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

Audio remastered May 2025 Episode page Joining me for episode #230 is Paul DeChant, MD, MBA to talk about reducing burnout, especially physician burnout, through Lean. Paul (see his bio here) is the former CEO of Sutter Gould Medical Foundation, a 300-physician multispecialty medical group in California's Central Valley. Before that, he had stints at organizations including Geisinger Health System and the Palo Alto Medical Foundation. He is now a consultant and executive coach for Simpler Healthcare. For a link to this episode, refer people to www.leanblog.org/230. In the podcast, we talk about questions and topics including: Tell us about your career... how did you get involved in healthcare leadership and how did you get exposed to Lean? What problems or opportunities were you trying to address with Lean? How did you see your role and participation as CEO? As a physician leader? You recently wrote a blog post "why is physician engagement even an issue?" How would you describe the current state of life for an MD before Lean? Can Lean help prevent burnout for MDs or others? Is there a point where somebody gets "too burned out" and can't be turned?

My guest for episode #229 is John Dyer, president of his consulting firm, JD&A, Inc., and a contributor for IndustryWeek.com. 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. John 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. For a link to this episode, refer people to www.leanblog.org/229. In the podcast, we talk about questions and topics including: Tell us about the early days of your career in manufacturing engineering and management... how did you get involved in operational excellence? While at GE, you had some experience with W. Edwards Deming, tell us about that... What are some of the key lessons from Dr. Deming that stick with you today? GE's CEO Jack Welch had once derided Deming as "too theoretical." Was it that or did Deming's concrete suggestions just fly in the face of Jack's way? What did John recently witness when a relative was a hospital inpatient? How did that compared to some things Dr. Deming saw and reported as a patient in 1987?

Remastered January 2022 Episode page: https://www.leanblog.org/228 Labor Day is Monday, so maybe it's appropriate that my guest for episode #228 of the podcast is Zeynep Ton, an Adjunct Associate Professor of Operations Management at the MIT Sloan School of Management. You may have recently seen her being interviewed by Fareed Zakaria on CNN. Read her full bio here. She is author of the 2014 book The Good Jobs Strategy: How the Smartest Companies Invest in Employees to Lower Costs and Boost Profits. I saw Ton give a lecture at an MIT alumni event back in June and immediately bought and read the book (read my blog post about the book and parallels to Lean and healthcare). I highly recommend it and I wish more hospitals and health systems would pursue this “good jobs strategy” instead of being so focused on cutting labor costs. As Ton explains in the book and our discussion, this strategy is not about being kind or nice — it's just good business that drives better long-term results for all. In the podcast, we talk about: How she transitioned from industrial engineering and supply chain management to studying retail companies. In the vicious cycle of the “bad jobs strategy, ” why is this considered conventional wisdom that the way to maximize profits in a low-margin industry is to offer minimal pay, training, and hours? What are the components (and system) of “the good jobs strategy?” What connections do you draw between the good jobs strategy and Toyota or Lean? Do the companies or founders that have a good jobs strategy sort of naturally embrace it? Of the “good jobs” components, is it most difficult to help people see that 100% utilization is often very harmful and that “slack” is necessary? Is it easier for privately held companies to pursue the good jobs strategy having less quarterly financial pressure? Any thoughts on why society focuses so much on wages, while seemingly ignoring other aspects of workplace conditions that need to be improved?

Joining me for episode #227 are Ruthie Davis and Stephen Cook, talking about the book that they edited, Do the Right Thing: Real Life Stories of Leaders Facing Tough Choices.' Episode page: https://www.leanblog.org/227 While this episode isn't focused on Lean, per se, I think you'll enjoy the discussion and I highly recommend the book, which highlights the role of ethics and integrity in leadership… hence “doing the right thing” and being a great leader who others chose to follow. The book is inspired by the life and lessons of Don Davis, who served as CEO of Stanley Works (now Stanley Black & Decker) from 1966 to 1988. After retiring as CEO, Don volunteered to teach a leadership seminar for the MIT Leaders for Global Operations program, which I was fortunate to take as a student there. You can read his obituary here. Ruthie is Don's daughter and Steve was, like me, a student of Don's at MIT, so they combined their efforts to publish a compilation of compelling stories from Don's students about real life leadership challenges that they faced and how Don's “leadership mantras“ helped them in those times. Stephen Cook is currently a co-founder and Executive Managing Director of the private equity firm, LFM Capital. Previously, he was a Principal with TVV Capital, following his role as COO of MFG.com, and 11 years of operations leadership roles at Dell. Prior to joining Dell, Steve served as a Lieutenant in the United States Navy, where he flew combat missions in support of Desert Shield. He is a fellow graduate of the MIT Leaders for Global Operations program, a year ahead of me, and we worked together at Dell at the turn of the century and have kept in touch since. Read his bio. Ruthie Davis is an entrepreneur and designer, the founder and CEO of the high-fashion Ruthie Davis shoes. Her shoes are a “top choice of celebrities and fashion tastemakers including… Beyoncé, Lady Gaga, and Jennifer Lopez; Halle Berry, Sofia Vergara, Taraji P. Henson and Shailene Woodley… and Emma Roberts, Zendaya Coleman, and Rumer Willis.” Ruthie was a recipient of Babson College's “Entrepreneur Hall of Fame” award in 2015. Read her full bio here.

