.
07:01
January 09, 2019
For Big Leaps With New Year’s Resolutions, Start With
For Big Leaps With New Year’s Resolutions, Start With
For Big Leaps With New Year’s Resolutions, Start With Baby Steps Thanks to the Lean Enterprise Institute for publishing my article about Kaizen, new habits, and New Year's resolutions: Take Baby Steps Towards Improvement Get the link: http://www.leanblog.org/audio262
07:48
January 08, 2019
LinkedIn Post: The Carrot and The Stick “On Steroids”
LinkedIn Post: The Carrot and The Stick “On Steroids”
Back in 2013, I wrote a post that I published as part of the LinkedIn Influencer series: The Carrot and The Stick “On Steroids” Please check it out. I hope it makes you chuckle and think.
05:54
August 16, 2018
React Less and Improve More by Using SPC More Effectively
React Less and Improve More by Using SPC More Effectively
It's been a while since I've contributed something to the Lean Enterprise Institute's online publication, The Lean Post (see past articles). Today, they're allowing me to introduce some ideas from my book Measures of Success. Many "Lean thinkers" just haven't been exposed to these ideas. Many haven't read Deming or Wheeler... it's not their fault for not knowing of Process Behavior Charts and methods like this. But, I hope this post helps people see that "bowling charts" and "red/green" analysis are not the only way (or the best way) to look at metrics. My article: "React Less and Improve More by Using SPC More Effectively"
16:19
August 14, 2018
#Lean Shouldn't be a Reason for Nurses to Strike
#Lean Shouldn't be a Reason for Nurses to Strike
A retired labor leader from the automotive industry (who reads this blog) sent me a link to this article: #RedforMed: 1,800 Vermont Nurses Are On Strike Demanding Their Hospital Put Patients Over Profits The article isn't from a newspaper; it's from a site that provides "independent and incisive coverage of the labor movement and the struggles of workers to obtain safe, healthy and just workplaces." Again, for the record, I'm all in favor of "safety, healthy, and just workplaces." That's what Lean management aims to deliver.
08:27
August 13, 2018
“ER wait times down, but only slightly” ??
“ER wait times down, but only slightly” ??
http://leanblog.org/audio258 “ER wait times down, but only slightly” or ER wait times are virtually the same? This article was sent by a friend and blog reader from Winnipeg the other day: “ER wait times down, but only slightly” Oh good, the waiting times are down. But what does “only slightly” mean? Have ER wait times gone down in a meaningful way? Or are they just comparing two data points? Is this “down” a signal or is it just noise in the system? These are the types of questions that can be answered by methods in my new book Measures of Success: React Less, Lead Better, Improve More
13:29
July 23, 2018
The Catch-22 of #Lean & Kaizen: You Get More ROI by NOT...
The Catch-22 of #Lean & Kaizen: You Get More ROI by NOT...
The Catch-22 of #Lean & Kaizen: You Get More ROI by NOT Focusing Only on High-ROI Projects http://www.leanblog.org/audio257
06:49
July 19, 2018
Leaders & Lean: We Need to Better Support Doctors and
Leaders & Lean: We Need to Better Support Doctors and
Leaders & Lean: We Need to Better Support Doctors and Other Providers When surgeons have no better options than complaining about process problems on LinkedIn, are their leaders and organizations really properly supporting them? In this post, we'll explore questions of blame, accountability, and engaging people in process improvement... being of better service to them.
10:00
April 17, 2018
My Talk in Vegas: Leadership Lessons from Statistics and Psych
My Talk in Vegas: Leadership Lessons from Statistics and Psych
My Talk in Vegas: Leadership Lessons from Statistics and Psychology Today, I’m giving a keynote talk at the Lean & Six Sigma World Conference being held in Las Vegas. I don’t normally attend or speak at “Lean Sigma” events, but I had an opportunity to give a new talk that touches on two of my favorite themes in recent years – the need to apply statistics and psychology to our “Lean Management” practices or Six Sigma or whatever. I also bury the lede and talk about the soft launch of my book "Measures of Success."
18:29
April 03, 2018
Elon Musk, Safety, and Leadership at Tesla
Elon Musk, Safety, and Leadership at Tesla
What's Going on at Tesla? Is @ElonMusk Following up on Employee Injuries? There's a lot to admire about Elon Musk. I admire his risk taking and his entrepreneurial spirit. I use PayPal a lot (one of his early companies) and I admire the innovation of Tesla and SpaceX. But, I question how much Musk and Tesla have been willing to learn from Toyota. I saw this article last year and never got around to blogging about it: "This Email From Elon Musk to Tesla Employees Is a Master Class in Emotional Intelligence"
11:26
March 12, 2018
What's Going on at Whole Foods? It Doesn't Sound Like Lean...
What's Going on at Whole Foods? It Doesn't Sound Like Lean...
The chain Whole Foods is reportedly having inventory shortages and morale problems. It sounds like a real mess, but thankfully nobody is calling it Lean. Their "Order to Shelf" system reminds me of "Pull to Order" work that I was involved in at Dell about 20 years ago...
12:02
February 16, 2018
Tour Preview: The Japanese Health Care System at a High Level
Tour Preview: The Japanese Health Care System at a High Level
Tour Preview: The Japanese Health Care System at a High Level As I prepare to go back to Japan, I'm sharing some insights about the Japanese health system from the excellent book "The Healing of America," by T.R. Reid.
10:11
February 13, 2018
The WSJ Overgeneralizes about The "Japanese Model," Not...
The WSJ Overgeneralizes about The "Japanese Model," Not...
The WSJ Overgeneralizes about The "Japanese Model," Not All Companies Are Toyota Not all Japanese companies are the same. "Lean isn't easy" if you're a Japanese company. Toyota has created something special, since "Toyota culture" is not exactly the same as "Japanese culture." The WSJ says the "model is cracking." Do scandals involving quality and ethical lapses involving companies including those and Nissan tarnish Lean and the Toyota Production System? No. That's as silly as thinking the Wells Fargo banking scandal tarnishes Silicon Valley (although the Valley does enough to tarnish itself).
10:29
February 13, 2018
#Lean Can Be Very Fragile, Especially With Executive Changes
#Lean Can Be Very Fragile, Especially With Executive Changes
#Lean Can Be Very Fragile, Especially With Executive Changes Lean can be very fragile. History shows that Lean can fall apart even in an organization that is years into a "Lean journey" with strong CEO involvement. How is this possible? If often happens when a new CEO is brought in from the outside. In the case of the manufacturing company, Wiremold, it happened when they were acquired by a French company, Legrand. As an aside, the team that coined the term "Lean" almost used the term "fragile," as I blogged about here. Back in 2007, Bob Emiliani joined me for Episode #30 of the podcast. As we revisit the podcast and the new transcript I had made, what are the lessons for manufacturers or hospitals? What's the risk that's created when new leadership takes over?
09:26
February 05, 2018
Employee Complaints About Lean in Healthcare, Even at...
Employee Complaints About Lean in Healthcare, Even at...
