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

A returning guest today for episode #280 is John Dyer, president of his consulting firm, JD&A, Inc., and a contributor for IndustryWeek.com. As we discussed in episode #229, John started his career at General Electric and later moved to Ingersoll-Rand, where he was VP of Operations for their Security and Safety sector. He also had the good fortune to learn directly from W. Edwards Deming, as he took the famed four-day seminar (that included the Red Bead Experiment) and was also invited to take the follow on course with a smaller group. You'll also want to scroll down to see the great picture that he posted on Twitter of him and Dr. Deming. Today, our focus is that famed "Red Bead Experiment." We'll talk about it, he'll share memories of Dr. Deming facilitating this, and we'll both share and discuss our reflections and our experiences with this, and the lessons learned. Tomorrow, I am facilitating the experiment as part of my "Better Metrics" workshop that I'm leading in Seattle through Catalysis. I'll also be doing this in June before the Lean Healthcare Transformation Summit (you can still sign up). And, of course, I'd love to come to your organization to do the workshop and help you with your approach to managing metrics, people, and improvement.

Back in 2012, I did a podcast interview (Episode 153) with a psychologist and family therapist, Robert Maurer, PhD. It's been almost five years since the discussion, but I'm often reminded of what I learned from his books and his advice about small change. It's human nature for us to be afraid of change. Instead of lecturing people to be brave, we need to work within our limitations. How do we avoid the "fight or flight" instinct and reaction from kicking in? We start by making change SMALL. That's a key Kaizen insight that Dr. Maurer is able to tie to the way our brain works. Here's our original discussion: https://www.leanblog.org/2012/07/podcast-153-robert-maurer-phd-the-kaizen-way/

In the Lean community (and in businesses and hospitals, as well), people often talk about "fire fighting" in a colloquial way. Today, my guest for episode #278 of the podcast is an actual professional fire fighter, Tom Bouthillet (@tbouthillet on Twitter). He serves as Fire Captain / Paramedic for the Hilton Head Island Fire Rescue where he is the Cardiac Care Program Manager (STEMI and CARES Site Coordinator). In this episode, we discuss the role of Lean and process improvement in fire departments and EMS, why blame is "completely ineffective" as a strategy, why "unsafe supervision" is a problem (and what that means), and why it's necessary to build in quality instead of just inspecting for quality.

Joining me for episode #277 of the podcast is Kay Kendall (@KayAKendall), co-author (with Glenn Bodinson) of the excellent book "Leading the Malcolm Baldrige Way: How World-Class Leaders Align Their Organizations to Deliver Exceptional Results." Kay is CEO & Principal at BaldrigeCoach (see her bio there). Since 1989, BaldrigeCoach has worked with organizations across every sector, large and small, to use the Baldrige framework to create focus, align empowered employees, provide high quality products and services, deliver exceptional customer experience, and achieve enviable results. In this episode, we discuss topics including her background in manufacturing and quality, her experience with the Baldrige approach, and the ways that Lean and Baldrige are complementary.

My guest for Episode #276 is a Lean consultant (although he might not prefer that term) and an author, A J (Andy) Sheppard. Andy is the author of The Incredible Transformation of Gregory Todd: A Novel about Leadership and Managing Change. He also contributed a chapter to my Practicing Lean book project. You can download the PDF of his chapter here and I hope you'll consider buying the book (it's for a good cause). He is a coach for leaders of change. His core expertise is helping workforces to quickly achieve systematic change in practice. A former McKinsey & Company consultant, he has now spent eighteen years working out this art of transformation in diverse industrial environments across the USA, Europe and Asia. He also continues to draw from prior experience of navigating change in corporate environments and experiencing it on shop floors. Further information about Andy can be found on www.ajsheppard.com. Andy is also happy to take any follow-up questions about leading change on his Goodreads Author Page. I hope you enjoy the conversation, which touches on Lean, change management, the need to balance empathy and urgency, and more.

My guest for Episode #275 is Katie Anderson, following up on her last appearance here in Episode #233. Now, she has been back home in California and shares some more recent reflections on her time there, what she learned, and what she continues to learn. In this episode, we talk about how Lean isn't inherently Japanese in all ways, Ashikaga (the "5S City"), a key mentor of hers (Isao Yoshino), and more.