My guests for episode #226 are Steve Hoeft and Dr. Robert (Bob) Pryor from Baylor Scott & White Health in Texas. Bob serves as President, Chief Operating Officer and Chief Medical Officer for the system and was formerly CEO of Scott & White Health before their merger with Baylor Health Care System. Steve is the Chief of Operations Excellence for the system. hoeft-pryor bookThey are co-authors of a recently released book that I think is outstanding: The Power of Ideas to Transform Healthcare: Engaging Staff by Building Daily Lean Management Systems. Steve is also previously author of another book I really like, Stories from My Sensei: Two Decades of Lessons Learned Implementing Toyota-Style Systems. I'm sure you'll enjoy the podcast, as they combine the perspectives of an industrial engineer and Toyota-influenced automotive guy (Steve) and a pediatrician and physician executive (Bob). They share a passion for healthcare improvement AND a belief that we need to respect and engage everybody who works in healthcare as a way to better serve patients. For a link to this episode, refer people to www.leanblog.org/226. Podcasts are sponsored by KaiNexus and their software that helps spread continuous improvement -- Learn more at http://www.KaiNexus.com

Joining me once again on the podcast today is John Toussaint, MD, the founder and CEO of the ThedaCare Center for Healthcare Value. We're talking about his latest book, Management on the Mend. John wrote this new book to document "core elements of successful Lean transformations" that he's seen, not just at ThedaCare, but at other organizations around the world. The book outlines a "transformation model" that can be used to structure a Lean transformation, while John admits there's not just one prescription or framework that could work. John was previously a guest for episodes #184, #159, #146, #72, #62, and #54 going back to 2008. His previous books, which I highly recommend, are On the Mend and the follow up Potent Medicine, both are Shingo Research Award recipients. For a link to this episode, refer people to www.leanblog.org/225. Podcasts are sponsored by KaiNexus and their software that helps spread continuous improvement -- Learn more at http://www.KaiNexus.com

My guest for episode #224 of my podcast is a returning guest, Mike Grogan. About two years ago, we talked about his Lean work in Tanzanian healthcare, in episode #182. Mike is an international trainer, coach, and speaker, who works with successful but overwhelmed management teams, to help them understand the technical and behavioral elements of Lean leadership, so that they can realize a culture of constant and never-ending improvement in their organization. In this eposide, we talk about his experience with mentoring, in Tanzania and other settings. For a link to this episode, refer people to www.leanblog.org/224. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

My guest for podcast episode #223 is Christian Wolcott, a senior advisor and director of Kaizen Institute North America and their director for Japan tours. Christian was an integral part of the team for the Japan Lean Healthcare Tour that I participated in last November as an instructor. Christian taught Lean concepts and facilitated discussions with me and the global attendees. In this podcast, we talk about our reflections on Japan and the tour, lessons learned, and reasons to go (which include wonderful camaraderie, fine cuisine, and evening discussions with the attendees). You can learn the difference between sushi, shabu shabu, and shōchū, in addition to learning about Lean and Kaizen. We're planning another tour in September, so please contact me if you'd like to be sent more information and check out the website I've set up about the tours. See past posts I've written about the tours --- http://www.japanleantrip.com. For a link to this episode, refer people to www.leanblog.org/223. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

Joining me for episode #222 of the podcast is Erin S. DuPree, M.D., FACOG, the Chief Medical Officer and Vice President for the Joint Commission Center for Transforming Healthcare. Dr. DuPree is an OB/GYN by training, was previously the Chief Medical Officer and Senior Vice President for Medical Affairs at The Mount Sinai Medical Center in New York City. She is a certified Six Sigma Green Belt and is also a TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) master trainer. For a link to this episode, refer people to www.leanblog.org/222. One thing we have in common is both growing up around Detroit, being exposed to the auto industry and the ideas of W. Edwards Deming early in life. In this podcast, topics include: Her role in the Center for Transforming Healthcare (the Joint Commission does more than accreditation) How Dr. DuPree first got involved in healthcare quality improvement and, in particular, Lean and Six Sigma (two complementary practices, as we agree) Of the different estimates about the number of patients harmed or killed each year due to preventable medical errors, which numbers does she cite and why? There are pockets of improvement around healthcare, but what are some of the biggest barriers, that she sees, that prevent adoption of Lean and Six Sigma and, more importantly, the improvement of quality and patient safety? How does the idea of "High Reliability Organizations" fit with other improvement methodologies? What's the personal patient story that helped her see the preventable harm that occurs and the need for improvement?