Employee Complaints About Lean in Healthcare, Even at Some of the Best Organizations Last week, I blogged about some employee complaints related to rotating day and night shifts at the Toyota San Antonio plant. In that post, I mentioned that employees who post on Glassdoor.com and other sites might not be a representative sample of the full employee population. With that in mind, what happens when we search the Glassdoor surveys of some well-known "Lean hospitals?" I posted a few of these employee comments on LinkedIn the other day (a short post that has received over 50,000 views and prompted a lot of discussion).
08:22
February 04, 2018
Somebody *Did* Get Unjustly Fired in Hawaii, But System...
Somebody *Did* Get Unjustly Fired in Hawaii, But System...
Somebody *Did* Get Unjustly Fired in Hawaii, But System Problems Should be Blamed TL;DR Summary: "Employee 1" (the guy who pushed the "wrong" button) got fired. But the FCC report says: "The report finds that the false alert was not the result of a worker choosing the wrong alert by accident from a drop-down menu, but rather because the worker misunderstood a drill as a true emergency. The drill incorrectly included the language "This is not a drill."  So, the language from the drill didn't meet the standard for what the drill language is supposed to say. So, how is it fair to fire the worker who heard "this is not a drill?"
08:22
February 04, 2018
"What would you say... you do here?" -- 2018 Edition
"What would you say... you do here?" -- 2018 Edition
I often get asked a question along the lines of "So, what exactly do you do?" Today, I give some updates about my various projects and partnerships, including continuing with KaiNexus (with a different title) and a new partnership with Value Capture.
05:32
January 22, 2018
My Thoughts on Standardized Work and #Lean
My Thoughts on Standardized Work and #Lean
I've written about many of these ideas and themes before in various blog posts, but I wanted to consolidate my thoughts on the Lean concept of "standardized work" in a single place. This is partly for my own personal reference (and future linking), but also can prompt some discussion amongst my friends, the Lean Blog readers.
15:23
January 18, 2018
What We're Looking Forward to Learning at Toyota
What We're Looking Forward to Learning at Toyota
What We're Looking Forward to Learning at the Toyota Plant Tour Tomorrow, with the entire KaiNexus team, I'm going to visit the Toyota truck plant in San Antonio, the plant referred TMMTX. The 15 of us will be there in closed toed shoes and all other required clothing to learn about the Toyota Production System, Kaizen (continuous improvement), and Lean. I've blogged about it on the KaiNexus blog. I asked the KaiNexus team to say a little bit about what they hope to learn in the visit and you can read their comments it here. In this post, I share a 24-minute tour preview webinar that I put together, links to past tour blog posts, and more.
11:24
January 16, 2018
What the Book "Lean Thinking" Said About Healthcare...
What the Book "Lean Thinking" Said About Healthcare...
What the Book "Lean Thinking" Said About Healthcare in 1996 http://www.leanblog.org/audio244 When the book Lean Thinking (by Jim Womack and Dan Jones) was originally published in 1996, it seems likely that hardly anyone was applying Lean principles in healthcare. Sure, you had organizations applying TQM or CQI principles (or even some of the lessons of Dr. W. Edwards Deming). Joan Wellman did some of her first Lean healthcare experiments in 1995, but there weren't any "Lean healthcare" case studies yet. What does their book say?
04:55
January 15, 2018
The Response to the Hawaii False Alarm...
The Response to the Hawaii False Alarm...
The Response to the Hawaii False Alarm Can't End With Firing Someone -- This and other nuclear threats due to bad systems http://www.leanblog.org/audio243 Saturday, you might have seen the news about a "false alarm" push alert that was sent to many iPhones and other smart phones in Hawaii. An alert was also sent out over many TV channels through the Emergency Response System. Is the response one that focuses on blame and punishment? Or is it focused on understanding how systems fail and how to improve them to prevent future recurrence? How does this all apply to your organization?
16:16
January 14, 2018
Did Toyota's Mindset Really Leave the (Now) Tesla...
Did Toyota's Mindset Really Leave the (Now) Tesla...
Did Toyota's Mindset Really Leave the (Now) Tesla Building? Tesla builds cars in what used to be the NUMMI factory, a joint venture between Toyota and GM (which meant it was run as a Toyota plant with "Lean" practices). Before that, it was a dysfunctional GM plant. Now that it's a Tesla plant, did they learn from Toyota or does it seem more like "the old GM?"
25:41
December 05, 2017
A Powerful Message from Toyota's President
A Powerful Message from Toyota's President
A Powerful Message from Toyota's President, Akio Toyoda: No Best, Only Better In today's post, I share and write about this message from Akio Toyoda that was posted online: “Making Ever-better Cars and Human Resource Development: The Forces That Power Sustainable Growth“
08:11
December 04, 2017
Should #Lean Conferences Add a "Code of Conduct" for S
Should #Lean Conferences Add a "Code of Conduct" for S
Should #Lean Conferences Add a "Code of Conduct" for Speakers and Attendees? In today's post, I pose a question: Should the major Lean conferences adopt or adapt a practice that's now common at tech events, including Agile and Lean Startup events: a "Code of Conduct" for participants and attendees. Is this a countermeasure to a problem that doesn't exist in the Lean community? Or, is it still good to proactively encourage people to speak up to conference organizers if they are subject to bad behavior during the event? In this post, I get feedback and thoughts from the Lean Enterprise Institute, AME, Catalysis, Lean Frontiers, and the Shingo Institute.
14:26
November 07, 2017
#ChangeChampions at Franciscan St. Francis Health
#ChangeChampions at Franciscan St. Francis Health
#ChangeChampions at Franciscan St. Francis Health - in Supply Chain and Beyond Today, I'd like to share the second in my series of articles about "Champions of Change." Here, we feature my friends at Franciscan St. Francis, the health system of my Healthcare Kaizen co-author Joe Swartz. As I wrote about in the first article in this series, successful and innovative organizations have "champions of change" at all levels of the organization, and we see that at Franciscan. You can read the article over at Becker's Hospital Review: Champions of Change Make the Difference at Franciscan Health Or you can download a PDF from Cardinal Health.
07:44
November 06, 2017
Highlights from a Great Book: "The Leader's Handbook"
Highlights from a Great Book: "The Leader's Handbook"
I've been going through the book by the late Peter Scholtes: The Leader's Handbook: Making Things Happen, Getting Things Done. His work builds upon the legendary W. Edwards Deming and Russell Ackoff, among others. I often quote Scholtes (something also attributed to Peter Senge and others) as saying: "People don't resist change, they resist being changed." I think that's very insightful and that thought has led me to study change management, "motivational interviewing" and other related topics. It turns out that having the right answer and pushing it on others isn't the best strategy for effecting sustainable change. I had to learn those lessons the hard way and I'm still learning.