Remastered January 2022 Episode page: https://www.leanblog.org/274 My guest for Episode #274 of the podcast is Jay Arthur, author of Lean Six Sigma for Hospitals: Improving Patient Safety, Patient Flow and the Bottom Line, Second Edition. Jay is owner and founder of his company KnowWare International, based on Denver. Before founding that company in 1995, Jay was in a number of quality roles at US West / Qwest from 1973 to 1995. He has a BS in Systems Engineering from the University of Arizona. Lean and Quality and Six Sigma To me, “Lean Sigma” is often a controversial topic… not because anything is wrong with Six Sigma. Six Sigma methods can be very compatible with a Lean culture. But, “Lean Sigma” books and trainers (including Jay), paint a picture that says Lean is only about speed or efficiency and that Six Sigma is the method to improve quality. He says pretty directly in his book that Lean helps fix all of the types of waste… except for the waste of defects. He says Six Sigma is used to address defects. That's silly. The Podcast Discussion I challenge Jay a bit about this in the podcast, and I'd like to remind the listeners that Lean and the Toyota Production System are about flow AND quality. Lean and quality go hand in hand. Lean methods, like error proofing, and mindsets, like not blaming people, can very directly improve quality. So, I disagree with him on that point, but there are many good points in his book about not overcomplicating Lean or Six Sigma — that the goal is results (and I'd add “developing people”). I'm also glad that the phrase “Patient Safety” is in the subtitle of his book, as it is in mine. You can read more about Jay and his bio here.

Joining me for Episode #273 of the podcast is David Veech, author of the new book Leadersights: Creating Great Leaders Who Create Great Workplaces. David is a senior lecturer in the Department of Management Sciences at Ohio State University and their Fisher College of Business, teaching in the MBOE program (see his full bio). Veech was previously a lecturer in the College of Engineering at the University of Kentucky. He joined the University of Kentucky after retiring from the US Army in 2001. He taught in the Defense Acquisition University from 1998 to 2001 and was assistant professor of military science at Stetson University from 1988 to 1991. In today's episode, we talk about his book, how his background and career in the Army influenced his views on Lean and leadership, "self-efficacy," and more.

My guest for Episode #272 is Steve Thompson, Director of Patient Driven Supply Network initiatives for Cardinal Health, a global, integrated healthcare services and products company. He is also a Lean Six Sigma Master Black Belt, dating back to his time spent working in the automotive industry. In today's episode, we talk about his lessons learned from General Motors and Lear Corporation and how he's helping healthcare leaders apply these lessons to improve their supply chain operations. In the past year, I've had a marketing partnership with Cardinal Health, which has led to content like this webinar and article, but after meeting Scott last year and having a great chat, I'm doing this podcast outside of that formal partnership. I'm pleased to have him on the podcast.

Joining me for Episode #271 is Isaac Mitchell (@IssacMitchell), talking about Lean Design for healthcare, the Society for Health Systems, and more. Isaac is a full-time lean practitioner at East Tennessee Children's Hospital, a lecturer at the University of Tennessee's Department of Industrial and Systems Engineering, and an instructor for the Institute of Industrial and Systems Engineers. You can read his bio (PDF) and learn more about Isaac via his personal website. Scroll down to the show notes for links to a special Lean Hospitals book excerpt and more free downloads about Lean Design and Isaac's work at ETCH.

My guests for Episode #270 of the podcast are two physicians: Paul DeChant, MD and Diane Shannon, MD. They are co-authors of the recently-released book Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Paul was previously a guest for Episode #230. In this episode, we talk about the symptoms and causes of burnout for physicians and other healthcare professionals. We also talk about how Lean, in particular "Lean done right," can help prevent or even reverse burnout by eliminating some of the systemic causes, such as the never-ending chaos that exists in far too many organizations.

Joining me for Episode #269 are Brian MacNeice & James Bowen, co-authors of the recently released book Powerhouse: Insider Accounts into the World's Top High-performance Organizations. They are founders of the international Kotinos Partners consultancy. In this episode, we talk about the book and take a deeper dive into two of the organizations they profiled: Toyota and Mayo Clinic. I think it's always interesting to see what people outside of our "Lean community" see when they study Toyota. They describe how "continuous improvement is at the heart of Toyota's high-performance model." And, as somebody committed to healthcare improvement, I'm always curious to learn lessons from organizations like Mayo Clinic. The authors write about a key driver of the Mayo Clinic's success being its "commitment to collaborative medicine."

