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

Thanks to this post by Bruce Hamilton (aka "Toast Guy" or "Old Lean Dude"), I was reminded of the old General Motors effort, spearheaded by then-CEO Roger Smith (of "Roger&Me" fame), to fully automate car factories. Their concept was the "lights-out factory" that could run without people (other than a security guard).GM invested $90 BILLION dollars over 10 years in this quixotic (if not foolha...

The 1994 book Why TQM Fails And What to Do About It is a book that could be very relevant today, in the context of Lean. I'll give credit to Greg Jacobson, MD from KaiNexus who had a copy of this book on his shelf. I bought a copy and have recently been reading it because I was curious to see if there parallels to be found with Lean failures. http://leanblog.org/audio147

http://leanblog.org/audio146 Earlier this year, we had rantings from two doctors about Lean in the esteemed New England Journal of Medicine... except what they described didn't really sound like Lean (as I wrote about here and here - and also see Dr. John Toussaint's rebuttal).Now, there's a story written by an emergency medicine physician, Dr. Brad Cotton, that appears in a publication called "Em...

Ah, whiskey. I like whiskey. I'm not afraid to say that. I've blogged about whiskey (or whisky) once before: Why Kaizen is an Important Differentiator for Japanese Whisky. I also have a personal Kaizen story that I need to write about from my day volunteering at a Texas bourbon distillery. On a recent flight, I was reminded of the need to follow standardized work, even in the context of something...

Previously on LinkedIn, I’ve written about Kaizen in a wine bar and the need for restaurants to not blame employees for problems. Yesterday, I published my 50th post for their Influencers program: This Restaurant Server Sadly Explains a Widespread Management Problem… I hope it’s thought provoking about your own workplace.

http://leanblog.org/audio143 I've written before about the subject of hospitals "flexing" nurses and employees. I've criticized flexing (or the practice of sending employees home early because patient census is low) and I've pointed out that it's not keeping with "Lean" principles to "save money" by sending people home early. See these posts: Is This The One Question That Determines If You're Trul...

http://leanblog.org/audio142 You might remember the hubbub (and my earlier blog post) about this article that somehow appeared in the NEJM: "Medical Taylorism."It's sad and frustrating that people so often talk past each other in these different "debates" about Lean. Drs. Groopman and Hartzband seem unwilling to learn about Lean and TPS. They have just now doubled down on their assertion that Lean...

As is often the case, I have too many open browser tabs full of articles that I was going to potentially blog about. This slows down my Mac (thanks, Chrome!).So, it's time for me to clear out my backlog and a little mental overhead... to share some articles I've been reading with some quick notes, instead of doing full blog posts. Well, I'll get my backlog down a little. Why Giant Hospital Systems...

I'm always happy to see success stories where healthcare organizations solve problems that matter through Lean concepts, practices, and principles. Today, I'm blogging about two articles I saw about this recently. One of the problems that needs to be solved in healthcare is long waiting times, whether that means waiting for care in the emergency department, waiting for an appointment, or waiting f...

http://leanblog.org/audio139 In the previous editions of my book Lean Hospitals, I've included case examples from Avera McKennan Hospital and Avera Health. Fred Slunecka is the former president of Avera McKennan and he is now chief operating officer for the Avera system. I talked with Fred again for the updated and revised third edition (available for pre-order now, shipping in June), with my high...

After the previous CEO of JC Penney, Ron Johnson, was fired (see my post "Lack of PDSA made JCP CEO SOL?"), it seems that new CEO Marvin Ellison might be taking a different approach. See this article from FORTUNE: "The CEO Who's Reinventing J.C. Penney."

The revised, updated, and expanded third edition of my book Lean Hospitals has been sent to the printer and copies should start shipping by mid June. I'm happy to now be offering a free PDF of the revised first chapter.

recently saw some updates and new details related to some topics I've covered here on the blog, so I'm combining them into this batch update. In this post, we cover everything from a hospital NICU, to baseball, to healthcare waiting times and a scandal there that won't die.