My guest for episode #221 is Jacob Stoller, author of a book that was just released: The Lean CEO: Leading the Way to World-Class Excellence. It's available now through Amazon or you can learn more through his book's website. As Jacob explains, he's a journalist, not a Lean practitioner, and he interviewed CEOs across different industries to get their thoughts on Lean management. We discuss topics including how CEOs get exposed to Lean thinking, why humility is so important, what "respect for people" means in the Lean context, and reasons why more CEOs don't embrace Lean. Did Six Sigma and Dr. Deming come up in his interviews? You'll also hear a bit about Bob Brody, the CEO at Franciscan St. Francis Health, which was featured in my Healthcare Kaizen books. For a link to this episode, refer people to www.leanblog.org/221. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

My guest for episode #220 is somebody I've wanted to interview for a long time, Dr. Robert Wachter, one of the leading voices in the modern patient safety movement. He's most recently author of a brand-new book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age. His book was excerpted in this New York Times Op-Ed piece, "Why Health Care Tech Is Still So Bad." In this episode, we cover topics including: How Bob got into the patient safety field Of all of the estimates of patient harm and death caused by medical errors, which does he find most valid? His perspectives on the interface between Lean principles and practices and the modern patient safety movement What were some of the pros and cons of the $30 billion in federal government incentives for EMR/EHR adoption? Is it fair to say that EHR systems solve some patient safety problems while solving others? Some of the new waste introduced by new "meaningful use" regulations The story of a preventable medication error that harmed a child - a combination of technology problems, human factors, and bad process Finding the balance between "system problems" and personal accountability (see this article) Disclosure: I received an advance copy of The Digital Doctor from the publisher. I highly recommend the book for its balanced presentation of the promise, successes, and challenges of healthcare IT. The book discusses why electronic medical records haven't been adopted more quickly, why government incentives were introduced, and EMR/EHR systems are not the panacea that some had promised. Previously, Dr. Wachter has written books on patient safety (that I've read and recommend) including Understanding Patient Safety and Internal Bleeding. He received one of the 2004 John M. Eisenberg Awards, the nation's top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past seven years, the only academic physician to achieve this distinction. I was honored when Dr. Wachter recently interviewed me about Lean and patient safety for his AHRQ "Web M&M" series. Dr. Wachter is Professor and Associate Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine, and Chief of the Medical Service at UCSF Medical Center. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term "hospitalist" in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. For a link to this episode, refer people to www.leanblog.org/220. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.Joining me for episode #219 is Tristan Kromer, a professional "Lean Startup" coach who works with startups around the world and volunteers for the non-profit Lean Startup Circle.

Joining me for episode #219 is Tristan Kromer, a professional "Lean Startup" coach who works with startups around the world and volunteers for the non-profit Lean Startup Circle. In this episode, we discuss topics including how he got involved in the Lean Startup movement, the difference between a coach and a consultant, and lessons from various startups. When are you "pivoting" versus just giving up on an idea? Tristan also talks about why being data driven and scientific "is the aspiration" and why somebody who "starts from a profound state of ignorance" can be helpful by asking the right questions. You can find Tristan on Twitter @trikro and via his blog. Read his bio here. For a link to this episode, refer people to www.leanblog.org/219. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.Joining me for episode #219 is Tristan Kromer, a professional "Lean Startup" coach who works with startups around the world and volunteers for the non-profit Lean Startup Circle. In this episode, we discuss topics including how he got involved in the Lean Startup movement, the difference between a coach and a consultant, and lessons from various startups. When are you "pivoting" versus just giving up on an idea? Tristan also talks about why being data driven and scientific "is the aspiration" and why somebody who "starts from a profound state of ignorance" can be helpful by asking the right questions. You can find Tristan on Twitter @trikro and via his blog. Read his bio here.

