Lean Blog Interviews: Real-World Lean Leadership Conversations in Healthcare and Beyond

Joining me today for Episode #330 of the podcast is Christoph Roser, a professor of production management at the Karlsruhe University of Applied Sciences in Germany. He has decades of experience with Lean manufacturing including time with Toyota in Japan, as a consultant at McKinsey & Company, and as a Lean expert and manager at Robert Bosch GmbH. He earned a Ph.D. from the University of Massachusetts. He is author of the book Faster, Better, Cheaper in the History of Manufacturing: From the Stone Age to Lean Manufacturing and Beyond. You can read his full bio here, via his excellent blog AllAboutLean.com. Today's discussion was sparked by his series of blog posts about his “grand tour” of automotive factories in Japan. You can read those or check out his overview blog post here. We'll talk about the differences between some of these companies, a bit about Lean in healthcare, and we'll discuss Christoph's concerns about the way Toyota's culture might be changing under CEO Akio Toyoda.

Joining me today for Episode #329 of the podcast is Mike Eisenberg, the director, editor, and producer of the film “To Err is Human,” a documentary about the incredibly important issue of patient safety. The film shares a title with the groundbreaking 1999 report from the Institute of Medicine. The film is available on as a digital download (through iTunes and other platforms) and a Blu-ray or DVD (through Amazon) and there also screenings taking place around the country (and you can arrange one at your organization). In our conversation, Mike and I talk about the scale and breadth of patient safety problems, some of the systemic causes, and some of the solutions that are being tried and used in healthcare. The term “Lean” is not a part of the film, but Mike said he's become aware of the alignment between Lean and systemic patient safety improvement, but there are limitations to what could be put into a 77-minute film. But, there are common themes including not blaming “bad apples” and improving the way care is delivered in a systematic way. I had the opportunity to watch the film before the interview — it's very powerful and well produced. I hope you'll check out the film, whether you are a patient or a healthcare professional (or leader). It's important that we help the public understand that patient safety can't be taken for granted… and it's important that hospitals step up their efforts on this front.

My guests for Episode #328 are Bette Gardner and Jeff Heil, of the company Breakthrough Learning. Bette is the creator of a fantastic simulation called "Friday Night at the ER" -- which I've blogged about. When we recorded the webinar, Bette was CEO and Jeff was COO, but recently Jeff took over the CEO role. They are also, as they mention, mother and son... which will be followed by an upcoming podcast with a father and son team (two of the authors of this book). In this episode, we talk about Bette's inspiration for the simulation, systems thinking, and healthcare improvement. We'll also talk about how the simulation is used by organizations in many industries as a way of teaching systems thinking principles.

My guest for Episode #327 of the podcast is Marc Rouppe van der Voort, Ph.D., who is joining me from Utrecht in the Netherlands. We first met back in 2009 when he invited me to come speak at a Dutch Lean Healthcare conference (which I blogged about here). We've crossed paths many times, as Marc has frequently visited the U.S. for the annual Lean Healthcare Transformation Summit, coming with a large group of Dutch Lean healthcare practitioners from many organizations (they collaborate through an organization he chairs called Lidz, which has 60 organizations as members). I've also had the chance to go back to visit and teach at Marc's current employer, St. Antonius Hospital, where he is vice president of operations management and leads the application of Lean principles and several supporting teams. He has also written three practical books on the application of Lean in healthcare. Today, we'll be talking about his learning and his experience with Lean in Dutch healthcare organizations -- what are the differences in the Dutch system and what are the ways in which it's similar to the American system? We'll also discuss the connections between Value Based Healthcare and Lean, with the focus on patient outcomes and quality of life... and other topics related to Lean and leadership.

Joining me for the fourth time, here for Episode #326 of the podcast, is my friend and colleague Katie Anderson, a leadership coach, Lean consultant, speaker and writer from the San Francisco area. Hear our previous podcasts about visiting and living in Japan. Today, we're talking about a number of topics related to learning and collaboration: Her upcoming book with Isao Yoshino, the local San Francisco Bay area AME consortium that she is leading, her next trip to Japan (which you can join), and more. I hope you enjoy our conversation as much as we did. For some other resources, and to enter to win a copy of my book Lean Hospitals (and a copy of Measures of Success) that Katie is giving away, visit kbjanderson.com/mark. Thanks, Katie!

