Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement

This article posted anonymously on AllNurses.com has over one million views in the month since it first appeared:"Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!" It's an "Open Letter to Hospital Administrators."

Engaging Staff in Improvement is Actually the Toyota Way, TooHere, I blogged about an article I read in Modern Healthcare that said, basically, Toyota isn't innovative and maybe therefore healthcare should look to Google as a management system and model of staff engagement and continuous improvement. WHAT? Toyota doesn't engage staff in continuous improvement? That's, frankly, ignorant and it's a...

I wrote a new piece for LinkedIn that I hope would be of interest to you even if you’re in healthcare. Why? It’s a story about what an organization does when you don’t have enough (or any) direct work for your front-line staff to do. Toyota would continue paying employees and would put them to...

I get asked a lot, "How do you know if a hospital is truly 'Lean?'"Nobody is ever perfect or "fully Lean," but you could ask, "How do you know if somebody is on a legitimate Lean transformation journey?" http://leanblog.org/audio120

Last year, Joe Swartz and I hosted a workshop at his organization, Franciscan St. Francis Health in Indianapolis. We called it“Kaizen Live!” and it was designed as an opportunity to see a culture of continuous improvement – what does it look like? What do people say? We lay this out in our Healthcare Kaizen books... http://leanblog.org/audio119

Alternate title:“Lean is an Integrated System. Of Course Just Implementing Pieces Leads to Failure.” Throughout the 10 years that I’ve been involved with Lean healthcare efforts, I’ve heard multiple stories of organizations that ended their formal Lean initiatives. They do so, as I’ve been told, because they need to cut costs... http://leanblog.org/audio118

At KaiNexus, we've been fortunate to have a good relationship with Professor Ethan Burris, from the University of Texas McCombs School of Business. He has done a lot of research and publishing around employee engagement and idea systems, as I've mentioned here on the blog before: "Is Fear the Only Reason Employees Don't Speak Up?"Burris has a new article on the Harvard Business Review website: "Em...

In the article posted today, Pamela Hartzband, M.D., and Jerome Groopman, M.D. (the later the author of the popular book How Doctors Think), rant about all sorts of things… some of which have nothing to do with Lean... http://leanblog.org/audio116

http://leanblog.org/audio115 A hat tip goes to Brian Buck for sharing this quote via email recently. Samuel Clemens, aka Mark Twain, was a pithy and wise man. I didn't remember this quote, but it is attributed to him. It's very appropriate for the type of work we do. I shared it last Saturday in my "Key Tweets" post, but it's worth discussing here in a separate post, I think.

I had a bit of a new year's resolution about being positive and not fretting about organizations that don't "get it" when it comes to Lean. But, resolutions are meant to be broken, I guess. It's very frustrating when I hear people in healthcare complain that their hospital or health system has equated Lean with cost savings -- only focusing on cost reduction or primarily focusing on it. Hospitals...

http://leanblog.org/audio113 This article, from December, was floating around social media the other day (hat tip to Paul Levy):Don Berwick Offers Health Care 9 Steps to End Era of 'Complex Incentives' and 'Excessive Measurement' Among the points that Berwick makes, here is the one most directly related to Deming, Lean, and continuous improvement: 5. Recommit to improvement science: For improvemen...

How is it that we have two realities out there in healthcare... in parallel, Lean is awesome and Lean is horrible. It depends on where you are, unfortunately. I had an amazing day yesterday with a major health system...

Humility is an important part of the Lean management philosophy... it also means being willing to admit that there is a problem. Humility means "we don't really know so we must understand and then try many things to see if we have the right solution."

When we see a simple error, even in something as silly as sports memorabilia, we would ask "why?" or "how?" instead of "who?" Blaming individuals doesn't help... http://leanblog.org/audio110

When I was at the recent Lean Startup Conference, somebody I know somewhat randomly introduced me to another attendee. As we chatted, I learned her background was social work and she was founder of a technology startup that solves a problem that was important to her and her work. I never met people like that when I worked in manufacturing... again, I've really grown to appreciate the perspectives...

How many times do we hear people say things like“We don’t have time for Lean” or “We don’t have time for Kaizen“? It happens a lot, right? As I’ve said before (and this video) a “lack of time” is a problem to solve... so how did I get hospitals to dedicate staff time for 12 to 16 weeks? http://leanblog.org/audio108

The "five" in the "five whys" methodology is not a magic number, be it Lean or Lean Startup approaches. http://leanblog.org/audio107

Why do we need to move beyond "The Five Whys" into a more robust problem solving model for Lean or Lean Startup settings? http://leanblog.org/audio106

In discussing Lean and working with people in different organizations, I so very often hear things like "we don't build cars" or "we're different." I know I'm not the only one who hears that. The implication is "Lean won't work here, because we're different" in some way. Different country, different industry, different hospital department, different patient or payer mix, etc.

Lean healthcare really is a global movement. Last year, when I went to Japan, we had people in the group from all across Asia, Denmark, Canada, the U.S., and Saudi Arabia. Health systems all around the world need to improve quality and patient safety, reduce waste and create better work environments, reduce waiting times, and get costs under control. These are universal challenges. Thankfully, Lea...

http://leanblog.org/audio103 Through our practice of Lean, we're looking at processes and our management system, looking to identify waste and opportunities for improvement. Lean is about engaging people to have them ask why we do things a certain way or if things could be better (it's not about finding fault from on high and telling them what to do). The answer to why we (frontline staff or leade...

http://leanblog.org/audio102 The world (especially the world wide web) is full of surveys. Tell us how we're doing! Your satisfaction is important to us! We see this so often, it's easy to become numb to it in our Yelp-ified world. It's definitely a "first world problem," but I've been shopping for a new car over the past few months and I finally bought something. I won't disclose what I bought, b...

http://leanblog.org/audio101 I'm going to be attending the Lean Startup Conference in San Francisco next month, as a "faculty member," a moderator for a session, TBD, and maybe serving as a mentor. The organizers asked me to write a post introducing myself to that audience. Eric Ries, author of the book The Lean Startup: How Today's Entrepreneurs Use Continuous Innovation to Create Radically Succe...

Many of you don’t care about football, but you might find it interesting, as I did, to learn that Northwestern’s defensive coordinator Mike Hankwitz is apparently a fan of Kaizen... http://leanblog.org/audio100

These Donald Trump hats (and hats for other candidates including Hillary Clinton and Jeb Bush) are made by a Newark company, Unionwear. Lean is their strategy and their production system. That’s how they are competing against China. http://leanblog.org/audio99