13:13
October 30, 2017
Looking for “Champions of Change” in Healthcare Supply
Looking for “Champions of Change” in Healthcare Supply
Who are the "champions of change" in your organization? Is your CEO a champion of change? How many of your front-line managers and staff are champions of change? Are you? What does it mean to be a champion of change? Today, I'm sharing an article that I've written on this subject... and I'd love to hear your stories about champions of change. Please share your stories on Twitter or LinkedIn with the hashtag #ChangeChampions. Or, you can post a comment below. Click the following link to download a PDF version of the article: "The Essential Ingredient to Improving the Hospital Supply Chain" You can also read the article on Becker's Hospital Review.
02:29
October 23, 2017
Of Course Doctors Hate Being "Excluded" From Attempts
Of Course Doctors Hate Being "Excluded" From Attempts
Of Course Doctors Hate Being "Excluded" From Attempts to Improve Thanks to those of you who sent me this HBR article: Doctors Feel Excluded from Health Care Value Efforts Long story short... brought to you by Bain consultants: Doctors don't like being excluded and organizational satisfaction goes up when you engage and include people. Brilliant! Obvious?
04:26
October 10, 2017
Healthcare People: Study Lean and Kaizen in Japan
Healthcare People: Study Lean and Kaizen in Japan
Come Join Me to Study Lean & Kaizen for Healthcare: Japan 2018 In the past year or two, it seems like I have heard more about people and organizations leading Lean study trips to Japan. This has gone on for decades, but there seems to be a resurgence. I first partnered with Kaizen Institute in 2012 to lead a "Lean Healthcare" study tour, we did another in 2014, and we're actively planning our next trip in early 2018. Click here to learn more via a web page that I run. You can also click here for a PDF that previews the 2018 tour. Registration has not yet opened, but contact me if you'd like to be notified with details. The dates are February 26 to March 2, 2018. Details are still being finalized, but the tour would start in Tokyo and end in Nagoya. The plan is to not just visit some hospitals that are leaders in Lean and quality improvement practices, but to also visit Toyota and some other world-class organizations. The trip costs 5400 euros, which is currently about $6300. This cost includes everything from the start of the tour on Monday morning to the end on Friday evening. Your airfare to Japan and back is a separate, independent cost to you. In the past two trips, we've had a very international group (a majority of attendees have been from Europe and Asia). This creates a special opportunity to not just learn from our Japanese hosts, but to compare notes and learn from others around the world. Our trips are intentionally a mix of hospital visits and other types of organizations that we can all learn from. It's great to see a Japanese hospital with a CEO who has been leading their quality and continuous improvement efforts for 20+ years and to hear their perspectives. At the same time, the hospitals we have visited were, at the time of our visits, relatively new to formal "Lean" practices - as they were building upon their "Total Quality Management" engagement and improvement practices... something that was NOT a fad for these hospitals or their leaders. These trips are rich learning experiences. It's not just the formal visits, but the time talking on buses and trains, the meals together, and the networking and sharing that, for me, has continued with attendees long after the week is over. Here are my past blog posts about visiting Japan, with a few links below.
04:25
October 09, 2017
Toyota Helps a Young Inventor; Look at His Dad's Toyota...
Toyota Helps a Young Inventor; Look at His Dad's Toyota...
it's great to see an 11 year old thinking like an engineer and an entrepreneur. He's the son of a Toyota "operational excellence" consultant. For those who try to unfortunately equate Lean to a "clean desk policy," the father's desk is a great argument against banning family photos and an illustration of why Lean isn't about putting tape around everything...
11:49
October 04, 2017
#Lean Enterprise Institute Announces New CEO
#Lean Enterprise Institute Announces New CEO
The Lean Enterprise Institute (a former employer of mine from 2009 to 2011) has announced a new CEO, the third in their history following founder James P. Womack and his successor, John Shook. Their press release: Lean Enterprise Institute Names Eric Buehrens New CEO The start of the release: "The nonprofit Lean Enterprise Institute, a global leader in lean thinking and practice, today announced the appointment of Eric Buehrens as its new CEO. The appointment took effect October 1, 2017. A proven lean thinker and leader, Buehrens led lean transformations at Beth Israel Deaconess Medical Center, where he served as COO and Interim CEO, and at Reliant Medical Group, a Massachusetts group medical practice, where he was COO."
05:20
October 03, 2017
"Our Hospitals Are Killing Us“ (1966)
"Our Hospitals Are Killing Us“ (1966)
Three or four months ago, in the midst of a discussion on LinkedIn about patient safety, somebody made reference to a 1966 cover story from the magazine "Look." Look was a very popular competitor to "Life" and the "Saturday Evening Post," so this was written for a very general public audience. The cover tease reads: "OUR HOSPITALS ARE KILLING US An alarming report on conditions in many American cities"
19:30
September 26, 2017
Free Webinar Today on #Lean Collaboration Across Companies
Free Webinar Today on #Lean Collaboration Across Companies
Free Webinar Today on #Lean Collaboration Across Companies and Industries I hope you'll join me today for a KaiNexus webinar that I'm hosting. The topic is near and dear to my heart (as well as to others at KaiNexus): collaboration, learning, sharing. Effective Collaboration Across Organizations and Industries Our presenters will be Teresa Hay McMahon, the Executive Director of the Iowa Lean Consortium and one of the ILC members, Stephanie Hill, Corporate Continuous Improvement Manager at Kreg Tool Company. Kreg is, coincidentally, a KaiNexus customer. It's at 1 PM ET, but if you can't attend it live or didn't see this post in time, you will be sent a link to a recording if you register.
05:57
September 21, 2017
Texas Hospital Saves Money Occasionally With Lean Six Sigma
Texas Hospital Saves Money Occasionally With Lean Six Sigma
Texas Hospital Saves Money Occasionally With Lean Six Sigma... But Can Do More, More Often? I saw this headline the other day about University Medical Center in Lubbock, Texas: "UMC finds savings through waste"
07:36
September 20, 2017
This Organization Chose Not to "Deploy #Lean" Because...
This Organization Chose Not to "Deploy #Lean" Because...
This Organization Chose Not to "Deploy #Lean" Because a Leader Thought it is Not Customer Focused? I posted an article on LinkedIn last week as a companion article and summary of my podcast with Dean Gruner, MD, the recently retired CEO of ThedaCare. That article: "A Retired Hospital CEO Shares the Employee Feedback That was 'A Bucket of Cold Water to the Face.'" There have been over 125 comments so far... but one has me scratching my head. It read: "I looked at deploying Lean within our PNO, and ultimately decided against it, in part for two reasons: because Lean is about doing the same thing, albeit better and it is not as much customer/outwardly focused as we need in healthcare." Lean is not customer/outwardly focused? I hope this isn't a widespread perception or belief out there. I hope I'm overreacting to something that's not really a problem... but I wrote the post anyway.
07:29
September 12, 2017
Toyota Helps Children's Health Dallas Reduce Some CLABSIs
Toyota Helps Children's Health Dallas Reduce Some CLABSIs
I've long been appreciative of the work that Toyota does, through their non-profit TSSC subsidiary, to help non-profits and community organizations improve. The latest example of that is some work done at Children's Health in my other backyard, in Dallas: "Children's Health Joins Forces with Toyota to Improve Patient Safety and Quality of Care" As it says in the release: "Through a collaboration with Toyota, Children's HealthSM, the leading pediatric health system in North Texas, announced today it has successfully reduced rates of central line-associated blood stream infections (CLABSIs) by 75 percent with patients in the gastroenterology unit."