Joining me for Episode #325 of the podcast is Andrea Hardaway, an operational leader and the executive director of the Association for Vocal Disorders. Andrea and I first crossed paths through LinkedIn, seeing what she shares there and vice versa. We also had a chance to visit a hospital together in Florida last year to learn about their Lean improvement work. We have enough professional interests in common, I thought it made sense to record a conversation and share it here with the listeners. Andrea has worked in manufacturing, healthcare, and other parts of the service sector and has seen common themes across industries. This includes the opportunity to better use metrics in a way that resonates with staff and is connected to improvement work, something I'm also very interested in. So, we talk about that and more in this episode.

My guest for Episode #324 of the podcast is Art Smalley. Art was one of the first Americans to work for Toyota Motor Corporation in Japan and, since then, has been helping other organizations with the Toyota Production System (a.k.a. “Lean”) methods and approaches. You can also visit his website to learn more, www.ArtOfLean.com. Episode page: http://leanblog.org/324 Art is a fellow faculty member at the Lean Enterprise Institute. He has written two Shingo Publication Award-winning books: Creating Level Pull and (co-authored with Durward Sobek) Understanding A3 Thinking. Art later wrote Toyota's Kaizen Methods: Six Steps to Improvement with Isao Kato. I own all of these books and have only met Art briefly in the past, so I'm happy to finally have him here as a guest. Today, we'll talk about Art's career and his most recent book, Four Types of Problems, published by the Lean Enterprise Institute (note: LEI provided me a free electronic copy of the book). I hope you enjoy the conversation as much as I did.

I first met Davis Balestracci at a conference a few years back, where I heard him give a very spirited and insightful presentation. That's why I'm happy to have him as my guest for Episode #323 of the podcast. We'll talk about a range of topics, including some of the key lessons that you'll find in his book (as a much deeper dive than we can get into here) Data Sanity: A Quantum Leap to Unprecedented Results (2nd edition). Davis has been a long-time columnist for Quality Digest, and you'll hear his thoughts on Process Behavior Charts, W. Edwards Deming, Lean Six Sigma, and more. From his bio: “Davis has a BS degree in chemical engineering and an MS degree in statistics, yet describes himself as a “right-brained” statistician: his Myers-Briggs profile is INFP and he is a pipe organist who done graduate work in conducting.”

Today's podcast is a departure from the usual interview format. As I blogged about last week, the Lean community has lost a young, thoughtful, inquisitive, and reflective member -- Samuel Selay. I regret not having Sam on the podcast to talk about our learning and reflections. He was a guest of Ron Pereira's on the Gemba Academy podcast in 2016, talking about Lean in the Department of Defense. Today, I'm doing a reading of a blog post that Sam wrote for this site back in August. I'm also sharing the audiobook version of his chapter from the book Practicing Lean (which is read by our audiobook narrator). It's not his voice, but it's his words and thoughts. As the Marines say (Sam was an active duty Marine for 13 years), Semper Fi. There is a GoFundMe page that was set up by Sam's sister-in-law to provide financial support to the family — his wife and four children under 18. I've donated and I hope you might consider doing the same.

My guest for episode #321 of the podcast is Mark Hamel, He is a partner and COO with The Murli Group. Mark is a two-time recipient of the Shingo Research and Professional Publication Award for his books The Kaizen Event Fieldbook and his most recent book Lean Math, the main subject of this episode. I hope you enjoy the discussion, which is about people as much as it is about math.

Skip Steward, the Chief Improvement Officer at Baptist Memorial Health Care in Tennessee, was a guest on Episode #314 of the podcast talking about TWI and Toyota Kata in healthcare (he was joined by Brandon Brown). Today, I've asked Skip to come back and chat 1x1, in Episode #320, about his experience with Don Wheeler, learning from W. Edwards Deming, and more. I hope you enjoy his reflections, our discussions about healthcare, and connections to my book Measures of Success (Skip undoubtedly has a book in him too).

My guest for Episode #319 is Karen Martin, whose most recent book is Clarity First: How Smart Leaders and Organizations Achieve Outstanding Performance. Episode page She was previously a guest on Episodes #151, #190, and #285. Karen is an author of many books on Lean, quality, and performance excellence. She is also a speaker and a consultant with a B.S. in Microbiology from Pennsylvania State University and an M.A. in Education from California State University, Bakersfield. Read her full bio. What is clarity? How can we work toward creating less fog and more clarity in organizations? We'll talk about that, along with a bit of discussion about clarity in metrics, as I write about in my book Measures of Success.