My guest for episode #218 is Karen Kiel-Rosser, Vice President/Quality Improvement Officer at Mary Greeley Medical Center in Iowa. You can see her full bio below in this post. You might remember Karen from a recent post where she told a great story about putting patient safety first. We're talking today about the Malcolm Baldrige National Quality Award and how that framework and process is mutually supportive of Lean and quality improvement. In December, Mary Greeley Medical Center was named a recipient of Gold level recognition in the 2014 Iowa Recognition for Performance Excellence (IRPE) program - the state level Baldrige award. They previously received the Silver level in 2011. In the podcast, we talk about why and when Mary Greeley decided to pursue the Baldrige award, what it was like to be reviewed at the state level, and their future plans for applying at the national level. Karen also shares thoughts about how Baldrige ("the what") and Lean ("the how") fit together, some of their key quality outcomes measures, and how the recognition has helped internally with staff. She also talks about their safety huddles, the importance of "engaging those closest to the work," and the need for a "systematic approach" to capture Rapid Improvement Events and daily improvement work and how their use of KaiNexus has supported those efforts. The hospital was previously featured in episode #201: Ron Smith & Suz Kaprich, the KaiNexus WorkOut at Mary Greeley Medical Center. For a link to this episode, refer people to www.leanblog.org/218. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.

Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com Our guest today is Alan G. Robinson, PhD, an award-winning author, educator, researcher and consultant. He has co-authored six books, including Modern Approaches to Manufacturing Improvement: The Shingo System, Ideas Are Free, and his latest, The Idea-Driven Organization. His specialties include managing continuous improvement, creativity, ideas and innovation, and Lean production, being one of the earliest professors to visit Japan to study the Toyota Production System. In this episode, we talk about the history of suggestion programs (and a surprising detail about their history), why 80% of an organization's improvement comes from staff ideas, and why high-performing idea systems are rare. We also talk about some of the pitfalls of traditional cost-benefit analysis, the role of leaders and humility, and a company, Scania, that intentionally overstaffs to provide time for Kaizen, leading to 12-15% annual productivity improvement. Why is mankind still battling against command-and-control management systems? And what's the real story behind American Airlines famously removing an olive from their salads? We cover all of that and more in this episode. For a link to this episode, refer people to www.leanblog.org/217. For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.

Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com Returning to the podcast after his first appearance in Episode #188 is Daniel T. Jones, founder and chairman of the UK-based Lean Enterprise Academy. You can find him on Twitter now as @DanielJonesLean. Dan collaborated with Jim Womack on the books The Machine That Changed the World, Lean Thinking, and Lean Solutions and published other books through the LEA. He is also a senior advisor to the relatively new website and journal "Planet Lean." In this episode, we talk about some of the progress being made in areas outside of manufacturing. Dan says there's "awareness everywhere" but asks if there's "real depth" in Lean progress? We'll discuss how we can reframe Lean for the public sector and healthcare as a way of going beyond mere cost cutting programs. What does Dan seeing happen in software and startup sectors with Lean in companies like Spotify in Sweden? How is interest in the core "respect for people" leading to a search for "more holistic management methods?" For a link to this episode, refer people to www.leanblog.org/216. For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.

Today's guest is my friend John Ervin and we were able to sit down together here in San Antonio to record this episode. John has about 20 years of healthcare leadership experience, including in military medicine and the civilian sector. He's been a manager and director of operating rooms in many types of hospital and surgical center settings. 2022 update: John is now a part of the team and is my colleague with the firm Value Capture and we were able to collaborate on an engagement with a Philadelphia health system. We share a passion for Lean and, more importantly, patient safety. We believe strongly that you need the right type of culture and leadership to encourage and support a culture of safety and that's what we'll talk about today. For a link to this episode, refer people to www.leanblog.org/215. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also subscribe and listen via Stitcher.

Today's guest is Michael Ballé, an author of many novels about Lean management, published by the Lean Enterprise Institute. He joins us for this episode from Paris (he shares many photos of “Paris moments” via his Twitter account @Michael_Balle). Michael and his father, Freddy, have collaborated on these books and have learned about as directly from Toyota as anybody (Freddy was CEO of the French automotive supplier Sommer-Allibert and was coached by Toyota there). The three novels are: The Gold Mine The Lean Manager Lead With Respect See all of his books via Amazon As we joke about in the podcast, I'm not a fiction reader, in general, so I don't care for business novels. But, many people do! I read Michael's non-fiction essays and articles, including: “The Gemba Coach” column on Lean.org His answers to questions on leanblog.org (where I'm also a contributor) Michael is a first-time podcast guest (which we were both shocked to discover), but I did host a four-part written Q&A with him back in 2009. For a link to this episode, refer people to www.leanblog.org/214. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also subscribe and listen via Stitcher.