My guest for Episode #268 is a long-time friend of mine in the Lean community and Lean Enterprise Institute circles, Tom Ehrenfeld (@tomehrenfeld). Tom is a writer and editor living in Cambridge, MA. A former writer/editor with Inc. Magazine and Harvard Business Review, he is the author of The Startup Garden: How Growing A Business Grows You. He works as a consulting editor for LEI and with many other Lean authors. He's a regular contributor to LEI's "The Lean Post." Eight of his edited books have won the Shingo Research Award. Today, we talk about some of the books he's played a role with, we'll talk about the evolution of the understanding of Lean, and his thoughts on shifting from his experience covering startups to thinking about "The Lean Startup" methodology in more recent years.

Joining me for Episode #267 is Stephen M. Shortell PhD, 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 is the director of the Center for Healthcare Organizational and Innovation Research (CHOIR). Today, we are talking about Lean healthcare and a new initiative that's part of CHOIR called CLEAR: the Center for Lean Engagement & Research in Healthcare. You can read a release about CLEAR, which highlights funding coming from the Lean Enterprise Institute, the ThedaCare Center for Healthcare Value, and Rona Consulting Group. In this episode, we talk about the Center, their planned research, and some reasons why there is variation in what organizations would describe as "Lean" - variation in methods and approach as well as variation in results.

My guest for Episode #266 of the podcast is Karyn Ross (KRCLean4Service on Twitter), co-author of the new book (with Jeff Liker): The Toyota Way to Service Excellence: Lean Transformation in Service Organizations. Karen first learned about and applied Lean in companies like Paychex, Zurich Insurance, and Liberty Mutual Insurance and has worked with other service sector companies as a consultant. In this episode, we'll discuss her book and the important applications of Lean in service settings. Karyn says delighting customers requires something different than a "mechanistic Lean implementation" approach - and I agree, completely. I hope you enjoy the conversation as much as I did.

Joining me for Episode #265 of the podcast is Bernita Beikmann, AIA, EDAC, LSSBB, a Principal and Director of Lean Strategy at HKS, an international architecture firm. Bernita is originally from Kansas and has a Bachelor of Architecture from Kansas State University and a Certificate in Regional and Community Planning. She moved to Dallas in 1996 and has been employed by HKS, Inc in Dallas since that time. We first crossed paths when we had the opportunity to work together on a project for Riley Hospital for Children in Indianapolis to work with staff and leaders on designing parts of a new patient tower. You can read a bit about that work here. I hope you enjoy our conversation.

My guest for Episode #264 is a friend from here in the Dallas / Fort Worth area, Tyrone Butler. He is LSS Managing Partner at his company, Butler Active Business Solutions LLC. He has a background in the Air Force, he pre-dated me at Dell Computer in the 1990s, and he's being doing a lot of work all over the world with Lean, Six Sigma, and other methodologies for improving software and project delivery, like ITIL. Tyrone is one of the first to hold the "Certified Executive Master Black Belt (CEMBB)" certification through Mikel J. Harry, PhD. We first met probably back in 2010 when we were both part of a Lean group that went to visit the Toyota plant in San Antonio (which I blogged about here and here). In this episode, he'll share some of his experiences, including a presentation to Michael Dell, his thoughts on the combination of Lean and Six Sigma, and methods that he has seen work in software development and other settings.

My guest for Episode #263 is another returning guest, Pascal Dennis (@AuthorPascal on Twitter). He was previously a guest on Episodes #96 and #239, talking about two of his previous books (see a full list here). Today, we're talking about his most recent book, a business novel called Andy & Me and the Hospital: Further Adventures on the Lean Journey. I don't normally read much fiction, and I generally don't read business novels, but I really enjoyed this book and tore through it in a few days. It was really compelling and many of the scenarios felt quite familiar. I think this is a helpful book for painting a picture of what it could feel like to start a Lean journey in healthcare. The book is, of course, a sequel to his earlier book Andy & Me, Second Edition: Crisis & Transformation on the Lean Journey.

My guest for Episode #262 is Steven J. Spear (@stevenjspear on Twitter). He is author of the fantastic book The High-Velocity Edge: How Market Leaders Leverage Operational Excellence to Beat the Competition. He's a Senior Lecturer at the MIT Sloan School of Management and recently taught a summer course on Lean and Six Sigma for the Leaders for Global Operations program (I graduated from that program in 1999 when MIT was teaching TQM in that summer course) and he also teaches executive education programs for MIT Sloan. Steve was previously a guest in Episodes #58 and 87. I'm glad to have him back on the show after six years. Steve is going to be one of the keynote speakers at the upcoming Northeast L.E.A.N. Conference, being held October 4th and 5th in Massachusetts. I hope you'll check it out, as I've participated in past years and it's always been great (and you get to meet Bruce Hamilton of "Toast Kaizen" fame).