318 - Marcus Hammarberg, How Lean & Kanban Saved an Indonesian Hospital Joining me from Sweden for Episode 318 of the podcast is Marcus Hammarberg, author of the fascinating book Salvation: The Bungsu Story: How Lean and Kanban saved a small hospital in Indonesia. Twice. And can help you reshape work in your company. Marcus is a software developer, consultant, lean/agile coach, speaker, and author. He ended up with an opportunity to work with a hospital in Indonesia and he tells that compelling story in the book. How did a huge hole in the roof help trigger a change in culture and results? You'll hear about that and more in this episode. I hope you enjoy it and find it inspirational, as I did.

My guest for Episode #317 of the podcast is Patricia Morrill, a speaker, trainer, consultant, researcher, and author of the book The Perils of Un-Coordinated Healthcare: A Strategic Approach toward Eliminating Preventable Harm. With 30 years of experience in the healthcare industry, she has focused on blending operational efficiencies with healing environments. Patricia has successfully integrated Lean and Project Management methodologies with organizational strategic goals to build roadmaps for execution. Check out her website and her blog. In today's episode, we discuss her personal story about her mother's death that came as the result of a preventable medical error. What can be done to prevent medical errors, harm, and death?

@Flinchbaugh Interviews @MarkGraban About "Measures of Success" Today's episode is the second time that friend and podcast guest Jamie Flinchbaugh has turned the tables by playing host to interview me about my new book, Measures of Success: React Less, Lead Better, Improve More, which has recently been the #1 best selling book in Amazon's Total Quality Management category. Jamie is very knowledgeable on these topics, so he was a great person to interview me and to have more of a conversation about choosing the right metrics and then managing them the right way. I hope you enjoy the conversation and future podcasts will return to the usual format where I interview guests and try to let them do most of the talking.

Why do people fear change? Why are adults afraid of talking about their fears? My guest today is eminently qualified to answer such questions and to provide advice that can help us. My guest for Episode #315 is Robert Maurer, Ph.D., author of the outstanding book Mastering Fear. Bob was previously my guest for Episode #153, where we discussed one of his earlier books on Kaizen, One Small Step Can Change Your Life: The Kaizen Way. By the way, earlier this year I noticed that his other book The Spirit of Kaizen was one of the few books by an American author that Toyota was selling at the Toyota Commemorative Museum of Industry and Technology in Nagoya (see photo below). I hope you enjoy today's discussion on Mastering Fear. As the subtitle says, can we "harness emotion to achieve excellence in health, work, and relationships"?

314 - Skip Steward & Brandon Brown, on TWI & Kata in Healthcare Today I have two guests joining me for Episode #314 of the podcast. They are Skip Steward, the Chief Improvement Officer at Baptist Memorial Health Care in Tennessee and Brandon Brown, the owner and "Master Kata Coach" of his firm, Continuous Coaching Commitment, LLC. In this episode, we discuss their use of methods such as "Training Within Industry" and "Toyota Kata" in the important work of healthcare improvement. Skip and Brandon both have backgrounds in manufacturing, but they have been able to translate Lean skills and mindsets into healthcare. We'll also talk about their dynamic as consultant / client and how the roles of "coach" and "learner" are often very situational and how we can be both at different times.

Today's episode (#313) of the podcast is a bit of a departure from the norm. Instead of interviewing a guest about their book or other work, I'm reading what's basically an audiobook-style excerpt of the first part of my new book Measures of Success: React Less, Lead Better, Improve More. I say "audiobook-style" because it's not professionally produced and my voice has been bad after being sick last week... but I thought this would be one way to share some of this material and promote the book. I won't be doing a full-blown audiobook because the book is so full of charts, I don't think it all translates well to the audiobook format. But, here I'm reading the foreword, the preface, the introduction, and part of Chapter 1.

Joining me today for Episode #312 of the podcast is Jeff Hunter, author of the excellent book "Patient-Centered Strategy: A Learning System for Better Care." Jeff was with the ThedaCare in Wisconsin, where he was Senior Vice President, Strategy and Marketing for the health system. After retiring from ThedaCare, he has been a faculty member for Catalysis and has started his own consulting firm, Jeff Hunter Strategy. In today's podcast, we discuss a number of topics, including how a good strategy is a necessary input for a "strategy deployment" management process, some of the problems with traditional approaches to strategic planning, and why an iterative PDSA approach works better than static plans.

http://www.leanblog.org/311 -- show notes My guest for Episode 311 is Jess Orr, a continuous improvement practitioner at WestRock, a large paper and packaging company, where she helps plants foster a culture of continuous improvement and employee engagement. Her experience includes working directly for Toyota Motor Manufacturing Kentucky. She is particularly passionate about sharing best practices across industries, which motivated her to found Yokoten Learning. In today's episode, we talk about her path from Six Sigma Black Belt to a Lean-thinking engineer at Toyota. How did she progress from solving problems herself to developing others? We'll talk about a blog post that she wrote for this blog earlier this year, Lean and ROI, leadership and culture, and much more. What is it like working outside of Toyota again? I hope you enjoy the discussion.