Today's podcast is different than my usual interview format. I still plan on continuing the podcast format and series, but I also wanted to try something new. I'm starting a “Lean Blog Audio” podcast, which is basically an “audio book” type reading of blog posts. I won't do it for all posts, but maybe a few a week. I'll also occasionally look back at an old post, as I did in this episode, which is actually #4 in the new series. The episodes in this new series won't have their own page, but the audio will be embedded in the blog post itself. To find all episodes, you can visit www.LeanBlog.org/audio. I realize this won't add value to all readers of the blog or all listeners of this podcast. But, many people tell me they like listening to the podcasts while they drive or workout and this new podcast provides a way to keep up on the blog in addition to or instead of the written word on the blog. These are really easy to do and many of them will be done while I'm doing a final proofreading of a new post, basically (which might reduce the number of typos and other defects!). Interviews (planning them, prepping for them, editing them) for my original podcast series is actually more time consuming than doing a podcast of this type. If you go to www.LeanBlog.org/audio, you'll see information about how to subscribe via an RSS feed or the iTunes podcast directory. For a link to this episode, refer people to www.leanblog.org/213. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also subscribe and listen via Stitcher.

Today's guest is David Mann (bio), talking about the new 3rd edition of his Shingo Research Award winning book Creating a Lean Culture. David tells us what's new in the book and we discuss “leader standard work” and other elements of a Lean culture. David also talks about the difference between “Lean production” and a “Lean management system,” and we discuss forcing “compliance” versus leaders teaching and learning in the workplace. What is the role of executives in creating a Lean culture? I hope you enjoy the discussion. David was also one of my earliest podcast guests, back in Episode #9. For a link to this episode, refer people to www.leanblog.org/212. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

Normally, my podcast is all about my guests. This episode has me being interviewed by the hosts at Healthcare Tech Talk, a new podcast for Healthcare IS professionals. This originally appeared as episode #23 of their series. Thanks to hosts Terry Baker and Kelley Hill for interviewing me and for allowing me to republish their episode here. I hope you like the podcast. You can subscribe to their series via iTunes, Google Play, and their app for iOS or Android. Learn more at their site. My podcast series will return next week. For a link to this episode, refer people to www.leanblog.org/211.

My guests today are Darrell Damron and Hollie Jensen and we're talking about Lean in Washington state government. Darrell and Hollie are both state employees, serving in the role of Enterprise Lean Consultant within a team called “Results Washington.” I've seen them both present at a Lean Enterprise Institute summit and I'm really happy to have them share their ongoing improvement story here in the podcast. In the episode, we talk about their backgrounds and how they got started with Lean – Darrell in the public sector and Hollie at Starbucks. How did the state of Washington get started with Lean? What are some of their goals and accomplishments? How is Lean a strategy under Governor Jay Inslee and why is Lean a non-partisan issue that was supported by both gubernatorial candidates in the last election? What are some of the challenges that lay ahead for Washington? For a link to this episode, refer people to www.leanblog.org/210. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. Darrell's Bio: With a passion for public service, Darrell has served as an enterprise lean consultant in the Governor's Office for the past 3 years, under two governors, helping Washington state government learn to use lean principles and tools to deliver better value to more Washingtonians. As part of the Results Washington team, Darrell created Washington State's Lean Expert Partnership Program through which, over the past 3 years, more than 200 private sector lean experts have volunteered their time (no cost to taxpayers) to give thousands of Washington state's public servants advice, training, and coaching as they learning to use Lean principles and tools to make improvements throughout state government. Darrell has been a public servant in Washington State government for more than 23 years, working in the Department of Corrections and the Department of Revenue. Prior to joining state government, Darrell served 6 years on active duty in the U.S. Marine Corps. Hollie's Bio: As part of her role with the State of Washington, Hollie Jensen is developing and implementing a Lean Fellowship program while also consulting on the governor's priority goal areas. In this role Hollie focuses on developing state leaders by teaching, consulting and coaching on Lean principles and leadership behaviors. Through her work with the Fellowship and State leaders, she is focused on every state employee learning how to problem solve and every state leader supporting the problem solving work by teaching and coaching. She joined state government in the spring of 2013 as an enterprise lean consultant after her 17-year tenure with Starbucks, where she began as a barista on the front lines and worked her way up through the organization with roles in human resources, global strategy and operations. Most recently she was a lean practice strategy manager with a focus on implementing the store system of work and the leadership/coaching program. Jensen holds a bachelor's degree from the University of Washington and has worked closely with LEI over the past 7 years to grow her lean knowledge and experience. Most recently, Hollie has had the opportunity to teach other practitioners at the Lean Transformation Summit, LEI public workshops in Seattle and the Lean Coaching Summit.