Joining me for Episode #261 is an old friend and trusted mentor, Jamie Flinchbaugh. Among other things, he's the co-author of the book The Hitchhiker's Guide to Lean. He writes for a number of publications, has his own blog, and was previously a guest blogger here on LeanBlog.org. He's a speaker, investor (including in KaiNexus), and a great guy. Jamie was previously a guest on episodes #5, #6, #10, #50 (where he interviewed me), and #64. We were long overdue for another one. This episode is intentionally more conversational than most, with no more of a plan than me asking Jamie, "What's new?" He's also in final editing of a chapter for the book Practicing Lean, so I'm happy to be adding that to the book. Jamie is also going to be giving a keynote talk at our upcoming KaiNexus User Conference.

See http://www.leanblog.org/260 My guest for Episode #260 of the podcast is Brad White, author of the recently-released book Lean Daily Management for Healthcare: A Strategic Guide to Implementing Lean for Hospital Leaders. He is currently a Senior Process Improvement Advisor at Grady Health System in Atlanta, but I first met Brad a few years back when we were both in San Antonio and he was working for a health system there. In San Antonio, Brad helped spread these "Lean Daily Management" practices at the Baptist system and University Health System. I was able to come visit and see how this process was engaging leaders and staff at UHS (see photos below). You can learn more about Brad's book at his website, which includes a two-page PDF on how these methods can improve patient flow. http://leandailymanagement.com/

See http://www.leanblog.org/259 Remastered audio 2025 Today's episode #259 is Part 2 of a discussion I started with Steve Bera in episode #256. Steve was one of the original 16 “NUMMI Commandos” that General Motors sent to work with Toyota in the 1980s, as discussed in the outstanding book Comeback: The Fall & Rise of the American Automobile Industry. In Part 1, we talked about his experience at NUMMI. Today, we talk about what happened after his two years at NUMMI, why he feared getting lost back in the regular old GM, what he's done to teach and spread Lean in various industries over the past 30 years, and other thoughts on the current state of Lean. A transcript of the discussion can be found at the bottom of the post. You can also read a summary I wrote of the two posts on LinkedIn. Topics Covered In This Episode: The book describes the confusion about the lack of a “repatriation plan” – what happened? To you? At GM? Why was it hard to spread lessons back into GM? What have you done since leaving GM? How do you see the “state of Lean/TPS” in America? How much progress are we making? Do you have any experience working with healthcare or seeing the opportunity for Lean as a patient? What's the “risk” of a poorly executed Lean initiative?

Joining me for Episode #258 is a many times returning guest, Jim Huntzinger, the President and Founder of Lean Frontiers (check out Episodes 8, 15, 33, 196, and 251, his with Russ Scaffede). Jim has written two eBooks, The Roots of Lean: Training Within Industry: The Origin of Japanese Management & Kaizen and Deflation: The Road to Prosperity. We'll talk about that second book and topic in the podcast today. We're also going to talk about Lean Accounting and Lean Management, the related topics at the upcoming Summits in San Antonio later this month. I hope you can join us, as I'll be giving a talk on "Practicing Lean" to kick off the event and I'll be around that whole day. Lean Frontiers produces many great events and I hope you can check one out some time.

My guest for episode #257 is somebody I've known for a while in the Lean healthcare community, Tania Lyon. She's the Director of Organizational Performance Improvement at St. Clair Hospital in Pittsburgh. She has a PhD in sociology (like Jeff Liker, author of the Toyota Way book series) and she initially got involved with Lean through PRHI, a common connection to previous podcast guests Paul O'Neill and Naida Grunden. St. Clair is a KaiNexus customer and Tania has played a major role in their rollout of our software to support their ongoing spread of continuous improvement. Regular readers of the blog know my part time role with KaiNexus, as the VP of Improvement and Innovation Services. We initially recorded this to be a podcast and blog posts for our customers, but I thought this was a conversation that would be of interest to a wider audience, as we're talking mainly about Lean and improvement strategies, with a little bit of KaiNexus talk thrown in.