Steve Shortell, The Impact of #Lean on Healthcare Quality http://leanblog.org/310 Joining me again for Episode 310 is Stephen M. Shortell Ph.D., MPH, MBA. He is Blue Cross of California Distinguished Professorship, HPM and is a Professor of Organizational Behavior at the University of California, Berkeley School of Public Health. He was previously a guest on Episode 267 talking about the establishment of the Center for Lean Engagement and Research (CLEAR) at the University of California, Berkeley, where he is the director. In this episode, we talk about some initial research that they released in a paper that was published in The Joint Commision Journal on Quality and Patient Safety: "Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results From a National Survey"

Episode page Back on the podcast for the sixth time is my friend David Meier, a Lean / TPS consultant who is a former Toyota leader at their plant in Georgetown, Kentucky. As we mentioned in our April episode (#304), he's gotten into what's, perhaps, the most Kentucky of industries… distilling bourbon (and more) at Glenn's Creek Distillery. Update — His “OCD #5” was named “US Micro Whisky of the Year” in the 2023 edition of the Jim Murray Whiskey Bible. Congrats, Dave!!! In this episode, there's a lot of bourbon talk, with some Lean concepts thrown in. If you share our interest in Lean and whiskey, then this might be your most favorite episode ever. Of course, if you don't have any interest in bourbon, you might well skip this one. Here is an article from IISE magazine about David's work: Helping the whiskey flow, Toyota style As David will talk about in the podcast: “Meier started work at Toyota in the 1980s and later became a traveling consultant. During his travels, he began thinking about establishing his own manufacturing-centered business closer to home. After researching his options, he came upon the original Old Crow Distillery that had been shut down since 1985. The 16-acre property had not been maintained since it closed, and Meier purchased the place in 2014.” I'll visit David and his distillery next week, so I'm sure I'll have more stories and photos. Topics and Links for this Episode: How did you get interested in distilling? Tell us the story about buying the business and getting things back up and running? There's lots of competition, long lead times before you can go to market… so why do this? Having solutions, versus understanding what's important, what the problems are, what the bottlenecks are… How do TPS / Lean principles apply to this business and the process? Are there annual cycles of strategy deployment to choose priorities and goals? Are there lessons from Toyota? “It's an area where I'm deficient.” What are needs vs. wants for the business? Bourbon usually requires a long value-added aging time in a warehouse… what can you do to reduce lead time in bourbon making? You can't level-load corn growing… Is there conventional wisdom, in Lean or whiskey making, that's superstition or proven in fact? Is there always a better way? Are you selling consistency or a product that's very different or better each year? In the IISE article, you said, “”When I was at Toyota all the Japanese guys would say, all we do is problem-solve,” he said.” — can you elaborate on that? “I took a one week class, so I'm an expert?” What's a “master distiller?” What's a “master?” The Japanese say you never achieve mastery no matter how good you get. “When you look at that mindset, you realize it's not about the savings. It's about the use of people, their creativity and directing that in a way that (pushes) them to think harder,” he said. – What do you do to be creative and encourage those who work with you to be more creative?

Joining me again for Episode #308 is Mike Grogan, a previous guest in episodes #182 (from Tanzania) and #224. Mike now lives in the Philippines, where he's helping and coaching many people and has written a new book, The MESSI Way. In this episode, we talk about the idea of "personal Lean" and being the best version of yourself. I appreciate Mike's reflections and honesty and I think we had a great conversation that was very thought provoking. What are your fears? Your failures? What have you learned about yourself in the last 12 months? What's a "thinking partner?" Those are just a few of things we discuss here today.

Joining me for Episode #307 of the podcast is my friend Andre DeMerchant, the President of DeMerchant Healthcare Solutions Inc., based in Kitchener, Ontario. We first crossed paths when we had the chance to work together with an American healthcare client via our then-affiliation with Pascal Dennis and Lean Pathways. In today's episode, we talk about Andre's history working for Toyota in Canada and what he learned there -- and why it's important that he learned about "how flow works" at Toyota. We chat about the terms "Lean" and "The Toyota Production System" and what those words mean to him. How does TPS "transcend culture and language," as well as industries? We then shift to talking about healthcare and some of the common challenges, including "financial hardships," that are faced in many countries. Why are hospitals "poorly prepared for change" in many cases? Another main theme is "cost cutting" and why you can't cut your way to success.