07:08
September 11, 2017
Variation in Definitions of #Lean (The Good, the Bad...
Variation in Definitions of #Lean (The Good, the Bad...
One challenge with teaching Lean is that there isn't aways a consistent definition that's used by everybody. Some of the definitions are really bad. Some of them are just different from others. Let's start with "different." Is a lack of standardization in definitions of Lean a problem?
08:27
August 30, 2017
"Practicing Lean" Audiobook is Released! And a New Essay
"Practicing Lean" Audiobook is Released! And a New Essay
I'm excited to announce that the audiobook version of our book Practicing Lean is complete! It's available for purchase via LeanPub.com and it might be available through other channels in the future. The audiobook is nearly seven hours of audio, which is the entire book, completely unabridged. As per the LeanPub.com approach, you can choose your own price. The suggested price is $24.97, but you can pay as little as $9.97 -- and you can pay as much as you want, considering ALL proceeds are being donated to the Louise H. Batz Patient Safety Foundation (about $2500 so far). Click here and choose the "Book + MP3 Audio Book" option, along with your price and you'll be able to download all of the MP3 files.
04:33
August 29, 2017
How NOT to Improve Patient Flow: Laws, Targets, Blame,
How NOT to Improve Patient Flow: Laws, Targets, Blame,
Let's start by stating the obvious: it sucks to wait 24 hours or more on a stretcher in an emergency department hallway waiting for a real hospital bed. It's sad and frustrating to have a couple of blog readers from Canada send me this story from Quebec: Quebec wants 24-hour cap for patients waiting on stretchers in ERs Barrette says there would be consequences for hospital staff, doctors who don't comply I think there's agreement that waiting 24 hours, 12 hours, or four hours for a bed after an admission is a problem. That's a problem worth working on.
10:11
August 29, 2017
Aim for "Effectiveness" in Your Gemba Walks, Not "Effi
Aim for "Effectiveness" in Your Gemba Walks, Not "Effi
This is an elaboration on something I originally posted on LinkedIn. I saw somebody touting an approach that would guarantee "maximum efficiency for your management gemba walks." Ah, the efficiency trap. Is efficiency really the goal here? Efficiency is usually defined as outputs divided by inputs. Visiting more departments more quickly would increase "efficiency." Shouldn't the goal there be "maximum effectiveness?"
03:39
August 24, 2017
Monday's #SolarEclipse: Supply Chain Challenges and Eye
Monday's #SolarEclipse: Supply Chain Challenges and Eye
Any rare event creates a number of challenges when it comes to manufacturing and supply chains. We're seeing a pretty historic "spike" in demand for products like the inexpensive glasses that allow one to safety view the eclipse (our friends in the totality zone can look at the totally-eclipsed sun safely, but that's the only time). You could call it "supply chain challenges" or a "lack of planning on my part," but I cannot find eclipse glasses anywhere. There are MANY articles online about this widespread problem -- it's been impossible to buy "eclipse glasses" anywhere. Why is this? What could have been done?
15:16
August 23, 2017
Highlights of "Boss Level Podcast" - Gen. Stan McChrystal
Highlights of "Boss Level Podcast" - Gen. Stan McChrystal
Highlights of "Boss Level Podcast" - Gen. Stan McChrystal and the Book "Team of Teams" I've read most of retired General Stanley McChrystal's excellent book Team of Teams: New Rules of Engagement for a Complex World (I start a lot of books and finish a few). Amazon reminds me that I bought the book just over two years ago. I meant to blog about it and never got around to it (I have a lot of ideas about posts and write a few). McChrystal, in connecting his lessons learned from helping reshape the military and, in particular, the special forces, to the business world ends up talking a lot about issues and history near and dear to those of us working with Lean as a methodology. I'll come back to my thoughts on the book later, but I was thrilled to stumble across a podcast called "Boss Level Podcast," which is hosted by Sami Honkonen from Finland.
08:48
August 17, 2017
My Webinar: Standardize What Makes Sense...
My Webinar: Standardize What Makes Sense...
Today at 3 PM, I'm doing a webinar at the invitation of the BC Patient Safety & Quality Council, as part of their "Quality Café" series. Thanks for the invitation! It's open to the public and it's titled: "Standardize What Makes Sense... Then Engage Everybody in Improving What You Standardized" I hope you can join us...
09:42
August 16, 2017
Does Being Giddy With Knowledge About Wine or Lean Cau
Does Being Giddy With Knowledge About Wine or Lean Cau
I enjoy "gemba visits" (of sorts) to wineries and vacations often focus on this walking, tasting, and learning. I usually read the wine column that's in the Wall St. Journal each Saturday, and this one stood out to me: "Do You Have What It Takes to Be a Sommelier?"
08:14
August 15, 2017
Dr. Don Berwick on Respect and Change at the Front Lines
Dr. Don Berwick on Respect and Change at the Front Lines
Back in 2012, I blogged twice about aspects of Dr. Donald M. Berwick's 1989 article in the New England Journal of Medicine titled “Continuous Improvement as an Ideal in Health Care.” The full text is only available to subscribers. As I posted on LinkedIn, another aspect of this article caught my eye when I was reviewing it the other day in advance of my talk at the Studer Group "What's Right in Healthcare" conference next week.
05:59
July 26, 2017
Change: Desire, Ability, Reason, Need, and Commitment
Change: Desire, Ability, Reason, Need, and Commitment
I'm excited to be attending the annual Lean Coaching Summit today through Thursday in Austin. If you're there, please say hi! Today, I've registered to take a class on a topic that I've taken an interest in over the past few years: "Motivational Interviewing," or MI for short. I'm hoping to learn more about coaching people through their stages of "change talk," as related to Lean and organizational change... and that's what today's post is about.
11:58
July 24, 2017
The Conundrum that is Dr. Deming on Metrics, Measures,
The Conundrum that is Dr. Deming on Metrics, Measures,
There are Dr. W. Edwards Deming quotes that get thrown around... one that sounds incredibly "pro-data" and others that say data and measures are not the only thing... which is it? How do you reconcile that?
07:58
July 16, 2017
Lean Healthcare Featured in Sunday's NY Times Business
Lean Healthcare Featured in Sunday's NY Times Business
An article from this week in 2010... Today's New York Times has an outstanding article about Lean Healthcare and what Seattle Children's Hospital calls C.P.I. or Continuous Performance Improvement. The article: "Factory Efficiency Comes to the Hospital" I wish the headline had also addressed quality, waiting time, and staff engagement, but the article body does, at least. The article highlights Seattle Children's Hospital, as well as others, including members of the Healthcare Value Network (Park Nicollet, Akron Children's, and Paul Levy's Beth Israel Deaconess Medical Center), and Virginia Mason Medical Center. Yours truly is quoted in the article, as well.