See http://www.leanblog.org/256 Remastered audio 2025 I'm really excited to have Steve Bera as my guest for episode #256 of the podcast. I read about him as he was featured prominently in a chapter of the 1994 Pulitzer-Prize winning book Comeback: The Fall & Rise of the American Automobile Industry. I just finished it during my recent flight back from China. The book is about the struggles of the Detroit automakers in the 1980s and early '90s. Steve was featured in the book as he was one of the first 16 GM managers and leaders to be sent to work with Toyota at the famed NUMMI joint venture factory in California. Steve was also part of the “This American Life” episode that looked back at the lessons from NUMMI. If you're not familiar with the NUMMI story, you might want to listen to that first. He learned some amazing lessons from Toyota… but left GM after his two-year NUMMI stint, as he was concerned that he wouldn't be effective back within the traditional GM (you'll hear about that in Part 2). So, since then, Steve has worked as a consultant and leader in many industries, including some recent time working for large retailers, working to create Lean supply chains. We had a very long chat, so I'm releasing two parts to this discussion in separate episodes (see also Episode #259). I am also sharing a transcript for the episode at the end of this post. I hope you enjoy the reflections as much as I did. You can also read a summary I wrote of the two posts on LinkedIn.

My guest for episode #255 is Mark DeLuzio, author of the recently-released book Turn Waste into Wealth: How to Find Cash in Every Corner of the Company. It's Mark's first book, but he's been well known in the Lean community for a long time. Mark started learning and practicing Lean in 1988 when he worked for Jake Brake, a Danaher company (and Danaher has long been considered a great Lean company). As his bio says, "After studying TPS under Taiichi Ohno's influential Autonomous Study Group, he was instrumental in developing Jake's first zero-defect line for Toyota's Hino Motors. He has spent considerable time in Japan implementing TPS at various world-class companies and has had a successful career in finance." In 2007, Mark was inducted into the Shingo Academy for his contribution to the Lean movement. He is also CEO of the consulting firm Lean Horizons. hixgdxw5

Episode #254 is interesting to me for a number of reasons. For one, I have a "guest co-host" joining me for the first time. He's Chip Ponsford, DVM, a doctor of veterinary medicine and former practice owner who I've gotten to know here in Texas over the past few years. Chip has been a great student of Lean, following a path similar to that of Sami Bahri, DDS ("The World's First Lean Dentist") in reading the "classic" Lean books from industry because there had been nothing written about Lean in VetMed. I've been helping Chip with his "Lean Vets" blog and we've collaborated in a few other ways to promote Lean in veterinary medicine. Our guest is Samantha (Sam) Parrett, the Director of Business & Administrative Services at North Carolina State University Veterinary Health Complex. Chip and I ran across Sam's name in one of the few articles we've found on Lean in VetMed: NC Vet College Dives Into Lean Training In the podcast, we'll discuss their story at NC State and the potential for Lean to make the jump into veterinary medicine more broadly. We hope you enjoy the discussion.

Joining me for Episode #253 is Ash Maurya, author of the book Running Lean:Iterate from Plan A to a Plan That Works and his latest, being released this week, called Scaling Lean: Mastering the Key Metrics for Startup Growth. Ash is an entrepreneur and a big part of the "Lean Startup" community. Visit his website at www.LeanStack.com.

My guest for episode #252 is Jordan Peck, a Senior Director in the Center for Performance Improvement at MaineHealth and Maine Medical Center. Jordan and I first met when he was a graduate student at MIT and was involved with the Lean Advancement Initiative (and I was working basically across the street at the Lean Enterprise Institute). At MIT, he earned a PhD in Engineering Systems and Health Care Systems. Jordan and I have continued to cross paths every year at the Society for Health Systems annual conference. His career has taken him to the Veterans Health Administration and now into the private sector at Maine Health, as we discuss in the podcast.

Episode #251 is a bit different in that it's audio shared by the good folks at Lean Frontiers. They recently hosted a webinar where Jim Huntzinger, founder and president of Lean Frontiers asked questions that answered by Russ Scaffede about Lean leadership. See their other webinars here. Russ has a lot of great wisdom and experience to share, so I asked Jim if I could share it here. Russ is a big part of the upcoming event - The Summit on Lean Leadership, which is being produced by Lean Frontiers. It's being held June 21-22 in Charlotte. You can save 25% off that event by using the discount code leanblog. I should also mention that I'm going to be a keynote speaker at their upcoming Lean Accounting Summit in San Antonio this August. In this discussion, Russ shares a lot of gems not just about how Toyota does things (as he learned in his time there), but also some key insights about transforming an organization that is NOT Toyota (as he learned from his experience at Tiara Yachts and other companies).