Podcast #306 - Mark D. Valenti, Motivational Interviewing and Health System Improvement My guest for Episode #306 is Mark D. Valenti, the manager of training, education, and workflow integration for the Enhanced Community Care Management (ECCM) at Highmark Health. In this episode, Mark and I talk about the use of "Motivational Interviewing" methods and mindsets in the ECCM program and how "everyday closer to better" is part of their mantra. We discuss the MI approach and how it's different than traditional healthcare or change management models that focus on telling people to change (or why they should change). There are many lessons that I think are helpful in any workplace or personal change context. ECCM is a "physician-led, patient-centered approach [that] focuses on prevention, high-quality and compassionate care, patient engagement and satisfaction, and health outcomes." According to Highmark, "In the first year, the ECCM program has provided a large Pennsylvania health plan with total medical care cost savings of greater than 19% for engaged members; equivalent to one inpatient admission per year per member engaged. More than 1,500 members are enrolled across more than 60 provider sites."

Respect for People and Continuous Improvement for Healthcare I was recently asked to do a recorded video presentation for a medical conference in Turkey. I spoke about the dual pillars of "The Toyota Way": Respect for People Continuous Improvement The video is about 20 minutes, split about half and half on each of those interrelated topics. I'm coming to you from a hotel room, somewhat tired after a day of consulting. (Slides PDF and transcript also included)

Episode page Back on the podcast for the fifth time is my friend David Meier, a Lean / TPS consultant who is a former Toyota leader at their plant in Georgetown, Kentucky. He's gotten into what's, perhaps, the most Kentucky of industries… distilling bourbon (and more). You can also listen to another, much longer episode where David and I talk about bourbon, whiskey, and continuous improvement for almost 90 minutes total there. Today is a shorter episode, where we catch up and hear more about what David has been doing since his last podcast appearance in 2010 when we talked about the challenges Toyota was facing then. In this episode, David drops a lot of knowledge and wisdom in a very short time — thoughts on problem solving and how Lean thinking isn't easy for anybody, even if you're Japanese. He's co-author, with Jeff Liker, of the books The Toyota Way Fieldbook and Toyota Talent.

Joining me for Episode #303 is Craig Deao, a senior leader with Studer Group. From his bio: "Since 2006, Craig Deao, MHA, has been an integral part of Studer Group as a senior leader for the organization's speaking and conferences teams, and he now directs thought leadership across Huron [Consulting Group]'s broader healthcare practice. Craig is a highly regarded national speaker on leadership, engagement, quality and patient safety. He works with medical staffs and healthcare executives to create highly reliable organizations where employees want to work, physicians want to practice and patients want to receive care." Today, we're talking about his book The E-Factor: How Engaged Patients, Clinicians, Leaders, and Employees Will Transform Healthcare. We'll talk about the differences between satisfaction and engagement, how to tell if people are engaged in their work, and how to engage various stakeholders, including employees, clinicians, and executives. We'll also talk about how Studer Group became a recipient of the Malcolm Baldridge National Quality Award in 2010.

My guest for Episode #302 is Katie Anderson, following up on her last appearances in Episode #233 (when she was living in Japan) and Episode #275 (after she returned to the U.S.). Today, we're chatting because I've just returned from a short trip to Japan and Katie's going back in May (and you can join her). We're sharing observations and reflections on topics ranging from standardized work to Kaizen. Would it be easier to "implement Lean" (or whatever term you'd use) if you're a Japanese organization? And what are some of the approaches you see with quality improvement and Lean in Japan's hospitals? Our conversation also meanders into topics like eating sushi and more.

This podcast is sponsored by Cardinal Health. All opinions expressed here are those of Joe Swartz and not of his employer or any other organization. Joining me again for episode #301 of the podcast is Joe Swartz, my friend and co-author for our books Healthcare Kaizen and The Executive Guide to Healthcare Kaizen:. You can learn more about our books here. He also contributed a chapter to the book Practicing Lean. (read an excerpt). Today, we're talking about "Champions of Change," as I've been writing about for Cardinal Health.

Episode page Remastered October 2022 My guests for Episode #300 of the podcast are Tracey and Ernie Richardson, authors of the excellent book titled: The Toyota Engagement Equation: How to Understand and Implement Continuous Improvement Thinking in Any Organization The book is full of solid insights and personal experiences from their time working for Toyota in Georgetown, Kentucky at the plant known as TMMK (Toyota Motor Manufacturing Kentucky). You can find their book's website. Tracey and Ernie are both faculty members for the Lean Enterprise Institute. Tracey's blog is called The Toyota Gal. In our podcast, we talk about their experiences at Toyota, including lessons they've learned about problem solving, people development, and what they call “D and A” – discipline and accountability. We also talk about Ernie's experience within health clinics at Toyota and other healthcare organizations. I hope you enjoy the discussion even if you work in healthcare or another realm outside of manufacturing.