11:03
July 11, 2017
Is This a 5S Problem or a Broader Healthcare Leadership Issue?
Is This a 5S Problem or a Broader Healthcare Leadership Issue?
A few of you sent me this sad article from the Wall St. Journal:  "'People Are Dying Here': Federal Hospitals Fail Tribes."  I feel like I've some variation of this article and exposé many times over. Sometimes, it's some form of government medicine (active duty military medicine, the VA, or another country) or it's a similar sad story from the private healthcare sector (be it non-profit or for-profit).
14:06
July 11, 2017
The Power of "How Might We?"
The Power of "How Might We?"
In this post, I write about a phrase that I heard many times when visiting Franciscan St. Francis Health in Indianapolis. How can this phrase help us challenge ourselves and to find positive solutions instead of barriers and obstacles?
02:36
June 20, 2017
Is it a "Lean Transformation" or a "Lean Metamorphosis"?
Is it a "Lean Transformation" or a "Lean Metamorphosis"?
Does the Phrase "Lean Transformation" Jump to a Solution? Another in the series of "do words matter?" posts... do phrases like "Lean Transformation" resonate as much as "Business Transformation?"
08:59
June 19, 2017
Imitation as a Path to Innovation... If You Know What..
Imitation as a Path to Innovation... If You Know What..
Imitation as a Path to Innovation... If You Know What to Copy... At the recent Lean Healthcare Transformation Summit, there were thought provoking presentations... and we had many discussions about the role of incremental improvement vs. redesign or transformation. And, lots of discussions about imitating vs. innovating... so I explore those themes in this post.
11:30
June 15, 2017
Do Words Matter on a Kaizen Card?
Do Words Matter on a Kaizen Card?
If we're going to practice Kaizen (continuous improvement), do the words matter? Should we call it a Kaizen Card or something else? Do we start with a "problem" or something else? Are we writing down "ideas" or "countermeasures?" Does it matter?
06:43
June 04, 2017
Easier, Better, Faster, Cheaper... What's Missing There?
Easier, Better, Faster, Cheaper... What's Missing There?
What if "easier" is less safe? Great question. It begs the question of why Safer isn't first in Shingo's list? Is it because safety is assumed to be such a fundamental pre-condition in the Toyota culture or the Lean approach? Safety is such a non-negotiable point that it doesn't need to be said?
04:20
June 04, 2017
A Prototype For My "Two-Bin Hand Sanitizer" Concept
A Prototype For My "Two-Bin Hand Sanitizer" Concept
Does your healthcare organization struggle with keeping hand sanitizer dispensers full? Let me know what you think of this "two-bin kanban" system prototype from a vendor that might more forward on this...
12:06
May 18, 2017
A Lesson From Toyota: Thanking Employees for Pointing
A Lesson From Toyota: Thanking Employees for Pointing
Thanks to Lean Frontiers for sharing a story from Mike Hoseus on LinkedIn. Mike is, of course, co-author of the excellent book Toyota Culture: The Heart and Soul of the Toyota Way (written with Jeff Liker, who I just learned is retiring from the University of Michigan... more on that soon).
07:09
May 16, 2017
3 Recent Audience Questions on Kaizen & Continuous Improvement
3 Recent Audience Questions on Kaizen & Continuous Improvement
Here are three audience questions we didn't have time to address after a recent talk that I gave... questions about engaging people in improvement and about how to share and spread improvement ideas broadly.
07:26
May 12, 2017
Reader Question: A Lone Wolf in #Lean Facilitator's Clothing
Reader Question: A Lone Wolf in #Lean Facilitator's Clothing
Today's reader question comes from somebody who has been put in the position of what I call "the lone wolf" in a health system. This happens a lot. A health system hires or designates one person to be "the Lean change agent." It doesn't matter how amazing and/or experienced this individual is... I'd very skeptical about the organization's Lean journey.
07:57
May 11, 2017
Thoughts on "Good" vs. "Better" from My College Marching Band
Thoughts on "Good" vs. "Better" from My College Marching Band
What are the parallels between the mindsets and approach of a world-class university band director and our mindsets in Lean, Kaizen, and continuous improvement, in healthcare or beyond?
13:18
May 11, 2017
The Good and the Bad of the United CEO's Follow Up to
The Good and the Bad of the United CEO's Follow Up to
It's good that United's CEO has taken responsibility for system problems. It's great that they are changing some policies. But why does he say they don't have a culture problem if employees aren't empowered? That sounds like "culture" and a "problem" to me.
04:19
May 05, 2017
"Practicing Lean" as an Audio Book - First Half Now Available
"Practicing Lean" as an Audio Book - First Half Now Available
I'm excited to announce that Practicing Lean is now available as an audio book... or least the first half is, but you can buy today.
14:57
May 04, 2017
My LinkedIn Article: Supply Chain Matters - at the Oscars
My LinkedIn Article: Supply Chain Matters - at the Oscars
The mistakes at The Oscars were trivial and unimportant in the grand scheme of things. What are some lessons learned that apply to improving healthcare supply chains?
07:27
May 04, 2017
Don't Have Time for Meditation or Improvement? You Should...
Don't Have Time for Meditation or Improvement? You Should...
If you don't have 20 minutes for meditation, you should.... do what? Does this classic Zen quote apply to Kaizen and continuous improvement?
02:32
April 30, 2017
Reader Question: How Many People & How Much Time for...
Reader Question: How Many People & How Much Time for...
A Lean-thinking physician from Canada asks how many people an organization or department should have in a dedicated Lean or continuous improvement function. How much time is needed from staff and managers?
07:12
April 26, 2017
Is Calling People "Concrete Heads" the Most Effective...
Is Calling People "Concrete Heads" the Most Effective...
When did the term "concrete head" start getting thrown around in Lean circles? Do people still use this label today? Is it helpful? Should we agree that the term is disrespectful and counter productive?
14:16
April 18, 2017
What are the "Quick Wins?" Ask the People Doing the...
What are the "Quick Wins?" Ask the People Doing the...
Last week, I received a few questions from somebody at a hospital system and I thought I'd address one of them here: "Can you suggest any "quick wins" to get staff engaged in a Lean culture?"
08:42
April 17, 2017
The United Flight 3411 Mess, Holding Individuals Accountable
The United Flight 3411 Mess, Holding Individuals Accountable
I posted this on LinkedIn earlier today and am re-posting as a blog post to get your thoughts... and then, as I writing this, the news about the man being forcibly removed from a United Airlines flight went viral. Full title: "The United Flight 3411 Mess, Holding Individuals Accountable vs. Fixing the System [Updates]"
15:45
April 13, 2017
My Article on Changing How We Think About Change
My Article on Changing How We Think About Change
As part of my partnership with Cardinal Health, they have published an article that I wrote on their "Essential Insights" blog: "Changing how we think about change: How healthcare leaders can create a progressive culture"
02:32
April 13, 2017
The Patient Pays Less, Yet the Surgeon's Paid More
The Patient Pays Less, Yet the Surgeon's Paid More
Can physician-led surgical centers provide lower out-of-pocket prices for patients, along with lower infection rates, and higher compensation for the surgeons? One surgical center in Oklahoma says so...
