Lean Healthcare Trip to China, Day 1, Part 1:
My first trip to China... http://leanblog.org/audio151
Jul 21, 2016•10 min
Lean Blog Audio
Lean Blog Audio features Mark Graban reading and expanding on LeanBlog.org posts. Explore real-world lessons on Lean thinking, psychological safety, continuous improvement, and performance metrics like Process Behavior Charts. Learn how leaders in healthcare, manufacturing, and beyond create cultures of learning, reduce fear, and drive better results.
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Episodes
Free Excerpt from "Lean Hospitals" and "Practicing Lean"
http://leanblog.org/audio150 Thanks to those of you who pre-ordered the 3rd edition of my book Lean Hospitals.Click below to read a free preview from the book, the start of the chapter on leading and engaging employees (arguably, it's all about leadership). Improving the Way We Manage [Preview of "Lean Hospitals" 3rd Ed.] And if you post a comment sharing some of your reflections on your Lean journey, you might receive a free copy of the the book. Also, you still have a chance for me to send you...
Jun 23, 2016•8 min
Be Careful With "No Waiting Rooms" Just Like "Zero Inventories"
For decades, manufacturers have been tripped up by the simplistic idea that Lean is about "zero inventories." It probably didn't help that one of the earliest and most prominent books about what many used to call "Japanese manufacturing practices" had that exact title: Zero Inventories. It was published in 1983, well before "Lean" was a term used for this.Not even Toyota has zero inventories. They don't have zero raw materials. They have non-zero buffer inventories in between parts of their asse...
Jun 13, 2016•9 min
GM's CEO Roger Smith Thought Toyota Had Magic,
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 foolhardy) quest. The robots often famously painted each other instead of painting cars, as described in t...
Jun 09, 2016•7 min
From 1994, But Relevant Today: "Why TQM Fails"
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
Jun 08, 2016•8 min
his Doctor is Upset About Something,
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 "Emergency Medicine News" -- FIRST PERSON: 'We Fired Our Hospital' What appears on the front page of th...
Jun 06, 2016•9 min
The Need for Standardized Work When Ordering Whiskey
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 as simple as ordering a drink. A passenger seated across from me (yes, it was another passenger, not ...
Jun 03, 2016•4 min
My LinkedIn Post on Bad Toast & Bad Management
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.
Jun 02, 2016•5 min
If Your Hospital Wants to "Implement #Lean,"
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 Truly a Lean-Thinking Hospital? "The Emperor's Sacred Cow's New Clothes - "Flexing" Hospital Staff" Where...
May 31, 2016•5 min
NEJM Authors Double Down on Their Claim That Lean = Taylorism
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 equals Taylorism and that it's not appropriate for healthcare. Sigh. The NEJM just published two le...
May 25, 2016•10 min
Stuff I'm Reading May 2016: Bad Patient Experiences...
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 Might Be Getting it Wrong Resiliency Training - Important but Not Nearly Enough 'Lean Six Sigma' co...
May 24, 2016•7 min
Congratulations on Reducing Waiting Times,
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 for test results. http://leanblog.org/audio140
May 19, 2016•7 min
Lean Hospitals: Thoughts from a Health System C.O.O.
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 highlights added for this post: Reflecting further in 2015, Slunecka says:
May 17, 2016•5 min
J.C. Penney's CEO on Listening to Front-Line Employees
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."
May 16, 2016•6 min
Free Chapter - Upcoming 3rd Edition of "#Lean Hospitals"
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.
May 14, 2016•5 min
Updates: NICU Innovation, Labs, MLB Netting, VA Waiting
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.
May 05, 2016•9 min
Why It's OK That This Suggestion Box Was Full of Cobwebs
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.foremanOne of those Lean DFW people is Rick Foreman, the VP of Lean Development at Federal Heath Sign Co. Fe...
May 04, 2016•6 min
A Radical Idea in Healthcare: Refunds for Dissatisfied Customers
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.
May 03, 2016•8 min
A Post-Mortem on a Different Hospital Lean Journey
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 were aggressively site specific. At a time when PresenceHealth is "Becoming One" I do not believe the ...
May 02, 2016•6 min
Why Would a New Healthcare CEO Kill a Lean Program?
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”
May 02, 2016•8 min
More on "Motivational Interviewing" as a Method for
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 old behaviors in the workplace (such as blaming others, not planning, or jumping in to be the hero). I...
Apr 11, 2016•9 min
From a Patient Safety Tragedy to Lean & Baldrige
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
Mar 26, 2016•7 min
There's a Yuuuge Problem with Donald Trump's
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 my remarks to one particular context - his view of "leadership."As reported by FORTUNE and other publ...
Mar 11, 2016•8 min
Early Days of Lean in Veterinary Medicine?
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 them this.
Mar 08, 2016•8 min
What Virginia Mason's CEO Dr. Gary Kaplan Warns Against
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
Mar 06, 2016•8 min
Announced "Workplace Principles" for NHS Wales Staff
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
Mar 01, 2016•8 min
What We Can Learn About Teamwork and Culture
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 lesson" "For us, it's easy. We're looking for character, but what the hell does that mean? We're looking...
Feb 25, 2016•7 min
#Lean: The Toyota Production System is Mainly
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 number of thoughts and ideas about the Toyota Production System and what we might describe elsewhere as ...
Feb 24, 2016•6 min
#Lean Would Be a Solution for What These Nurses Complain About
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."
Feb 23, 2016•7 min
Engaging Staff in Improvement is Actually the Toyota Way, Too
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 great example of L.A.M.E. -- Lean As Misguidedly Explained.
Feb 12, 2016•6 min
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