Lean Blog Audio

In my travels, I often meet people or visit organizations that say something like:"We're doing Lean... we just call it Process Improvement." They have a "Process Improvement" (PI) department, or they call it "Continuous Process Improvement" (CPI). They have people in roles like "Process Improvement Facilitators." While process improvement is great, in using a term like that,there's perhaps a risk that they miss the full and complete essence of Lean and, therefore, don't get the results that they might hope for. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

http://www.leanblog.org/audio172 StoreSMART is partnering with me on this contest where you can win one of four sets of books, along with a selection of sample supplies that can help you with 5S, visual management, and other Lean methods.By January 31, 2017, we'll select four winners who will each get a set that includes: Lean Hospitals, 3rd Edition (signed by Mark Graban) Work That Makes Sense (signed by Gwendolyn Galsworth) The Batz Guide for Bedside Advocacy (a great patient safety guidebook) One winner's package will includethe book Visual Workplace Visual Thinking instead of Work That Makes Sense. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

It's a weight loss program called "Lean 13." It's the everyday use of the word "lean," as in thinner, that has nothing to do with the Lean methodology and the Toyota Production System. They're promising that you'll lose 13 pounds in the first month.As with the Lean methodology, in hospitals, factories, or wherever, your results might vary based on a number of factors. For example, Nutrisystem can't stop a customer from supplementing their food with Buffalo wings and chocolate milkshakes. We have situations out there where people say, "We tried Lean and it didn't work." Maybe it was because they were cherry picking a few Lean tools or they just thought Lean was about cost cutting, instead of focusing on safety, quality, patient flow, and employee engagement. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

My favorite book, as I've written about before, is not a "Lean book" -- it's Understanding Variation: The Key to Managing Chaos by Donald J. Wheeler, PhD. It might look like a book about statistics... http://www.leanblog.org/audio170 --- Support this podcast: https://anchor.fm/lean-blog-audio/support

I'm extremely honored that The W. Edwards Deming Institute published my first blog post in a series of three that I've written for them, to be published over the next month or so.The post is titled: "Why Dr. Deming's Work is So Important to Me" http://www.leanblog.org/audio169 --- Support this podcast: https://anchor.fm/lean-blog-audio/support

Before Christmas, I was listening to the Dan Le Batard Show and their guest for the day was former NFL player Domonique Foxworth, pictured at left. Foxworth earned an MBA from Harvard Business School after his playing days. He's the perfect participant in a smart show about sports and whatever.During one segment, they all talked about NFL offensive and defensive coordinators and how they often fail when promoted to a head coach position.... and the discussion seemed relevant to other types of organizations. http://www.leanblog.org/audio168 --- Support this podcast: https://anchor.fm/lean-blog-audio/support

I had a chance to visit one of their community hospitals, Hillcrest Hospital, as well as the main campus. It was a very stimulating visit and it was great to see the progress they were making in building a "culture of improvement." http://www.leanblog.org/audio167 --- Support this podcast: https://anchor.fm/lean-blog-audio/support

"Making mistakes is better than faking perfection."I saw this quote the other day and tweeted it. It seemed like food for thought and something to reflect on for a new year. A Google search doesn’t lead to a clear creator of this quote… it’s a common thought that has been around a long time, I guess. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

http://www.leanblog.org/audio165 I get annoyed by corporate euphemisms, such as referring to people as "resources," the term "right-sizing" for layoffs, and the type of jargon and babble parodied in the Weird Al song "Mission Statement."Using unclear language can intentionally mask and hide reality, or sometimes it's just another form of incompetence. You might know about the recent Wells Fargo scandal (as I blogged about here). The bank is trying to make amends for customers being harmed by unnecessary fees and the hit to their credit score that resulted from accounts being opened in their name without authorization (because employees were under pressure to hit unrealistic goals). I can't find the commercial online, but Wells Fargo has been running ads that sort of apologize and promise to make things right (better latethan never). The ad says something like: "... customers who were impacted..." They don't say WHAT the customers were impacted by. They make it sound like a tornado or some other natural

It's a bit of a modern management cliché to say "Don't bring problems! Bring me solutions!" I think what that means is "Don't just complain! Think about improving things!" It's good to think about improvement, but sometimes (if not often!) that improvement process starts by identifying problems. In a "Kaizen" process in a team, I encourage people to bring problems forward even if they do NOT have a solution or "countermeasure" in mind. When somebody points out a problem, that can prompt discussion or brainstorming (with the manager and colleagues) about what solutions could be tested. Here's an article from Harvard Business Review that delves into this same topic: "Don't Bring Me Problems--Bring Me Solutions!" --- Support this podcast: https://anchor.fm/lean-blog-audio/support