06:24
April 10, 2017
Why You Shouldn't Call Yourself "Sensei" Or Make Other
Why You Shouldn't Call Yourself "Sensei" Or Make Other
Six Sigma and Lean Sigma has "belts." Some people in Lean call themselves a "sensei." Is that really appropriate? The term is supposed to be situational... it's a term of respect one chooses to use for another person...
14:54
April 06, 2017
Measures, Incentives, Heart Attack Mortality, Driving
Measures, Incentives, Heart Attack Mortality, Driving
In this post, I look at the impact (or lack thereof) of targets, rankings, and incentives, when it comes to safe driving or PCI (angioplasty) procedures in a hospital cath lab. Are we improving? How do we know? How do we improve?
13:07
April 05, 2017
Coming Soon– 4th Revised Ed. of “Lean Hospitals” (April Fool)
Coming Soon– 4th Revised Ed. of “Lean Hospitals” (April Fool)
It's time for another new, revised edition of my book! It was originally published in 2008 as Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction.
07:30
April 04, 2017
Sad Bloomberg BusinessWeek Article on Auto Supplier Safety
Sad Bloomberg BusinessWeek Article on Auto Supplier Safety
A few of you sent me this article... and you were correct to think I would be interested:"Inside Alabama's Auto Jobs Boom: Cheap Wages, Little Training, Crushed Limbs The South's manufacturing renaissance comes with a heavy price."
09:38
March 27, 2017
10 Years of "L.A.M.E."
10 Years of "L.A.M.E."
It's been 10 years since I first wrote about my awkward acronym L.A.M.E. Is it helpful to distinguish between true Lean principles and "Lean As Misguidedly Explained?" Will we see more L.A.M.E. talk and behaviors in the future?
09:42
March 21, 2017
New Whitepaper: "#Lean for Doctors"
New Whitepaper: "#Lean for Doctors"
Today, I'm happy to share a link to a white paper that I co-authored for Catalysis (formerly the ThedaCare Center for Healthcare Value).The paper is titled: "Lean for Doctors." Appropriately, the co-authors are two physician leaders you might very well know: Dr. John Toussaint (founder of Catalysis) and Dr. Jack Billi (from the University of Michigan).
04:21
March 10, 2017
#TBT: Don't Blame the Kicker, Don't Blame...
#TBT: Don't Blame the Kicker, Don't Blame...
Today's Post in&t;50 words: Lean thinkers don't blame individuals who in a bad system, whether that's a presenter at Oscars, a kicker in a football game, or a healthcare professional in a hospital.
07:25
March 09, 2017
Personal Kaizen: How I Reduced Effort...
Personal Kaizen: How I Reduced Effort...
In today's post, I write about how Kaizen starts with you. I share some examples of "personal Kaizen," including the way I've streamlined my call scheduling process, for my benefit and for others. http://leanblog.org/audio186
08:17
March 08, 2017
Learning & Emulating Without Copying Blindly from...
Learning & Emulating Without Copying Blindly from...
While I'm writing here about Northwestern men's basketball learning from Duke (without copying everything), the same ideas apply if you're Ford learning from Toyota or a hospital learning from ThedaCare. http://www.leanblog.org/audio185
11:25
March 06, 2017
I Was Asked to Share "Pet Peeves" About Lean (and Lean Sigma)
I Was Asked to Share "Pet Peeves" About Lean (and Lean Sigma)
Thanks to GoLeanSixSigma.com for asking me some questions for a discussion that they've posted on their website.
04:43
February 23, 2017
If a Surgeon or Hospital Puts Quantity over Quality...
If a Surgeon or Hospital Puts Quantity over Quality...
Today's Post in&t;50 Words: I get worked up about labeling a troubled surgical department as "a factory," but there are far more important issues of patient safety and hospital culture to be discussed related to a Seattle Times investigative piece. http://www.leanblog.org/audio183
07:05
February 22, 2017
The Advice about #Lean That Your Hospital CEO Should Be Getting
The Advice about #Lean That Your Hospital CEO Should Be Getting
Art Byrne's latest book, The Lean Turnaround Action Guide, has a lot of great tips that he's trying to share, CEO to CEO. How many CEOs are reading this book and heeding his advice, in manufacturing or in healthcare?
05:39
February 20, 2017
Registration is Open! "Kaizen Live!" at Franciscan
Registration is Open! "Kaizen Live!" at Franciscan
Registration is now open for our "Kaizen Live!" event, where you can visit Franciscan St. Francis Health in Indianapolis to see what a "culture of continuous improvement" is like in a way that will help you in creating the same for your organization.
04:22
February 13, 2017
Lessons Ford & the UAW Learned in Japan in 1981 Still Apply
Lessons Ford & the UAW Learned in Japan in 1981 Still Apply
Today's Post in&t;50 Words: I continue sharing documents from the Don Ephlin library archive. What did Ford and the UAW learn when they visited Japan in 1981? Many of the things that made Japanese industry successful are the same things that make organizations successful with Lean today, including in healthcare. http://www.leanblog.org/audio180
09:58
February 12, 2017
#TBT: My Reflections on Dr. Deming's Notes...
#TBT: My Reflections on Dr. Deming's Notes...
Today's post points to my guest blog post for the W. Edwards Deming Institute: Reflections on Dr. Deming's Hospital Notes - What Has Changed Since 1990? Why do the same problems that Dr. Deming experienced as a patient 30 years ago still happen so often today? http://www.leanblog.org/audio179
10:23
February 02, 2017
The Heroism of Incremental CarIe & Incremental Improvement
The Heroism of Incremental CarIe & Incremental Improvement
This post in&t;50 words: Are there parallels between medicine and organizations when we look at the tension between heroism and the sometimes boring work of preventing problems and improving things? I comment on an article... http://www.leanblog.org/audio178
09:57
January 30, 2017
Lean as Redesign and Continuous Improvement,
Lean as Redesign and Continuous Improvement,
Lean sometimes gets, I think, an unfair rap that it's only a method for incremental improvement. See this article, from the NEJM website, for example: "Limits of Lean -- Transformative Care Redesign Must Go Beyond Typical Lean-Based Improvements." http://www.leanblog.org/audio177
08:27
January 29, 2017
Improving Safety & Quality Matters, but...
Improving Safety & Quality Matters, but...
http://www.leanblog.org/audio176 I saw this article a few days ago in one of the larger healthcare industry trade publications:How One Woman Saved IU Health $54 Million The headline is misleading, as addressed in the opening sentence / sub-headline of the story (via HealthLeaders): "With a little help from about 10,000 of her friends and colleagues, the head of Indiana University Health's office of transformation leanedin to cut waste and encourage value, one project at a time." That's more like it and more likely... Lean is a team effort that, ideally, engages everybody... so it's not surprising to hear about 10,000 participants and the need to share that credit. Like almost every health system, IU Health faced financial pressures. I'll give their board credit for pushing for a method other than traditional layoff-based "cost cutting." "IU Health had already tried some performance improvement projects, but they were scattershot and not based on a unified philosophy. In order to improve results and scalethe improvement process, the board challenged then-CEO Dan Evans to deploy a system-wide value-improvement tool that could enlist all employees."