Joining me again for episode #299 of the podcast is Joe Swartz, my friend and esteemed co-author for our books Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements and The Executive Guide to Healthcare Kaizen: Leadership for a Continuously Learning and Improving Organization. Episode page with links and more. You can learn more about our books here. He was previously the guest in episode #187. Joe is Administrative Director of Business Transformation for Franciscan St. Francis Health System in Indiana (his full bio is here). Today is the first part of a two-part discussion, where Joe reflects on the history and evolution of more than ten years of "Kaizen" or continuous improvement in his system. In our next episode together, Joe will be talking about "Champions of Change." I hope you enjoy the discussion!

Joining me again for Episode #298 is Billy R. Taylor, for Part 2 of a discussion we started in Episode #293. Last week, a friend texted me last week and said he couldn't wait for Part 2. He said he pulled off the road to take some notes when he listened to Part 1. So without further ado, here is Part 2. Here, we discuss "extreme ownership," why creating ownership is more important than forcing accountability, and important lessons he's learned along the way.

My guest for Episode #297 is John (JJ) Villarreal, Ed.D., the superintendent of the Rockwall I.S.D. here in the Dallas area. In this podcast, we talk about the applications of Lean in education, how to move beyond what JJ calls "the behavior waste of judgment and blame," and how visiting a factory was inspiring and helpful, among other topics. Even if you don't work in education, I hope you'll be inspired by this podcast.

Joining me for Episode #296 of the podcast is Zeev N. Kain, MD. MBA, FAAP. He is a physician and a Chancellor's Professor at the University of California, Irvine. See his full bio. He has many additional roles and titles, including: Director, System Redesign & Value Based Care for the UC-Irvine Health Policy Research Institute Executive Director of the UCI-Yale Center on Stress & Health President of the American College of Perioperative Medicine Dr. Kain is "recognized as an international expert in the clinical management of perioperative fear and anxiety, and management of children undergoing invasive medical procedures. His research addresses major dilemmas encountered in the management of affected children." He's also an advocate for Lean and Six Sigma and the connections to reducing "clinical variation" in healthcare. So, that's what we're talking about today.

My guests for Episode #295 are Sarah Steinberg of Atrius Health and Ted Toussaint, a healthcare innovation strategist, formerly of Atrius Health. Ted is also a faculty member for Catalysis. Today, we're talking about some innovative work that they led at Atrius, using a variety of modern product development and innovation methods, including Lean, Lean Startup, Design Thinking, and more to create a new "Care in Place" model for home-based patient care that helps reduce trips to a clinic or hospital. Their work was featured in this HBR article: "How Atrius Health Is Making the Shift from Volume to Value."

Joining me for episode #294 is Clay Linkous, an account leader and speaker with Studer Group. He is an accomplished cultural transformation and leadership expert who has synthesized Lean and other improvement methods with Studer Group principles and practices. Today, we'll talk about Clay's career and his purpose and motivations - both for working in healthcare and improving healthcare. We're both firm believers in the combination of Studer and Lean practices, so we're also discussing that as our main topic. I hope you enjoy the discussion!

My guest for Episode #293 of the podcast is a dynamic speaker and manufacturing leader, Billy R. Taylor. I saw him speak a few years ago at a Shingo Prize Conference and I've wanted to get him on the podcast ever since. He's currently the Director of Commercial, Off Highway, and Support Manufacturing North America for The Goodyear Tire & Rubber Company. Over the past 20 years, he has risen from "the lowest level of the organization," up through the manufacturing leadership ranks at Goodyear, including time as a Plant Director at facilities in Oklahoma and North Carolina. He's been "engaged in Lean" for over 15 years and he is a Six Sigma Master Black Belt. Billy has a BS in in Electrical Engineering from Prairie View A&M University and an MBA from Baker University. Billy was very giving of his time and we talked for over 75 minutes, so I'm breaking this up into two parts, with Part 2 coming soon. Today, we talk about how he got started with Lean, the shift from tools- and event-based Lean to a culture focus, how to build a sense of ownership, servant leadership, strategy deployment, employee recognition and more.

