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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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Why Keep Asking, “What’s Your Favorite Mistake?”

Lean Blog AudioMay 15, 2023

00:00
05:58
Why Keep Asking, “What’s Your Favorite Mistake?”

Why Keep Asking, “What’s Your Favorite Mistake?”

Blog post link

The following material was found on the “cutting room floor” for my upcoming book, The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. And I've supplemented it with some new material to flesh it out into a post.

Come to the live book cover reveal event tomorrow (Tuesday, May 2) if you can!

I've asked more than 215 people the same question (releasing 208 episodes to date):

What's your favorite mistake?

You might wonder why I seem to be so obsessed with this question. It's not because I love embarrassing people or because I want to gloat about the mistakes of others. I ask this question to learn and improve myself as a person and leader. 

The book and the podcast series are meant to be reminders that we shouldn't mock people for their mistakes. We shouldn't be too hard on ourselves, even if that's easier said than done.


May 15, 202305:58
Organizations Cannot Solve Problems Unless Leaders Admit Them and Help Others Feel Safe Speaking Up

Organizations Cannot Solve Problems Unless Leaders Admit Them and Help Others Feel Safe Speaking Up

Link to the blog post at Value Capture's website

As we explore concepts like psychological safety and Diversity, Equity, Inclusion, and Accessibility (DEIA) in this blog post series, I’d like to kick things off with a look at some serious problem statements that we must address. I’m thankful for the organizations, including Value Capture clients, who aim to close these performance gaps in systematic and sustained ways.

May 12, 202312:14
Kindle Pre-Orders Open for “The Mistakes That Make Us” — Enter to Win Signed Paperback

Kindle Pre-Orders Open for “The Mistakes That Make Us” — Enter to Win Signed Paperback

Episode page and blog post

If you're interested in my upcoming book (available June XX, date TBD), The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation, the Kindle edition is available to be pre-ordered now through Amazon!


The date is set as June 27th, but it will likely be available sooner. Amazon (and their KDP platform) make it easier to pull a date forward… and they punish you for pushing a date back.

The book will also be available at the same time in paperback and hardcover formats. I'm going to work on an audiobook version over the summer.

Amazon also makes it more difficult for me to make a paperback or hardcover book available for pre-order. But again, I think it will be on sale early- to mid-June.

You can also enter this contest to win a free signed copy of the paperback edition.


May 07, 202303:24
Reader Question: Why Did I Get Into Lean Healthcare?

Reader Question: Why Did I Get Into Lean Healthcare?

Blog post for this episode

Here's another reader question, this one received from The Netherlands, a country I have loved visiting over the past eight years (see my blog posts about the country and Lean healthcare efforts there).

Here is the question, in part:

Your work has been an inspiration here, so I started to research the origin and dissemination of lean in healthcare in the USA. Your first book, can be considered a standard work in this field and won a number of awards. But what I couldn't found in my search, was your motivation to write it. Can you please answer that for me: what triggers made you decide to start practicing lean in healthcare?

In a nutshell, here's the answer...

Apr 11, 202310:21
“The Mistakes That Make Us” — My Manuscript is Done! Some Backstory and What Comes Next

“The Mistakes That Make Us” — My Manuscript is Done! Some Backstory and What Comes Next

Blog post for the episode

I'm happy to announce that I've finished the manuscript for my upcoming book (a real one, not an April Fool's Joke).

The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation

It's taken about a year from saying, “I'm going to write a book based on the My Favorite Mistake podcast” to completing the book writing.

Apr 05, 202314:28
Measures of Success (Paperback Version) Turns Four Years Old

Measures of Success (Paperback Version) Turns Four Years Old

Blog post including a link to buy the book

Tomorrow is the 4th anniversary of the paperback release of my book Measures of Success: React Less, Lead Better, Improve More.

Long story short, I'm running a limited-time sale to celebrate.

Looking back to the release, I took an odd approach, perhaps, in that the eBook and Kindle version were available first, in August 2018, I think.

I wanted to test my hypothesis about people being willing to buy the book. Once I saw eBook sales start coming in (and getting positive feedback), I made the investment in getting the paperback book created (a professional page design and layout process). By the way, the phrase “self-publishing” is a misnomer. My company is the publisher, but I didn't do it myself!

For my next book, The Mistakes That Make Us, my company will be the publisher again, but the plan is to launch Kindle and paperback versions together at the same time. Probably this summer. But I need to finish the manuscript first! I'm almost there. That's my main focus these days, finishing that up.

Amazon has sold over 5,000 copies to date (a total of both formats). A relatively small number of books have been sold through other channels, including direct sales through me. One advantage of being the publisher is that I can see real-time data from Amazon and IngramSpark. For previous books, I have to ask my former editor to run a report.

Mar 31, 202305:56
Learning from Small Mistakes to Avoid Big Mistakes, Operating Rooms and Patient Harm

Learning from Small Mistakes to Avoid Big Mistakes, Operating Rooms and Patient Harm

Blog post

  This article caught my eye today, and it's a change of pace to think about and write about mistakes other than my own (and I made more today — but healthcare mistakes are more important).

Penn Medicine hospital cited over wrong-site surgery

It's a mistake to perform surgery on the wrong leg. Not an “unintended mistake” (which is redundant). All mistakes are unintentional. Intentional harm could be called sabotage or assault....


Feb 23, 202309:05
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).

Dec 01, 202208:35
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.

Nov 28, 202214:52
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

Nov 22, 202207:55
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."

Nov 10, 202204:03
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.

Nov 10, 202203:31
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?

Jul 03, 202214:10
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.
Jan 04, 202212:15
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
Oct 11, 202107:06
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.