08:13
January 25, 2017
You Don't Build a Culture of Continuous Improvement by...
You Don't Build a Culture of Continuous Improvement by...
When I talk to organizations about Kaizen, or continuous improvement, there's far too much self-defeating talk, where people say things like:"We're not going to try this Kaizen process because our culture isn't ready yet." That's not only self-defeating, it's self-fulfilling prophecy. If you don't work on continuous improvement, you'll never have a culture of continuous improvement. http://www.leanblog.org/audio175
05:27
January 19, 2017
2nd Post for the Deming Institute Blog
2nd Post for the Deming Institute Blog
Yesterday, the W. Edwards Deming Institute published the second in my series of three posts for them: "The Failure of "The Livonia Philosophy" at my GM Plant." Read more... http://www.leanblog.org/audio174
06:47
January 17, 2017
Lean is Not Just Process Improvement
Lean is Not Just Process Improvement
In my travels, I often meet people or visit organizations that say something like:"We're doing Lean... we just call it Process Improvement." They have a "Process Improvement" (PI) department, or they call it "Continuous Process Improvement" (CPI). They have people in roles like "Process Improvement Facilitators." While process improvement is great, in using a term like that,there's perhaps a risk that they miss the full and complete essence of Lean and, therefore, don't get the results that they might hope for.
05:19
January 16, 2017
Contest: Win a Set of #Lean & Patient Safety Books
Contest: Win a Set of #Lean & Patient Safety Books
http://www.leanblog.org/audio172 StoreSMART is partnering with me on this contest where you can win one of four sets of books, along with a selection of sample supplies that can help you with 5S, visual management, and other Lean methods.By January 31, 2017, we'll select four winners who will each get a set that includes: Lean Hospitals, 3rd Edition (signed by Mark Graban) Work That Makes Sense (signed by Gwendolyn Galsworth) The Batz Guide for Bedside Advocacy (a great patient safety guidebook) One winner's package will includethe book Visual Workplace Visual Thinking instead of Work That Makes Sense.
03:00
January 15, 2017
Marie Osmond and The Excuses for Not Getting Lean
Marie Osmond and The Excuses for Not Getting Lean
It's a weight loss program called "Lean 13." It's the everyday use of the word "lean," as in thinner, that has nothing to do with the Lean methodology and the Toyota Production System. They're promising that you'll lose 13 pounds in the first month.As with the Lean methodology, in hospitals, factories, or wherever, your results might vary based on a number of factors. For example, Nutrisystem can't stop a customer from supplementing their food with Buffalo wings and chocolate milkshakes. We have situations out there where people say, "We tried Lean and it didn't work." Maybe it was because they were cherry picking a few Lean tools or they just thought Lean was about cost cutting, instead of focusing on safety, quality, patient flow, and employee engagement.
04:05
January 11, 2017
Better Metrics & "Understanding Variation"
Better Metrics & "Understanding Variation"
My favorite book, as I've written about before, is not a "Lean book" -- it's Understanding Variation: The Key to Managing Chaos by Donald J. Wheeler, PhD. It might look like a book about statistics... http://www.leanblog.org/audio170
07:09
January 09, 2017
My Post for the Deming Institute Blog:
My Post for the Deming Institute Blog:
I'm extremely honored that The W. Edwards Deming Institute published my first blog post in a series of three that I've written for them, to be published over the next month or so.The post is titled: "Why Dr. Deming's Work is So Important to Me" http://www.leanblog.org/audio169
09:03
January 06, 2017
What the World's Best Organizations...
What the World's Best Organizations...
Before Christmas, I was listening to the Dan Le Batard Show and their guest for the day was former NFL player Domonique Foxworth, pictured at left. Foxworth earned an MBA from Harvard Business School after his playing days. He's the perfect participant in a smart show about sports and whatever.During one segment, they all talked about NFL offensive and defensive coordinators and how they often fail when promoted to a head coach position.... and the discussion seemed relevant to other types of organizations. http://www.leanblog.org/audio168
05:55
January 04, 2017
My Visit to Cleveland Clinic
My Visit to Cleveland Clinic
I had a chance to visit one of their community hospitals, Hillcrest Hospital, as well as the main campus. It was a very stimulating visit and it was great to see the progress they were making in building a "culture of improvement." http://www.leanblog.org/audio167
11:14
January 02, 2017
Food for Thought on Mistakes and Perfection
Food for Thought on Mistakes and Perfection
"Making mistakes is better than faking perfection."I saw this quote the other day and tweeted it. It seemed like food for thought and something to reflect on for a new year. A Google search doesn’t lead to a clear creator of this quote… it’s a common thought that has been around a long time, I guess.
02:33
January 01, 2017
Examples of Corporate Speak Masking Reality
Examples of Corporate Speak Masking Reality
http://www.leanblog.org/audio165 I get annoyed by corporate euphemisms, such as referring to people as "resources," the term "right-sizing" for layoffs, and the type of jargon and babble parodied in the Weird Al song "Mission Statement."Using unclear language can intentionally mask and hide reality, or sometimes it's just another form of incompetence. You might know about the recent Wells Fargo scandal (as I blogged about here). The bank is trying to make amends for customers being harmed by unnecessary fees and the hit to their credit score that resulted from accounts being opened in their name without authorization (because employees were under pressure to hit unrealistic goals). I can't find the commercial online, but Wells Fargo has been running ads that sort of apologize and promise to make things right (better latethan never). The ad says something like: "... customers who were impacted..." They don't say WHAT the customers were impacted by. They make it sound like a tornado or some other natural disaster impacted those customers.
05:27
December 20, 2016
Bringing Me Problems is OK, We'll Find Solutions Together
Bringing Me Problems is OK, We'll Find Solutions Together
It's a bit of a modern management cliché to say "Don't bring problems! Bring me solutions!" I think what that means is "Don't just complain! Think about improving things!" It's good to think about improvement, but sometimes (if not often!) that improvement process starts by identifying problems. In a "Kaizen" process in a team, I encourage people to bring problems forward even if they do NOT have a solution or "countermeasure" in mind. When somebody points out a problem, that can prompt discussion or brainstorming (with the manager and colleagues) about what solutions could be tested. Here's an article from Harvard Business Review that delves into this same topic: "Don't Bring Me Problems--Bring Me Solutions!"
03:52
December 18, 2016
#TBT: What CFO Magazine Wrote About #Lean in 2009
#TBT: What CFO Magazine Wrote About #Lean in 2009
I first blogged about this article back in 2009 and it's still online:"Keen to Be Lean" The sub headline talks about hospitals being "desperate to cut costs." Has that changed? I wish the motivation was more often about hospitals being "desperate to improve patient safety and quality." Lean can address that too and should be mentioned, even in a publication for CFOs.