Episode #250... a big round number. 250 podcasts in just under 10 years. Thanks again to Norman Bodek (my first guest and frequent guest) for the idea back in 2006. My goal with the podcasts has always been to showcase my guests. Occasionally, I take the stage or share the stage with audio of me. Today is one of those episodes. Earlier in May, I had the chance to co-present a webinar with Dr. Jack Billi from the University of Michigan (archived here). The webinar was hosted by the Physician Consortium for Performance Improvement, which is being spun off by the American Medical Association. Before the formal webinar, Jack and I recorded some informal Q&A with the host, Stephen Davidow. This audio, shared with the permission of the PCPI also includes the Q&A that was done after the webinar presentation. I hope you enjoy our discussion about how we each got started with Lean in healthcare and more.

My guest for episode #249 of the podcast is Steve Leuschel, author of the book Lean Culture Change: Using a Daily Management System. You might remember a post from January that included an excerpt from his book on "huddles." In this episode, we discuss topics including his greatest influences, the lessons he learned from Rodger Lewis (a former Toyota general manager), "mutual trust," PDCA cycles, daily huddles, and more. What's the potential of a Lean management system and why is it difficult to get organizations and leaders to embrace a holistic system like that?

Joining me for episode #248 of the podcast is Drew Locher, an author, consultant, speaker, and, also like me, a faculty member for the Lean Enterprise Institute and the ThedaCare Center for Healthcare Value. You can read his bio via his consulting website, Change Management Associates. Drew's books include Value Stream Mapping for Lean Development: A How-To Guide for Streamlining Time to Market, Lean Office and Service Simplified: The Definitive How-To Guide, and Unleashing the Power of 3P: The Key to Breakthrough Improvement. He also, most recently, released a second edition of The Complete Lean Enterprise: Value Stream Mapping for Office and Services, a recipient of the Shingo Research Award. You can also read his two guest posts that I've published on this blog. In this episode, we talk about his books, how Lean is about more than just tools, and the need to focus on "the critical few things" instead of falling victim to a "scattershot" approach to reducing waste. "We learn more by doing than talking about it," says Drew about Lean.

My guest for episode #247 is James Chisholm, a principal and co-founder of the Toronto-based ExperiencePoint. James is a pioneer in the design of online game-based learning, and has authored numerous leadership simulations in use by over 100,000 executives and managers worldwide. I fell in love with their "Lakeview" hospital change management simulation a few years back when I first got to try it and I've been very happy to learn from James and to partner with ExperiencePoint. James speaks and writes widely on the subject of games, learning and change. He co-authored chapters in the "Handbook of Experiential Learning" and in the Center for Creative Leadership's Fieldbook, "Experience-Driven Leader Development: Strategies, Tools, and Practices" (both published by Pfieffer). Read his full bio: (PDF). In this episode, we discuss topics including why change management is such an important issue for him and organizations, the role of simulations and experience-based learning, how "leadership is a process," and how "change is synonymous with leadership."

Episode #246 is my second episode in recognition of Patient Safety Awareness Week. My guest is Steve Montague, who talked about Lean and Crew Resource Management with me in episode #195 in 2014. He's a retired Navy fighter pilot, a commercial pilot, and a consultant for hospitals and health systems... and a fellow Texan and a near-neighbor of mine. See his full bio here. Today, we're talking about a number of topics, including patient safety and checklists... what's the difference between good checklist systems and bad (and what are the parallels to Lean done well and Lean done badly). We talk about a number of articles and recent events about how NHS employees are afraid to speak up, an Iowa hospital that had four wrong site surgeries in 40 days, and the recent NEJM brouhaha.

See http://www.leanblog.org/245 Today is the first of two episodes that I'll post here during Patient Safety Awareness Week. I agree with the National Patient Safety Foundation that every day should be patient safety day. I'm sure my guest for episode #245 would agree with that. He is Tom Evans, MD, FAAFP, the President and CEO of the Iowa Healthcare Collaborative. I've know Dr. Evans for many years, but was prompted to do the podcast by this editorial he wrote in the Des Moines Register: "Iowa hospitals succeed at keeping patients safe." In this episode, we talk about the progress being made in Iowa hospitals, what they are doing, and the lessons learned.

