http://leanblog.org/audio61 My wife and I were in Boston over the weekend, as it was her fifth reunion from her MIT master’s program. I’m also an alum, but was considered a “guest” since I graduated 16 years ago from my program and you don’t have to have an MIT degree to know 16 divided by 5 is not an integer. Being MIT, the reunion wasn’t just about parties (and it’s not a homecoming weekend with a football game, as my Northwestern 20th reunion will be this fall). The reunion was also full of l...
Jun 18, 2015•9 min
At this year's Lean Healthcare Transformation Summit (see my summary here) Dr. John Toussaint talked about and introduced his newly released book Management on the Mend, a follow up to 2010's On the Mend. Summit attendees received a copy of the book, so they're the first to have a chance to read this important work.
Jun 15, 2015•7 min
In American healthcare, there's a growing gap between hospitals and clinics that are being innovative and those who are stuck in the "way it's always been done" mode. For example, innovative primary care clinics are using a combination of better processes and better technology to deliver a patient experience that I wish I could experience.
Jun 13, 2015•12 min
Jack Dorsey is well known among tech circles, as a co-founder of Twitter (he's @Jack) and, now, as the CEO of Square. I'm a frequent Twitter user (I'm @MarkGraban) and I also utilize the Square reader occasionally to sell a book to somebody. I appreciate being able to easily and inexpensively accept a credit card here and there.This interview on the public radio program Marketplace caught my eye (I mean, ear): Jack Dorsey: Twitter co-founder, Square CEO, punk
May 29, 2015•7 min
Don Davis, former CEO of Stanley Works, passed away in 2010 and left an unfinished book in progress. One of my friends (and former colleagues from Dell in the late '90s), Steve Cook and a number of other alumni completed the book, working with Don's daughter Ruthie Davis (of the eponymous shoe company).The book is Do the Right Thing: Real Life Stories of Leaders Facing Tough Choices. Do the Right Thing highlights Don's "leadership mantras" and real-life stories from alumni who leaned upon these ...
May 28, 2015•8 min
It's not uncommon to hear statements thrown around about Lean that are more of a myth than anything resembling reality.I remember the time a professor told a group that if Toyota ran a health clinic, a buzzer would go off at the end of the planned appointment time and the patient would be kicked out of the room. That's ridiculous. That's a myth (and it's not one of the widely spoken myths). A Lean myth might be an example of L.A.M.E. or "Lean As Mistakenly Explained." This post addresses other m...
May 27, 2015•12 min
I love to cook and I"m the primary chef in my home. I often get asked a question - sometimes it’s serious and sometimes it’s smart-alecky - “Do you 5S your kitchen?” If by that, they mean, “Do you label the outside of your cabinets and put tape outlines around everything?” then the answer is no. And I’m not sure why anybody would want to… but if doing so makes your life easier, then great - that’s what Lean is all about, solving problems and being more effective. I do, however, try to apply Lean...
May 26, 2015•10 min
Here's my latest post for LinkedIn through their "Influencers" series. It might be old hat to readers of this blog, but I hope what I shared is useful for a wider audience that I have there.10 Key Lean Mindsets for Factories, Hospitals, Startups, and More http://leanblog.org/audio54
May 25, 2015•11 min
http://leanblog.org/audio53 In my first post about the on-site Kaizen learning experience at Franciscan St. Francis Health, an event I came to call "Kaizen Live," I wrote about some of the initial presentations and discussions from Franciscan leaders. You can also see my tweets from the days.A big part of the 1.5-day event was the three "gemba visits" that took place. Each attendee had the chance to visit pharmacy, endoscopy, and the NICU. I had visited all three departments before (when we shot...
May 19, 2015•9 min
http://leanblog.org/audio52 There's been a back and forth of views about the state of pediatric emergency medicine recently in the Wall St Journal.Let me start first, actually, with the more recent statement, a rebuttal from Michael Gerardi M.D., FACEP, President of the American College of Emergency Physicians, in the form of a letter to the editor. He wrote: "Emergency care of children in the U.S. is the best in the world. Emergency physicians treat more than 22 million sick and injured childre...