Oct 08, 202112:08
Free Webinar: Applications of Lean Leadership Methods in Home-Based Care
Oct 07, 202103:15
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.


May 20, 202115:51
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?
Mar 18, 202108:03
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.

Mar 04, 202107:40
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...


Feb 21, 202111:00
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)


Dec 30, 202013:12
Announcing a New Podcast Series: “My Favorite Mistake: Reflections From Business Leaders”
Aug 27, 202007:38
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.

Aug 08, 202008:22
Great Piece: "Health Care Workers Protect Us. It's Time to Protect Them."
Jun 22, 202004:19
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.

Jun 11, 202002:25
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.

May 19, 202006:19
Remembering a Great Leader, Paul O'Neill (1935-2020)
Apr 22, 202013:36
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).

Apr 12, 202008:34
Thoughts From Lean Thinkers on Coping with the Coronavirus Crisis
Apr 11, 202004:23
See? Lean is About Flexibility, Not Low Inventory
Apr 10, 202007:25
One Doctor's Troubling Experiences in the Emergency Department [Covid-19]
Mar 20, 202012:04
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.

Mar 17, 202011:09
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.

Mar 16, 202015:17
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...

Mar 03, 202005:22
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:

Feb 12, 202005:16
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?


Jan 30, 202008:53
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...

Jan 30, 202010:12
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.

Nov 23, 201906:25
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.

Nov 23, 201904:28
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.

Oct 11, 201907:25
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?

Oct 08, 201907:32
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.

Oct 07, 201903:40
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.


Sep 10, 201908:51
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. 

Sep 03, 201908:25
Third Time's the Charm for the Iced Tea -- On Errors, Blame, and Process
Sep 02, 201905:14
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.

Sep 02, 201904:15
Embracing and Helping Surgeons Accept Change -- Instead of Blaming & Labeling Them
Aug 23, 201904:12
What Chefs and Restauranteurs Say About Learning From Failures & Mistakes
Aug 20, 201904:02
Bob Lutz on Tesla, Threats, & Communication About Quality - and Implications for Healthcare
Aug 18, 201904:55
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?"

Aug 16, 201907:34
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.


Jun 24, 201907:02
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.

Jun 24, 201904:30
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).

Jun 11, 201908:31
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.

May 25, 201909:11
How PBCs (Process Behavior Charts) Can Enhance the Practice of OKRs (Objectives & Key Results)
May 20, 201917:57
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

May 17, 201936:45
When Old Habits and Old Science No Longer Make Sense - Evidence vs. Habit in Medicine and #Lean
May 16, 201914:11
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.”

May 13, 201906:37
A Hospital CEO Who Wants Other CEOs to “Give a Damn” About Their People
May 01, 201908:00
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.
Apr 30, 201916:60
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.

Apr 29, 201912:46
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.”
Apr 22, 201904:55
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.
Apr 16, 201909:22
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.
Apr 15, 201908:45
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?
Apr 10, 201905:02
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
Jan 30, 201914:24
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.
Jan 14, 201912:31
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)

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.
Jan 09, 201907:01
For Big Leaps With New Year’s Resolutions, Start With
Jan 08, 201907:48
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.
Aug 16, 201805:54
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"
Aug 14, 201816:19
#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.
Aug 13, 201808:27
“ER wait times down, but only slightly” ??

“ER wait times down, but only slightly” ??

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
Jul 23, 201813:29
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
Jul 19, 201806:49
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.
Apr 17, 201810:00
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."
Apr 03, 201818:29
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"
Mar 12, 201811:26
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...
Feb 16, 201812:02
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.
Feb 13, 201810:11
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).
Feb 13, 201810:29
#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?
Feb 05, 201809:26
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).
Feb 04, 201808:22
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?"
Feb 04, 201808:22
"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.
Jan 22, 201805:32
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.
Jan 18, 201815:23
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.
Jan 16, 201811:24
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

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?
Jan 15, 201804:55
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

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?
Jan 14, 201816:16
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?"
Dec 05, 201725:41
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“
Dec 04, 201708:11
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.
Nov 07, 201714:26
#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.
Nov 06, 201707:44
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.
Oct 30, 201713:13
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.

Oct 23, 201702:29
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?
Oct 10, 201704:26
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.
Oct 09, 201704:25
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...
Oct 04, 201711:49
#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."
Oct 03, 201705:20
"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"
Sep 26, 201719:30
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.
Sep 21, 201705:57
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"
Sep 20, 201707:36
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.
Sep 12, 201707:29
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."
Sep 11, 201707:08
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?
Aug 30, 201708:27
"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.
Aug 29, 201704:33
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.
Aug 29, 201710:11
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?"
Aug 24, 201703:39
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?
Aug 23, 201715:16
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.
Aug 17, 201708:48
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...
Aug 16, 201709:42
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?"
Aug 15, 201708:14
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.
Jul 26, 201705:59
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.
Jul 24, 201711:58
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?
Jul 16, 201707:58
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.
Jul 11, 201711:03
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:Â

"'People Are Dying Here': Federal Hospitals Fail Tribes."Â

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).
Jul 11, 201714:06
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?
Jun 20, 201702:36
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?"
Jun 19, 201708:59
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.
Jun 15, 201711:30
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?
Jun 04, 201706:43
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?
Jun 04, 201704:20
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...
May 18, 201712:06
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).
May 16, 201707:09
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.
May 12, 201707:26
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.
May 11, 201707:57
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?
May 11, 201713:18
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.
May 05, 201704:19
"Practicing Lean" as an Audio Book - First Half Now Available