Today, our topic is something that I've really taken an interest in the past two years: "Motivational Interviewing." See my past blog posts on this subject. I think it's a powerful methodology that will help anybody in their Lean transformation efforts... as well as our work engaging anybody in a small improvement. "Motivational Interviewing" or M.I. is defined by Miller and Rollnick (in their seminal book) as a "collaborative conversation for strengthening a person's own motivation and commitment to change." My guests for Episode 292 are the three co-authors of an excellent book, Motivational Interviewing for Leadership: MI-LEAD. They are (pictured from left to right in this order): Jason Wilcox, Director of Education and Connected Care at VA Roseburg Dr. Brian Kersh, Clinical Psychologist at New Mexico VA Health System Dr. Elizabeth Jenkins, Clinical Psychologist/Courtesy Assistant Professor at University of South Florida

My guest for Episode 291 is my friend and colleague, Jeff Roussel (@jeff_roussel on Twitter). Jeff is the VP of Sales at KaiNexus, a technology company that I have been involved with for over six years. As Jeff will humbly explain in the podcast, he joined our team almost four years ago as an experienced sales leader, not as an expert in Lean or process improvement. But, he's a voracious learner and he probably talks to more organizations about their process improvement efforts - what their aims are and what they're struggling with - than anybody I know. Our main theme for the podcast today is not technology. Our topics include what Jeff is hearing from organizations and trends he hears about. I hope you'll enjoy our conversation, as I did. I hope you'll also join us on Thursday as Jeff presents a free webinar hosted by me and KaiNexus: The Why, How and What of Continuous Improvement

@EricRies: From #LeanStartup to "The Startup Way" Joining me again for episode 290 is a three-time guest, Eric Ries. When we first talked, in episode 115 six years ago, his New York Times bestselling book The Lean Startup was being published. In 2012, we discussed the impact of Toyota's Taiichi Ohno on his work, in episode 142. This time, we're talking about his new book, The Startup Way. In this episode, Eric talks about how "Lean Startup" concepts came from "Lean" and the Toyota Production System and how Toyota then approached him about applying Lean Startup concepts in the development of a new in-dash electronics system. In recent years, GE and other large companies, in their efforts to be more innovative and entrepreneurial, have adapted these approaches into what Eric calls "The Startup Way." Will modern companies embrace a formal "entrepreneurship" function as they earlier embraced finance and marketing? We'll discuss that and more. Below, you'll find the full audio podcast, a 7-page PDF summary, and a complete transcript. The Startup Way is set for release tomorrow, October 17. Learn more at www.TheStartupWay.co. I had a chance to read the book in advance and enjoyed it very much. I hope you'll also join me at Lean Startup Week, where I'll be a speaker and session facilitator.

Episode page Audio remastered January 2023 My guests for Episode #289 are Kathleen Sharp, MBOE, LSS MBB, now the Director of Optimization at McLeod Health, and David Schoenwetter, D.O., FACEP, a Medical Director at Geisinger Medical Center. They are joining me to talk about the innovative Geisinger Mobile Health Paramedic program that they developed and piloted with Lean thinking throughout. Kathleen and David will discuss why it was important to engage stakeholders in innovation, how they viewed and addressed resistance to change, why it was important to test the idea in practice, and why it was important to measure results. They also discuss their lessons learned and their challenges along the way. This WSJ article has a nice summary of the program: "Paramedics Aren't Just for Emergencies." "In the Geisinger pilot program, mobile health visits can be requested by a patient's primary-care doctor, a cardiology clinic, or after an emergency room or hospital discharge. Patients who frequently visit the ER are offered the option of being seen at home by a paramedic as an alternative to an ER visit and potential hospital admission, especially for conditions that can be treated at home if caught early." I hope you enjoy the episode.

Joining me again for Episode #288 is Dean Gruner, MD, the recently retired CEO of ThedaCare, a health system in Wisconsin that has long been considered a worldwide leader in the practice of Lean in healthcare. Recently, in Episode #286, Dean shared his reflections on his work and ThedaCare's "Lean journey." Today, the topic is Accountable Care Organizations and other bigger-picture healthcare reform topics. Dean was also previously my guest in Episodes 119 and 144. I'm including a full transcript along with a three-page PDF summary, as I've been doing recently.

Joining me today for Episode #287 is another returning guest (see Episode #198), Harry Kenworthy. We're talking about his book, which will be released on Friday, Lean Government NOW! : Increase Service, Capacity and Employee Engagement While Reducing Costs and Wastes. The book is now available for pre-sale on Amazon at $19.95 (until September 7, 2017, at a $5.00 discount from list price). Harry was also a contributor to the book Practicing Lean, which is now available in audiobook format. I've been involved with some "government healthcare" organizations in different countries, but have never delved into other parts of government. I'm glad Harry is doing so! This seems like a big challenge, but an important and necessary one. We're seeing some examples of success with Lean at the local and state levels around the U.S., it seems. I hope we see more. I hope you enjoy our discussion whether you work in government or vote, pay taxes, or use government services (or all of the above!!). I'm including a four-page PDF summary, as I've been doing recently.