09:33
December 14, 2016
Human Nature Around Incentives & Rewards
Human Nature Around Incentives & Rewards
http://www.leanblog.org/audio162 Dr. W. Edwards Deming used to warn against replacing intrinsic motivation with extrinsic rewards and incentives.Brian Joiner (author of Fourth Generation Management), who worked with Deming, warned that setting targets and quotas can lead to three things: improving the system, distorting the system, or distorting the numbers. It’s often easier to distort the system or the numbers than it is to actually improve. We’ve seen that happen (gaming the numbers) in situations ranging from the VA waiting time scandal and the recent Wells Fargo scandal. It’s predictable human behavior for managers to try to entice people to perform better through promises of rewards or threats of punishment...
08:43
December 12, 2016
"The reign of the king-leader is gone" at GM?
"The reign of the king-leader is gone" at GM?
I was happy to see an engineer (Chemical Engineering) and a General Motors leader, Alicia Boler Davis, on the cover of the Northwestern University alumni magazine.See this profile and story: "DRIVING GM" http://www.leanblog.org/audio161
06:54
December 11, 2016
Lean People Don't Say Things Like "Idiot Proofing"
Lean People Don't Say Things Like "Idiot Proofing"
In the Lean approach, we don't call people idiots or dummies. We don't say, or shouldn't say, things like "idiot proofing" or "dummy proofing."There's an old Toyota story about how the term "fool proofing" upset an employee, they switched to using the equivalent of "mistake proofing" or "error proofing." Read more about the story in a comment on an old blog post of mine. Terms like mistake proofing help us focus on the process and the system instead of blaming individuals. Instead of labeling people as idiots, we have to focus on improving the system so it's easier to do the right thing and harder for errors to occur.
05:58
December 06, 2016
In My Global Lean Healthcare Travels,
In My Global Lean Healthcare Travels,
http://www.leanblog.org/audio159 I do a lot of work across the U.S., but I've also been very fortunate to work with hospitals, clinics, and health systems around the world over the past 11 years.It started with a few trips to Canada to conduct some hospital lab assessments and Lean leadership training when I worked for a J&hospital consulting group. Then, came an opportunity to spend about eight weeks working with a hospital north of London in 2008, a fascinating opportunity.In recent years, I've visited and/or coached hospitals in The Netherlands, Sweden, Finland, Japan, China, and Thailand. These are very different countries in their national cultures, of course. Their high-level, big-picture healthcare systems are designed differently (including the level of universal coverage, or lack thereof, and who pays). But, when you look at the details of how the work is done... how healthcare is delivered... how people manage... things are more the same than they are different. In England, they said, "Same problems, different accent." The same has been true in my most recent stop here in Thailand - except it's same problems, different language.
06:47
November 17, 2016
ThedaCare CEO Dean Gruner to Retire; What's Next for ThedaCare?
ThedaCare CEO Dean Gruner to Retire; What's Next for ThedaCare?
A few weeks ago, I saw this announcement about Dean Gruner, MD, the second CEO to lead ThedaCare during their Lean journey:Dr. Dean Gruner, ThedaCare President and CEO, Announces Retirement "Dean Gruner, MD, president and CEO of ThedaCare since April 2008, today announced his plans to retire. Dr. Gruner began in healthcare 40 years ago, has served this community for 33 years, and has served as President and CEO of ThedaCare since April 2008." Congratulations and best wishes to Dean on his retirement! He has been a great leader and advocate for healthcare improvement.
06:46
October 28, 2016
Good News: UCSF to Teach #Lean to Residents
Good News: UCSF to Teach #Lean to Residents
I was happy to see this announcement the other day:UCSF to Train Residents in Lean Management and Process Improvement From the announcement: “UC San Francisco will train medical residents and fellows in Lean management principles, as part of a broader institutional commitment to continuous quality improvement. The effort is being supported inpart with a grant from the Accreditation Council for Graduate Medical Education (ACGME) through its Pursuing Excellence in Clinical Learning Environments initiative. UCSF was one of eight medical training sites nationally to receive the competitive grant.”
02:59
September 27, 2016
This Time, the NEJM Publishes Something Positive About #Lean
This Time, the NEJM Publishes Something Positive About #Lean
You might remember the hubbub (a kerfuffle?) over the NEJM opinion piece written by Dr. Jerome Groopman and Dr. Pamela Hartzband. See my first post about their article. There are more links at the bottom of this postNow, the "Perspective" section of the New England Journal of Medicine has published a piece titled "The Hard Work of Health Care Transformation" by Dr. Richard Bohmer. Check it out. Dr. Bohmer says "government and regulators influence" (or attempt to influence, I'd add) healthcare organizations through financial rewards and penalties, regulatory constraints, and attempts to encourage "performance-improvement activities through education, research, and measurement programs." These approaches might help, but aren't sufficient.
08:28
September 06, 2016
Part 3 of Day 1: #Lean Healthcare Trip to China
Part 3 of Day 1: #Lean Healthcare Trip to China
More notes and discussion about my trip to China. http://leanblog.org/audio155
08:19
July 28, 2016
Lean Healthcare Trip to China, Day 1, Part 2
Lean Healthcare Trip to China, Day 1, Part 2
http://leanblog.org/audio154 Continuing from Part 1 of my post about my first day of my first China trip, I'd like to share more about the Lean healthcare conference and presentations that took place.In the next presentation from a Chinese hospital, the speaker started talking about the need to "improve [patient and employee] satisfaction through Lean management" and that "we have the same goals and purpose" as I expressed in my presentation... namely safety, quality, waiting times, cost, andemployee morale (SQDCM). I had showed a "spaghetti diagram" in my talk, shown below, of a podiatrist running around an Illinois clinic searching for supplies (this was the walking required for ONE patient... 10 minutes of waste):
11:29
July 26, 2016
Mark Graban Interviewed on "Quality Digest Live"
Mark Graban Interviewed on "Quality Digest Live"
Audio courtesy of Quality Digest Live -- see www.QualityDigest.com for more info and http://www.leanblog.org/audio153 for the link to the article referenced.
10:48
July 25, 2016
"Lean Is About Quality, Not Just Speed or Efficiency...
"Lean Is About Quality, Not Just Speed or Efficiency...
We'll probably also talk about this article that was published yesterday on QualityDigest.com:"Lean Is About Quality, Not Just Speed or Efficiency... in Factories or in Hospitals" It might ruffle some feathers, but oh well. I'll stand by what I say here as factual, not just opinion: http://leanblog.org/audio152
08:37
July 24, 2016
Lean Healthcare Trip to China, Day 1, Part 1:
Lean Healthcare Trip to China, Day 1, Part 1:
My first trip to China... http://leanblog.org/audio151
09:48
July 21, 2016
Free Excerpt from "Lean Hospitals" and "Practicing Lean"
Free Excerpt from "Lean Hospitals" and "Practicing Lean"
http://leanblog.org/audio150 Thanks to those of you who pre-ordered the 3rd edition of my book Lean Hospitals.Click below to read a free preview from the book, the start of the chapter on leading and engaging employees (arguably, it's all about leadership). Imp