My guest for episode #209 is George Friesen, Business Practice Leader for Lean Transformations in the Workforce Solutions Group at St. Louis Community College. In this episode, we talk about his early experiences at the GM/Toyota NUMMI plant, why candor and trust are so important in a Lean transformation, and how to engage front-line employees in Kaizen and continuous improvement, and much more. For a link to this episode, refer people to www.leanblog.org/209. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. George's Bio: George has been a Lean Manufacturing Consultant with St. Louis Community College since April 2000. Since coming to the College, George has developed an extensive and very well received series of training and consulting services focused on helping the College's clients take advantage of the power of Lean thinking and Lean work processes. In addition to services specific to certain Lean tools such as 5S, Value Stream Mapping, and Six Sigma, the College's Lean Transformations Business Unit has developed and provided to various clients, the Lean Leadership Certification Program, the Kaizen Thinking series, a series of discussions focused on Mike Rother's Toyota KATA, and the Lean Culture Change Symposia. These programs have received high praise from participants, eliciting comments such as, “What a great set of experiences.” “The training was just great. I learned a lot I can apply right now on the job.” Prior to joining the College, George worked for the Maritz Performance Improvement Company. He has provided performance improvement consulting and training services across a wide variety of industries, serving companies such as Toyota, Mercedes Benz, Texaco, BellSouth, Duke Power, Sigma-Aldrich, Caterpillar, AT&T, ThermoKing, Shell Oil Company, Illinois Bell, GM, Nestle, and Ford Motor Company. Over the past 35 years, George has facilitated over 800 seminars in areas such as 5S System implementation, Toyota KATA, Kaizen Thinking, Value Stream Mapping, Lean Leadership, Lean Culture Change, SMED, Visual Management, sales training, strategic planning, time management, and communication techniques. He has made presentations on Lean Manufacturing at the conventions of the National Council of Advanced Technology Centers, the National Council on Workforce Education, the Society of Manufacturing Engineers, and the American Society for Quality. George is a graduate of Washington University (AB), Webster University (MA), and United States Air Force Flight Training. He is also a certified AchieveGlobal and DDI facilitator.

Joining me for episode #208 is Michael Bremer, author of the recently released book How to Do a Gemba Walk. Michael is president of The Cumberland Group, a business improvement consulting firm based in Illinois. In today's episode, Michael talks about different types of gemba walks, key behaviors that need to be exhibited by leaders, and why it's critically important to build trust and credibility over time. How can gemba walks help a leader be more in touch with reality in the workplace? How can gemba walks help develop critical thinking skills in others? Listen to find out. For a link to this episode, refer people to www.leanblog.org/208. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

Episode #207 is part two of my conversation with Chris Jerry, founder of The Emily Jerry Foundation. The foundation was created in the aftermath of the tragic death of his daughter, Emily – a preventable medical error caused by a number of factors and bad systems. You can read Emily's story here. In the first part (Episode #203), Chris told the story of what happened. In part two, we talk about topics including: A systems view vs. blaming an individual Chris skipping over the “anger” phase of grief Why his barber required more certification than a pharmacy tech compounding medications? “Emily's Law” was passed in 2009 in Ohio and he's working on this nationally How he learned his ex-wife pursued the criminal charges against Cropp Publicly forgiving Cropp and meeting him face to face for the first time How we're all fallible and capable of making a mistake All of the elements of the system have to fit together and work together Differences between advances in automotive safety over time and healthcare safety Warning people without demonizing the individuals The importance of patient and family involvement How to reduce hospital acquired infections – hand washing! How much progress is being made in the patient safety battle? For a link to this episode, refer people to www.leanblog.org/207. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

My guest for episode #206 is Ed Pound, co-author of the book Factory Physics for Managers: How Leaders Improve Performance in a Post-Lean Six Sigma World that was released in April. It is, of course, a new version of the original Factory Physics textbook that I used in college and was the subject of Podcast #25 with Prof. Mark Spearman. Ed is the chief operations officer of Factory Physics, Inc., a company started by Spearman. In the podcast, we talk about the term "Factory Physics" (including the origin of the term) and what it means, including understanding the relationships between capacity, throughput, inventory, and variability. Ed also brings up great points about "dogma" versus manufacturing science, including dogma that can get companies in trouble, including: - Thou shalt have no finished goods inventory - Thou shalt have single piece flow, always - Thou shalt always have a moving assembly line We also talk about the subtitle of the book and what he means by a "post-Lean Six Sigma world" (it doesn't mean a world without Lean or Six Sigma). It's a great discussion and I hope you'll enjoy it, even if you don't work in factories. The lessons and ideas are certainly applicable. For a link to this episode, refer people to www.leanblog.org/206. For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