I first blogged about this article back in 2009 and it's still online:"Keen to Be Lean" The sub headline talks about hospitals being "desperate to cut costs." Has that changed? I wish the motivation was more often about hospitals being "desperate to improve patient safety and quality." Lean can address that too and should be mentioned, even in a publication for CFOs. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

http://www.leanblog.org/audio162 Dr. W. Edwards Deming used to warn against replacing intrinsic motivation with extrinsic rewards and incentives.Brian Joiner (author of Fourth Generation Management), who worked with Deming, warned that setting targets and quotas can lead to three things: improving the system, distorting the system, or distorting the numbers. It’s often easier to distort the system or the numbers than it is to actually improve. We’ve seen that happen (gaming the numbers) in situations ranging from the VA waiting time scandal and the recent Wells Fargo scandal. It’s predictable human behavior for managers to try to entice people to perform better through promises of rewards or threats of punishment... --- Support this podcast: https://anchor.fm/lean-blog-audio/support

I was happy to see an engineer (Chemical Engineering) and a General Motors leader, Alicia Boler Davis, on the cover of the Northwestern University alumni magazine.See this profile and story: "DRIVING GM" http://www.leanblog.org/audio161 --- Support this podcast: https://anchor.fm/lean-blog-audio/support

In the Lean approach, we don't call people idiots or dummies. We don't say, or shouldn't say, things like "idiot proofing" or "dummy proofing."There's an old Toyota story about how the term "fool proofing" upset an employee, they switched to using the equivalent of "mistake proofing" or "error proofing." Read more about the story in a comment on an old blog post of mine. Terms like mistake proofing help us focus on the process and the system instead of blaming individuals. Instead of labeling people as idiots, we have to focus on improving the system so it's easier to do the right thing and harder for errors to occur. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

http://www.leanblog.org/audio159 I do a lot of work across the U.S., but I've also been very fortunate to work with hospitals, clinics, and health systems around the world over the past 11 years.It started with a few trips to Canada to conduct some hospital lab assessments and Lean leadership training when I worked for a J&hospital consulting group. Then, came an opportunity to spend about eight weeks working with a hospital north of London in 2008, a fascinating opportunity.In recent years, I've visited and/or coached hospitals in The Netherlands, Sweden, Finland, Japan, China, and Thailand. These are very different countries in their national cultures, of course. Their high-level, big-picture healthcare systems are designed differently (including the level of universal coverage, or lack thereof, and who pays). But, when you look at the details of how the work is done... how healthcare is delivered... how people manage... things are more the same than they are different. In England, they said, "Same p

A few weeks ago, I saw this announcement about Dean Gruner, MD, the second CEO to lead ThedaCare during their Lean journey:Dr. Dean Gruner, ThedaCare President and CEO, Announces Retirement "Dean Gruner, MD, president and CEO of ThedaCare since April 2008, today announced his plans to retire. Dr. Gruner began in healthcare 40 years ago, has served this community for 33 years, and has served as President and CEO of ThedaCare since April 2008." Congratulations and best wishes to Dean on his retirement! He has been a great leader and advocate for healthcare improvement. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

I was happy to see this announcement the other day:UCSF to Train Residents in Lean Management and Process Improvement From the announcement: “UC San Francisco will train medical residents and fellows in Lean management principles, as part of a broader institutional commitment to continuous quality improvement. The effort is being supported inpart with a grant from the Accreditation Council for Graduate Medical Education (ACGME) through its Pursuing Excellence in Clinical Learning Environments initiative. UCSF was one of eight medical training sites nationally to receive the competitive grant.” --- Support this podcast: https://anchor.fm/lean-blog-audio/support

You might remember the hubbub (a kerfuffle?) over the NEJM opinion piece written by Dr. Jerome Groopman and Dr. Pamela Hartzband. See my first post about their article. There are more links at the bottom of this postNow, the "Perspective" section of the New England Journal of Medicine has published a piece titled "The Hard Work of Health Care Transformation" by Dr. Richard Bohmer. Check it out. Dr. Bohmer says "government and regulators influence" (or attempt to influence, I'd add) healthcare organizations through financial rewards and penalties, regulatory constraints, and attempts to encourage "performance-improvement activities through education, research, and measurement programs." These approaches might help, but aren't sufficient. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

More notes and discussion about my trip to China. http://leanblog.org/audio155 --- Support this podcast: https://anchor.fm/lean-blog-audio/support

http://leanblog.org/audio154 Continuing from Part 1 of my post about my first day of my first China trip, I'd like to share more about the Lean healthcare conference and presentations that took place.In the next presentation from a Chinese hospital, the speaker started talking about the need to "improve [patient and employee] satisfaction through Lean management" and that "we have the same goals and purpose" as I expressed in my presentation... namely safety, quality, waiting times, cost, andemployee morale (SQDCM). I had showed a "spaghetti diagram" in my talk, shown below, of a podiatrist running around an Illinois clinic searching for supplies (this was the walking required for ONE patient... 10 minutes of waste): --- Support this podcast: https://anchor.fm/lean-blog-audio/support