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

Forgive me for being a bit of an Industrial Engineering geek here in this post. After all, my bachelor's degree is in Industrial Engineering, even though I sometimes get called "a healthcare guy" after focusing on healthcare for just about ten years now. One of the things we learned about in our IE organizational psychology class was something called "the Hawthorne Effect." In the past few months,...

Dr. W. Edwards Deming advised against relying on slogans and posters as a way of trying to improve quality. Point 10 of his famed 14 points said: Eliminate slogans, exhortations, and targets for the work force asking for zero defects and new levels of productivity. Such exhortations only create adversarial relationships, as the bulk of the causes of low quality and low productivity belong to the s...

http://leanblog.org/audio43 You might know my friend Karl Wadensten, the president of VIBCO, a small manufacturer in Rhode Island. I've interviewed him for episode #84 of my podcast series (which was also episode #10 of my video podcast series).I've had a chance to visit his factory a few times (mostly in the 2009-2011 timeframe). Each time, I've been impressed with the visible employee enthusiasm...

have been going through some old papers recently and I found two sheets of paper with hand-written thoughts or "truisms" that I had scribbled down in early 2002. The word truism, it turns out, doesn't mean "true" so much as it means "a statement that is obviously true and says nothing new or interesting." Oops. This was a list of things I had learned after two years at GM, two years at MIT, two ye...

http://leanblog.org/audio41' I hope you might have access to this interesting article from the Wall St. Journal: "Toyota Veteran Rises to Corporate Office From Factory Floor." I was able to access it while logged out from my WSJ account. Mitsuru Kawai, pictured, started working at Toyota in 1963, at age 15. After 52 years of employment, Kawai is going to be in the position of senior managing offic...

http://leanblog.org/audio40 Every time I am in a hospital or clinic setting, one of the first things I do is get a pump or squirt of gel or foam from a wall-mounted dispenser to clean my hands. Or, I should say *try* to get hand sanitizer. For one, it's important to practice proper hand hygiene when entering or leaving a unit, for my sake and the patients (and to practice what I preach, a secondar...

http://leanblog.org/audio39 Joe Swartz and I have been planning the first-ever workshop (a conference of sorts) where people can come see what a Kaizen culture, or a culture of continuous improvement, looks like at his health system, Franciscan St. Francis Health in Indianapolis. It's designed to be a small event. We have ten people registered right now, with a few more committed, and we have spac...

http://leanblog.org/audio38 When people ask me why I do what I do, my first answers are:improving patient safetycreating better workplaces for people It's as simple as that. Those are the important problems that I'm passionate about (and have been able to help fix, at least in some local situations). At a more global scale, too many patients are hurt or killed by preventable medicalerrors. Too man...

Last Monday, I had the chance to attend a Lean Startup event in Austin where Eric Ries announced the launch of a Kickstarter project for a new book. 10 days ago isn't much of a "throwback," but bear with me. He was asked a question from the audience: "Do you wish you had used a different name than Lean Startup to resonate more broadly?" Before we get to Eric's answer, I thought back to me asking J...

http://leanblog.org/audio36 When we introduce the idea of Lean to healthcare organizations, it's very common for somebody (often a senior physician) to say something like,"But we don't want assembly line medicine." The implication is that assembly lines and factories are cold, rigid, uncaring places that focus on ruthless efficiency and making the numbers at the expense of safety and quality. Do a...

Today's Throwback Thursday is a look back at a 1993 book that I purchased in 2011 on somebody's recommendation. It was probably one of those used books you can buy for a penny on Amazon... Creating the New American Hospital: A Time for Greatness. It's indeed available for a penny today. I had flipped through the book at the time as it was interesting to me to get more context on how hospitals are...

http://leanblog.org/audio34 OK, so it’s not the kind of scientific research that involves lab coats and microscopes, but I’m doing some research that I’d like your help with. I’m looking to do some research and some interviews for writing projects related to two different topics: Understanding Variation and Reducing Blame.