May 18, 2015•7 min
Following up on yesterday's post on seemingly successful experiments with ACOs, here's another article, from HBR, on "safety huddles" in healthcare:"How Every Hospital Should Start the Day"
May 13, 2015•7 min
You might be considered "wonky" for enjoying the topics discussed here at LeanBlog.org... but that's fine. This is a safe environment for being wonky about Lean and improvement.From Vox.com, Sarah Kliff normally does a great job covering healthcare topics, including this latest piece: "This small, wonky Obamacare program saved $384 million over 2 years"
May 12, 2015•5 min
http://leanblog.org/audio49 I was quoted in two articles that appeared in "Today's Hospitalist":"Discharging Mr. Wood: Time to get serious about waste" and "Standardized work: Improving quality by reducing practice variation." Reducing Waste The author, David A. Frenz, MD, points out that it's a "collective delusion" that the U.S. spending so much more on healthcare leads to safer or higherquality care. People are waking up to the fact that there is too much waste in healthcare. We have poorly d...
May 05, 2015•6 min
http://leanblog.org/audio48 On April 22 and 23, I collaborated with Joe Swartz and a countless number of his colleagues to host 24 visitors from different health systems (and an Indiana state government organization) to learn about the "Kaizen" approach to continuous improvement first hand at Joe's health system - Franciscan St. Francis Health in Indianapolis.I tend to "take notes" these days via Twitter and you can read all of my tweets and quotes if you like. Here are a few highlights, incorpo...
May 04, 2015•10 min
http://leanblog.org/audio47 One of the many things I admire about W. Edwards Deming is how hard he worked into his 90s. He must have had "pride and joy" in his own work.I learned from this IndustryWeek piece that Dr. Deming was teaching seminars up until two weeks before his death at age 93. IndustryWeek was kind enough to share Dr. Deming's last interview, originally published in January 1994, on their website in three parts....
May 03, 2015•6 min
Chris Van Gorder, CEO of Scripps Health in California, wrote this article in HBR back in January: "A No-Layoffs Policy Can Work, Even in an Unpredictable Economy."
Apr 20, 2015•5 min
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, I can recall maybe three different occasions where somebody referred to the Hawthorne Effect in a po...
Apr 15, 2015•3 min
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 systemand thus lie beyond the power of the work force.
Apr 14, 2015•4 min
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 for improvement and the way VIBCO has used Lean to meet business objectives of better customer serv...
Apr 13, 2015•4 min
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 years at Dell Computer, and just over a year at a startup. These aren't all original thoughts, by any m...
Apr 09, 2015•7 min
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 officer, "the highest position ever held by a blue-collar worker in Toyota's eight decades," per the WSJ....
Apr 07, 2015•6 min
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 secondary concern). Secondly, I'm testing to see if the hospital's support processes work well - isthe dispen...
Apr 06, 2015•13 min
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 space for up to 25 people total. You can still sign up and attend on April 22 (full day) and April 23 (ha...
Mar 31, 2015•7 min
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 many people end up hating their jobs or going home crying or exhausted at the end of the day. That need...
Mar 27, 2015•10 min
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 Jim Womack that same question about the term "Lean." When I worked for LEI back in 2009, I asked Jim c...
Mar 26, 2015•11 min
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 Google search for the term and the implications of "assembly line medicine" are very negative. It's...
Mar 25, 2015•6 min
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 not just suddenly in crisis (financial or otherwise) in recent years. Book-NAHChapter 1 of the book i...
Mar 19, 2015•10 min
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.
Mar 17, 2015•5 min
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...
Mar 12, 2015•8 min
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 - causes and root causes. There's no simple answer to the question of why so much harm occurs and why...
Mar 11, 2015•8 min