See http://www.leanblog.org/244 Joining me again for Episode #244 is Dan Markovitz (@DanMarkovitz on Twitter). Today's episode is part 2 of our discussion about his most recent book Building the Fit Organization: Six Core Principles for Making Your Company Stronger, Faster, and More Competitive, a recipient of the Shingo Research Award. You can hear Part 1 in Episode #241.

Episode page with transcript, links, and more My guest for Episode #243, Michael Bungay Stanier, takes us a bit outside of the Lean realm... but that's good. Our topic today, which ties in very nicely to Lean and Kaizen (as you'll hear in our conversation) is coaching. His most recent book is titled The Coaching Habit: Say Less, Ask More & Change the Way You Lead Forever and it's available today. It's a very practical book that's full of tips and seven key questions that you can use as a coach. Michael is "founder and Senior Partner of Box of Crayons, a company that helps organizations do less Good Work and more Great Work." Remastered audio, Feb 2023

Episode #242 is unique in that it's a collection of audio clips from videos that Joe Swartz and I shot in late 2014 at his health system, Franciscan St. Francis Health in Indianapolis. In the videos, a number of nurses and leaders talk about continuous improvement in a way that's fun, wise, and inspirational. As we did last year, Joe and I are hosting a learning event at his system called "Kaizen Live!" where you have a chance to see and hear what a culture of continuous improvement is really like. We hope you'll join us April 5 & 6 for the main experience (where we'll be out visiting departments instead of spending all of our time in a conference center) and we have some optional classes on April 4. We hope you enjoy the stories and reflections here in the podcast.

Joining me for Episode #241 is a returning guest and friend of mine, Dan Markovitz (@DanMarkovitz on Twitter). He was a guest on Episodes #135 (talking about A Factory of One) and #52 (talking more generally about office Lean). He has also written a number of guest posts here. Oh, and he has his own blog. Today we're talking about his most recent book Building the Fit Organization: Six Core Principles for Making Your Company Stronger, Faster, and More Competitive, which, like his first book, is a recipient of the Shingo Research and Publication Award. Congrats!

My guest for episode #240 is somebody I've wanted to interview for a long time, Leah Binder, the president and CEO of Leapfrog Group, "a voluntary program aimed at mobilizing employer purchasing power to alert America's health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded." In this episode, Leah talks about the story behind Leapfrog Group, the scale of the patient safety problem in America, some efforts of Leapfrog Group to grade hospitals, the connections between Lean and patient safety, and other topics. Please check out Leapfrog Group and their Hospital Safety Score website. How does your hospital measure up? How do the hospitals in your community compare? What can hospitals be doing to close their gaps so they get an "A"? How can large businesses who pay for healthcare and have their employees' interest in mind, like manufacturers, help put positive pressure on healthcare to improve?

Joining me for Episode #239 is Pascal Dennis, somebody I really respect and have learned a lot from over the years... I'd call him "sensei" gladly (although he and I agree that's not a term one should bestow upon themselves... see his blog post). I'm very happy to have him as a guest again for what is just his second time (I thought it had been more frequent). In Episode 96, we talked about his book The Remedy. Today, we are talking about the new third edition of his book Lean Production Simplified.

Episode #238 is a conversation with somebody I've wanted to talk with for a long time, Kevin Cahill. He is the executive director of the W. Edwards Deming Institute. He's also a grandson of Dr. Deming! Kevin played an instrumental role in getting NBC to publicly release the 1980 documentary, "If Japan Can, Why Can't We?" that featured Dr. Deming (see my blog posts about it). We talk about that in the podcast, along with his other recollections of Dr. Deming and how he watched the original NBC airing with him. We also discuss his reflections on learning the Deming philosophy and his attempts to utilize the ideas in his career (and how challenging that can be when it flies in the face of the prevailing business culture). It was a really fun discussion and I hope you enjoy it. If you have follow up questions for Kevin, please post a comment, as I'm sure we can do another podcast in the near future.