Back in 2002, when I worked for a software startup called Factory Logic, I was able to sit in on some Lean training that was created and presented by a large electronics manufacturer that will remain unnamed (and it wasn't Dell). The class was for that company's suppliers, primarily...

http://leanblog.org/audio32 This week is the annual Patient Safety Awareness Week, presented by the National Patient Safety Foundation, a non-profit that I like and support. As Lean thinkers, I hope we'd recognize that the amount of patient harm and death that's caused by preventable medical errors is a huge problem around the world. When we ask "why is there so much harm?" there are many answers...

One of the two main pillars of the Toyota Way management system is "respect for people." I've blogged about that often over the past ten years, including this post. Lean provides a philosophy and a management model that should be nothing but good for staff and patients. The idea of "respect for people" might sound nice in principle, but what does it mean in a practical sense. Respect for people ca...

As often happens, I have too many open browser tabs full of articles that I was going to potentially blog about. Too much WIP (a problem that Jim Benson will discuss in our upcoming Boston workshop).So, it’s time for me to clear out my backlog and to share some articles I’ve been reading with some quick notes, instead of full blog posts. Well, I got my backlog down by three. I’ll...

http://leanblog.org/audio29 Some of you might know that I'm on the board of a Texas-based non profit, the Louise H. Batz Patient Safety Foundation. It's an important organization that helps patients, family members, and hospitals work together in the name of better care and safer care. One of the ways the Foundation helps is their publication "The Batz Guide for Bedside Advocacy." You can get a fr...

This article caught my attention the other day, primarily because I like scotch, whisky (and whiskey and bourbon). The Japanese love scotch whisky and have long produced a product that's a variation of scotch -- Japanese whisky (the lack of a standardized spelling for whiskey is an endless debate). I'll settle on "whisky."The article: Japanese Whisky Got a Lot of Hype, But Can One Bottle Really Be...

Here's another video in the series that Joe Swartz and I shot at Franciscan St. Francis Health back in October. See them all here or via a YouTube playlist. You might remember pharmacy manager Ronda Freije from two previous videos. Here, she talks about a concept called "Seven Days' Grace." It's a concept that Joe Swartz and I wrote about in Healthcare Kaizen using stories from Franciscan (see exc...

Today's post is hosted over at LinkedIn, as part of my participation in the LinkedIn Influencers series. The post is titled: "The One Thing Google Should Show When You Search for a Hospital." It's not about Lean per se, but it's about topics that I hope we'd agree are relevant: Transparency of quality and patient safety data Making that data easily available and understandable by patients Using th...

http://leanblog.org/audio25 In yesterday's blog post ("Safety is always our top priority" - From lip service to daily practice?"), I challenged hospital leaders to back up the "happy talk" with real action and stories about putting safety first. It's easier said than done. I wanted to share a story from Karen Kiel-Rosser, Vice President/Quality Improvement Officer, at Mary Greeley Medical Center i...

http://leanblog.org/audio24 It's really easy to make statements like "patient safety is our top priority." That same statement can be applied to hospital staff, as well. Or, it should. But the "happy talk" (as Pascal Dennis calls it) isn't always followed up by action. When a hospital executive makes the "safety is always our top priority" statement, is it REALLY true? Is that statement backed up...

"Accountability" is a word that's easy to throw around in an organization. It's often pretty meaningless (or not well understood). What does it really mean? http://leanblog.org/audio23

Recently, I've seen many examples where businesses don't pay attention to little details. When you see little things going wrong, it makes you wonder about the more important stuff. One example from healthcare might be this story from the Cleveland Clinic, where patients told the CEO that there were dust balls under the beds in patient rooms. Why don't staff notice these things? Why don't they hav...

It's a pretty common facilitation technique to do a "plus / delta" discussion at the end of a meeting, exercise, etc. In the plus column go the things that went well, were enjoyable, were helpful, and should repeated. The "deltas" (which is meant to seem more positive than saying "minuses," I guess) are the things that could be improved upon. A "delta" is a gap between where you are and where you...