My guest for Episode #286 is Dean Gruner, MD, the recently retired CEO of ThedaCare, a health system in Wisconsin that has long been considered a worldwide leader in the practice of Lean in healthcare. See this article about his retirement, where he says "I've gotten more than I've given." Dean was previously my guest in Episodes 119 and 144 and I'm thrilled that he took time out of his retirement to talk with me about his lessons learned as he looks back on how ThedaCare's Lean journey has evolved, including some things he would consider to be missteps and challenges that they used as a springboard to get even better. I will also be releasing a separate episode where Dean talks about their experiences with Accountable Care Organizations (our topic from #144) and other "big picture" healthcare issues of the day. I'm including a full transcript along with a three-page PDF summary, as I've been doing recently.

In this episode, Mark and Karen discuss a provocative question she raised: "Is Lean Dead?" (or "dying?"). Karen is the author of books including "Value Stream Mapping" and "The Outstanding Organization." Her next book is titled "Clarity First" and we'll be discussing that in a future episode. http://www.leanblog.org/285 Is Lean dead—or just misunderstood? Karen Martin joins Mark Graban to explore why Lean often gets dismissed, how leadership habits and short-term thinking derail improvement, and why Lean still matters when practiced as a true management system—not a toolbox.

My guest today for episode #284 of the podcast is Dr. Margaret (Margie) Balfour, the lead author of an article, published in The Joint Commission Journal on Quality and Patient Safety, titled "Using Lean to Rapidly and Sustainably Transform a Behavioral Health Crisis Program: Impact on Throughput and Safety." Today, we're talking about that article, the important improvement work that led to it, and her belief, as stated in the article that "Lean methods can positively affect safety and throughput and are complementary to patient-centered clinical goals in a behavioral health setting." Dr. Balfour is the VP for Clinical Innovation and Quality at Connections Health Solutions, one of the largest providers of psychiatric emergency care in Arizona, and an Assistant Professor of Psychiatry at the University of Arizona. Dr. Balfour received her MD and PhD in Neuroscience from the University of Cincinnati and completed residency and a fellowship in Public and Community Psychiatry at the University of Texas Southwestern Medical Center in Dallas. A link to the article can be found at http://www.leanblog.org/284

Joining me today is Jim Lancaster, CEO of the company Lantech, a manufacturer that is the leader in stretch wrap technology and innovation, as well as case handling equipment. Jim is also author of the new book, published by the Lean Enterprise Institute, titled The Work of Management: A Daily Path to Sustainable Improvement. This episode is sponsored by the eVSM Group. It's almost 20 years now since the book "Learning To See" was published and value stream maps were established as central to a lean deployment. What has changed rapidly, however, is the supporting eVSM toolset that captures and analyzes the initial wall maps, making it easy to do "what-if" studies and prioritize improvements. Receive a free eBook and see the state of the art at evsm.com/2020.

My guests for Episode #282 of the podcast are two continuous improvement leaders from Cleveland Clinic: Dr. Lisa Yerian and Nate Hurle. Lisa is the Medical Director, Continuous Improvement and Nate is the Senior Director, Continuous Improvement.She's a doctor, he's an engineer, and they work together very closely in their efforts to help drive improvement at the Clinic. You can find them on Twitter as @LisaYerianMD and @NateHurle. In today's episode, we talk about topics including the Cleveland Clinic Improvement Model (see my previous posts on this), how their program is structured, what a "culture of continuous improvement" means to them and their staff, how to get others to accept Lean and C.I. methods, and some of the challenges they are facing in their work.

Joining me for Episode #281 of the podcast is Julie Firman, DNP, RN, FACHE, the Vice President/ System Chief Nursing Officer (CNO) at Southern Illinois Healthcare. We have the opportunity to chat about the Lean transformation efforts at SIH thanks to my partners at Catalysis, as they are presenting the annual Lean Healthcare Transformation Summit this year in Palm Springs, June 7 and 8. Julie and I will both be there and I'll be doing a full-day workshop called "Better Metrics." Come join us! In today's episode, we talk about how Lean has been helpful to nurses (and other healthcare professionals), Julie's role as a nurse leader, and different ways patients and the health system have benefitted.