Episode #237 is, like the last episode, a bit different... but in a different way. My guest is my friend Paul Akers, author of the new book Lean Health. Paul was previously a guest for Episode 133, where he talked about his book 2 Second Lean and also for Episode 122. Today, we're talking about his new book, just released. What's different about this podcast is that I attempted to broadcast it live via YouTube. We eventually got there, but not until after some errors I made (and reflected upon here). What appears here is an edited audio-only version of our conversation, which includes some questions from live viewers. Paul has put a lot of time and money into this book. You can buy it on Amazon or download a FREE version as a PDF or audiobook via his webpage.

For episode #236, things are a little different than usual. Today, I wanted to share a video discussion between my friends Ted Stiles and John Toussaint, MD. Ted is a partner with the recruiting firm Stiles & Associates. John, of course, is the president of the ThedaCare Center for Healthcare Value and has been a frequent guest in my podcast series. John's most recent book is Management on the Mend. For a link to this episode, refer people to www.leanblog.org/236.

For the episode and more details, visit http://www.leanblog.org/audio235. If you've been a listener of my LeanBlog Podcast series, you might know that I normally record conversations and then publish them into the podcast feed. Today, I'm going to do my first live broadcast of a podcast discussion via the "Blab.im" streaming platform. My guest is Sam MacPherson and we are talking about Lean leadership, including his lessons learned from his time as a Green Beret. Topics Include: Differences between Special Forces (The Green Berets) and the rest of the military Similarities between “The Green Beret Way” and The Toyota Way - shockingly similar Command and Control vs. Leadership "Commander's Intent" Misconceptions regarding military leadership and industry leadership Lean transformation - you current leadership style and skills wont cut it!

Today's guest is Mitch Cahn, president of Unionwear, a manufacturer of hats, bags, and apparel in Newark, NJ. I first learned about Mitch and his company because of a display they had at the Northeast LEAN Conference, which I blogged about here. What caught my eye was their display of politician hats they produce, including the famous red "Make America Great Again" hat that Donald Trump wears. Beyond the surface of those hats is a fascinating story about competing instead of making excuses. As Mitch explains in the podcast, Unionwear has been very successful even though he's producing in one of the highest-cost parts of the world. Unionwear has had to compete against imports from China and lower-wage southern states in the U.S. Starting in 2007, Lean has been a major part of their strategy for improving productivity, reducing cost, and being fast to market. Whether you work in healthcare or manufacturing, I think you'll love the story behind Mitch, his company, and his employees. For a link to this episode, refer people to www.leanblog.org/234.

Today's guest is Katie Anderson, and we're talking about her experiences living in Tokyo for 18 months and what she's learning about Lean culture, Japanese culture, and how those aren't always one and the same. I first met Katie through the Healthcare Value Network and our participation in that collaborative. She's an experienced Lean healthcare practitioner, coach, consultant, having worked for Stanford Children's Hospital and the Palo Alto Medical Foundation before starting her own consulting practice. Katie has been generously sharing her experiences in Japan and her reflections on her blog, which I highly recommend. You can also find her on Twitter and LinkedIn. For a link to this episode, refer people to www.leanblog.org/233. Podcasts are sponsored by KaiNexus and their software that helps spread continuous improvement -- Learn more at http://www.KaiNexus.com

Today's podcast, #232, is presented with a heavy heart, after the recent passing of my friend Dr. Michel Téatrault, the CEO of St. Boniface General Hospital and a great Lean leader. He was a friend to many in the Healthcare Value Network and the broader Lean healthcare community. As I was remembering Michel, it occurred to me that I had recorded a podcast with him, back in 2010, as part of a series that I was doing for the Healthcare Value Network. I never shared that audio as part of my main podcast series, so I'm doing so today. In the episode, we talk about "Lean from the CEO perspective." I hope Michel's words and experiences at St. Boniface continue to help and inspire people. For a link to this episode, refer people to www.leanblog.org/232.

Today's guest is Eric Dickson,MD, MHCM, FACEP, the president and CEO of UMass Medical Center. Episode #231 of the podcast is a little different than the usual. Normally, I record a podcast interview via Skype or a phone call. Today's podcast is a recording of an interview that I did on stage at the 2015 Lean Healthcare Transformation Summit, as part of the CEO panel I was moderating. Eric was one of three CEOs who did a 10-minute interview with me, then we had them take questions as a panel group. The audio quality isn't as good as normal, so there's a transcript of the conversation below. Eric tells what I think is an important story about why UMass Medical Center used Lean and Kaizen as an important strategy for the challenges and crisis they faced at the time. For a link to this episode, refer people to www.leanblog.org/231.