Lean Blog Audio

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 this series of videos last October) and I focused this time on the NICU, going there all three times. Why did I go three times? Some of it was logistics, as I was the person responsible for getting each group there and I don't know my way around the hospital that well. It was easier to learn one path - how to get to the NICU and back. Since my last visit in October 2014, the NICU movedinto a new physical space (in November). The old unit was the traditional NICU of days past - a big open room with curtains that divi

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 children under age 15 each year, and the vast majority of them have good outcomes. If a child has a medical emergency, parents should get that child to the nearest emergency room and have confidence that they are receiving top-quality care in the right place from the right physicians." It's "the best in the world." Is that an opinion? Where is the data to back that up? --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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" --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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" --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 designed systems and processes -- it's not the fault of individuals, nor is the waste due to a lack of clinical expertise or a lack of technology. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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, incorporating some of these tweets, as appropriate.... --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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.... --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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." --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 positive light, as in: "We'll have to see if the data improves, maybe we'll get the Hawthorne Effect." People have meant this in a positive light in the context of the flow of the conversations. I remember somebody almost bragging that the improvement in an area was due to the Hawthorne Effect. I cringed... that's not really anything to hope for. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 service and performance. Then, and over time, I've been impressed with Karl's transformation into a Lean leader. Beyond VIBCO, Karl has been a tireless proponent of Lean for the state of Rhode Island. These efforts have led to Governor Gina M. Raimondo supporting Lean and signing an executive order that will mandate the use of Lean principlesand methods in state government. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 means, but I had written them down when I was in between jobs (the startup had a real cash crunch after 9/11).If Twitter had existed, I might have tweeted many of the thoughts on that paper. Not all of them are under 140 characters, but here some of the things on that sheet from 13 years ago. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 dispenser actually not empty? It's usually not difficult at all to find an empty gel or foam dispenser on the wall. Sometimes, the first one I try is empty (as are others). Sometimes, I have to try a few... but there's almost always an empty one. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 (half day). Learn more at http://leanblog.org/audio39. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 needs to change. In my 20-year career, in manufacturing and in healthcare, Lean has been a powerful and effective methodology for meeting those goals, along with improving quality, reducing waiting times (for products or for care), and reducing cost. But, not always. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 casually and he said basically, "It's just a word" or something like that. But, I got a longer response to this question from Jim back in Podcast #118, in 2011 (which makes it more of a real throwback now). --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 also a bit of a "red herring" (or is it a "straw man") for them to bring up assembly lines when we're in agreement (I hope) that our goals are to improve safety, quality, waiting times, cost, and staff morale. --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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 is titled "Why Hospitals Fail." The author says, "Clearly, something isn't working." --- Support this podcast: https://anchor.fm/lean-blog-audio/support

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. --- Support this podcast: https://anchor.fm/lean-blog-audio/support