Episode #205 is a conversation with Joe Schnur, VP Business Development at Intelligent M, a company that “designs data-driven hand hygiene compliance improvement solutions for hospitals that dramatically reduce healthcare-acquired infections and their associated costs.” Joe and I share a passion for improving patient safety and we've had a number of great conversations comparing notes on the problem and the different ways we need to work toward solving it. We decided to finally record one of those discussions for a podcast. In the podcast, Joe shares some shocking statistics about “hand hygiene compliance” – that while hospitals report numbers that are far higher, the typical care provider washes or cleans their hands only about 20% of the time. One management challenge (and sales challenge for Joe) is that hospital executives might find it too easy to sit back and point to the inaccurately high numbers that claim 90%+ compliance (numbers that are based on sampling instead of real data). When I first started talking to Joe, I was skeptical about a “monitoring” technology for healthcare professionals, since I see hand hygiene as a system problem (lack of time, empty gel dispensers) that management has to work to fix… it's a process problem. But, I think (as in many cases) there is a role for technology that can be supportive of people (patients and staff) and can enable systemic improvement. What's the proper balance between individual accountability and the role of “the system?” I'm curious to hear what you think (you can post a comment on this post). For a link to this episode, refer people to www.leanblog.org/205. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

Joining me today for Episode #204 is Paul Plsek (@PaulPlsek) and we're talking about his excellent book (a Shingo Research Award recipient this year) titled Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience. Virginia Mason, of course, is Virginia Mason Medical Center, the outstanding Lean organization that was named “Hospital of the Decade” by Leapfrog Group. In our discussion, we touch on topics including how you can be Lean AND innovative, how an organization and people can LEARN to be innovative, and what is the health system board's role in this innovation and improvement strategy? I think you'll enjoy the discussion (and the book!). You can learn more about Paul, his book, and his work at his website: www.directedcreativity.com. For a link to this episode, refer people to www.leanblog.org/204. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

My guest for Episode #203 (and for Part 2 of our discussion in episode #207) is Chris Jerry, founder of The Emily Jerry Foundation. The foundation was created in the aftermath of the tragic death of his daughter, Emily – a preventable medical error caused by a number of factors and bad systems. You can read Emily's story here. I first learned about this tragedy a few years back and I blogged about it: “A Pharmacist's Jail Cell Interview – What Good Does Blame Do?” Some people ask, “Why are you defending a pharmacist who screwed up and killed a sweet little girl?” The main victims were, of course, Emily and her family. That doesn't mean that a simplistic response of punishing and jailing one person will do anything to protect other patients in the future… and Chris Jerry agrees with that view. I saw Chris speak at a conference earlier this year and we finally found an opportunity to record a podcast after talking about this for a few years off and on. The story is powerful and I admire Chris for his work and advocacy to help others — as a way of honoring Emily and her life and memory. In this first part, Chris tells the story of what happened. Again, also check out Part 2, which was released later. For a link to this episode, refer people to www.leanblog.org/203. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

My guest today for Episode 202 is Patrick Graupp, co-author of the excellent book Getting to Standard Work in Health Care: Using TWI to Create a Foundation for Quality Care, co-authored with Martha Purrier from Virginia Mason Medical Center. If you're brand new to the Training Within Industry (TWI) model, you might want to first listen to Episode 196, with Jim Huntzinger, on “What is TWI?“ Patrick is also a senior master trainer with the TWI Institute. His other publications include the book The TWI Workbook: Essential Skills for Supervisors, a Shingo Research and Professional Publication Prize Recipient for 2007 and Implementing TWI: Creating and Managing a Skills-Based Culture which was published by Productivity Press. In the episode, we discuss topics including: How often do you meet Lean practitioners who don't know about TWI? What are some of the challenges that hospitals address using TWI? How did Virginia Mason get introduced to these concepts? How has TWI helped in healthcare? About the TWI Institute and Patrick's work For a link to this episode, refer people to www.leanblog.org/202. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. More info and links related to this podcast: Previous podcasts on TWI: #196: (3/18/14) Jim Huntzinger, What is TWI? #104: (11/23/10) Dr. Peter Patterson, Lean in Histopathology #28: (7/29/07) Norman Bodek, on Training Within Industry and more #15: (1/7/07) Jim Huntzinger about the “Training Within Industry” program Other Related References & Links: Podcast #31 on “Toyota Talent” My article on “Training Within Healthcare“ A longer overview presentation about TWI