As I guy who started his career in manufacturing before moving to healthcare in 2005, I don't get many opportunities to visit the "gemba" at a factory very often anymore. I get to occasionally visit a Toyota plant (in the U.S. or Japan). As I'm getting settled back into the Dallas / Fort Worth (DFW) area, I'm reconnecting with some of the people I know through our local "Lean DFW" network.foremanO...

I love stories of humility and customer focus in healthcare. Let me share two such stories with you today. Oh, and, I ended up sharing a story of mine that's related and might just recount a few screw ups on my part... but I think I eventually did the right thing.

Today's post is an addendum from Saturday's post on the apparent death of a health system Lean program: "Why Would a New Healthcare CEO Kill a Lean Program?"If you read that post, there's an interesting comment from a Presence Health employee that doesn't shed too much more light on this: "From the standpoint of a current Presence Health Employee~ my opinion is that the RIEs failed because they we...

Apparently, the Lean journey at Presence, regardless of what form it was taking in late 2015, has not survived a CEO transition at Presence Health. A new CEO, Michael Englehart, took over about six months ago (just after that Modern Healthcare story was published).Here is the latest Modern Healthcare piece by Sabriya Rice: “Presence Health rethinks its Lean initiative”

http://leanblog.org/audio131 Back in December, I wrote about a method called "Motivational Interviewing" (MI), something I learned about from a social worker who was also at the Lean Startup Conference. It's funny how these worlds intersect sometimes. I saw parallels between people being addicted to food, drugs, or what have you (the reason the MI method was created) and people being addicted to o...

As Patient Safety Awareness Week continues, thanks to all of you who shared this PBS News Hour story with me via email or Twitter. If you ever see something you think might be of interest, please let me know. On March 9, this story aired on PBS: After tragic mistake, rural hospital transforms into model of success. http://leanblog.org/audio130

http://leanblog.org/audio129 I generally avoid politics here on the blog... In October, I broached the subject when I blogged about a company that uses Lean principles to make Donald Trump hats in New Jersey (and interviewed the owner of the company), but that was during a time when Trump seemed like a novelty or fringe candidate. It might be a "third rail" to even bring him up... but I'll limit m...

Last Friday morning, I partnered with Chip Ponsford, DVM, a doctor of veterinary medicine, to give an introductory Lean continuing education presentation at the annual conference of the Texas Veterinary Medical Association. Our talk was titled: "What Veterinarians Can (and Should) �Learn From Toyota." That was Chip's suggested title... him talking to the vets, not me as the engineer telling...

Dr. Gary Kaplan is the CEO of Seattle's Virginia Mason Medical Center, considered one of the world leaders in the adoption of Lean healthcare principles. He wrote the foreword for my book The Executive Guide to Healthcare Kaizen. He co-authored a recent editorial in the BMJ Quality&Safety journal:"Lean and the perfect patient experience" http://leanblog.org/audio127

Each Saturday, I get an email newsletter from the UK-based site "Nursing Times." They cover issues that are somewhat universal in healthcare, including patient safety, healthcare culture, nursing shortages, budget cuts, and the like. Last week, this article, caught my eye: "Workplace principles revealed for NHS staff in Wales." http://leanblog.org/audio126

http://leanblog.org/audio125 The Spurs have had great players, but there's a culture of teamwork and unselfishness. The Spurs (after learning their lesson with Dennis Rodman) have learned to draft and sign players who FIT into their culture and system. Here's a recent interview with head coach Gregg Popovich: "Gregg Popovich broke down what he looks for in players, and it was an inspiring life les...

http://leanblog.org/audio124 I made a few tweaks to the content of the 3rd edition's "first pages" based on some input from Jamie Bonini, vice president of the TSSC group within Toyota. They are the ones that did the great work with UCLA Harbor Medical Center and others, as highlighted in "The Toyota Effect" videos and earlier work with the NYC Food Bank. Jamie talked with me and contributed a num...