Joining me for episode #201 are Ron Smith, a Process Improvement Coordinator/Lean Facilitator at Mary Greeley Medical Center (in Iowa) and Suz Kaprich, a consultant with KaiNexus (disclosure: I'm on the management team of KaiNexus and have an ownership stake in the company). Today, they are talking about a three-month “WorkOut” process that Ron and Suz ran recently at the hospital. Given the challenges in today's healthcare environment, the focus was on cost reduction and financial benefits, but they of course made improvements to the timeliness and quality of patient care, as well. The total financial impact, validated by finance, was about $800,000 in that time. The goal was not just to drive short-term improvements, but to also demonstrate how improvement was possible… to help spark a culture of ongoing continuous improvement. Through the course of the WorkOut, Mary Greeley Medical Center used the KaiNexus web-based continuous improvement platform to facilitate and track their improvements and results and they remain a customer of KaiNexus for their ongoing improvement efforts. For a link to this episode, refer people to www.leanblog.org/201. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher.

My guest for episode 200 is Paul Spiegelman, author of the book Patients Come Second: Leading Change by Changing the Way You Lead. Today, we're talking about his book and its provocative title – what do you mean patients don't come first? What about this trend for “patient-centered care” (and why wasn't it patient-centered to begin with?). In the podcast, Paul talks about: The book's title and how it was meant to be provocative Why focusing on engaged employees leads to better patient care and more success for the organization How do we create engagement? Why is it important to connect things to purpose and values? Why is being vulnerable important and why is that the sign of a strong leader? And more…. For a link to this episode, refer people to www.leanblog.org/200. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. About Paul: Paul Spiegelman is Chief Culture Officer of Stericycle, a NASDAQ listed global services organization with 13,000 employees and is the Founder of BerylHealth and The Beryl Institute. Paul also co-founded the Inc. Small Giants Community, an organization that brings together leaders who are focused on values-based business principles. As the former CEO of BerylHealth, Paul led a unique, people-centric culture for a company that won nine “best place to work” awards, including the #2 Best Medium Sized Company to Work for in America. Paul was honored with the Ernst & Young 2010 Entrepreneur of the Year award. Paul is a sought-after speaker and author on leadership, employee engagement, entrepreneurship, corporate culture, and customer relationships. He makes frequent radio and TV appearances and writes columns on culture for Inc. Magazine and the Dallas Business Journal. He's written several books on employee engagement and is the New York Times best-selling author of Patients Come Second: Leading Change by Changing the Way you Lead. Paul practiced law for two years prior to founding BerylHealth. He holds a bachelor's degree in history from UCLA and a law degree from Southwestern University.

Joining me for episode #199 is Jeff Gothelf (@jboogie), talking about “Lean UX” or “Lean User Experience,” a key method for software development, usually used in conjunction with design thinking, agile development, and Lean Startup business practices. Jeff is author of the book Lean UX: Applying Lean Principles to Improve User Experience and he is Managing Director at Neo, the global product innovation company. Jeff is teaching a workshop in Austin on June 10 called “Lean UX Bootcamp: Agility through cross-functional collaboration.” I barely know anything about LeanUX, but have chatted with Jeff before and read the first few chapters of his book… but my role here is to just ask questions… Jeff will explain Lean UX to us today. I'm taken by the parallels between Lean UX (along with Lean Startup) and more general “Lean,” as I know it in manufacturing and healthcare. It's about deeply understand the customer and their needs, forming hypotheses, and iterating in an experimental and data-driven way… a departure from the old way of the designer “knowing” what the customer wants or a software company writing a huge specification document (about “half of which never got used,” says Jeff). Lean UX designers are problem solvers, they “get out of the building,” and they get their designs (or even just sketches) in front of customers to get feedback early and often. It's better to do small, inexpensive tests of change… if you're going to fail, better to fail early and fail often… and we'll be more successful as a result. That's good solid Lean thinking and Kaizen thinking. Read more about Jeff via: His bio His blog For a link to this episode, refer people to www.leanblog.org/199. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #198 is a discussion with Harry Kenworthy about his work bringing Lean into local and state governments. We had a great conversation that touches on the influence of Dr. W. Edwards Deming and many other concepts that might be of interest even if you're not interested in “Lean Government” and the work happening there. Harry is Principal and Manager of the Quality and Productivity Improvement Center (QPIC, LLC), a consulting organization he founded in 1984 and has been with full time since 2004. He worked with Dr. Deming in 1983-85 on a series of 2 day seminars throughout the US, sponsored by MIT. He has spoken at over 90 conferences on quality, productivity, Lean, and Six Sigma, and has been published several magazines including Quality Progress and Purchasing. He also had working relationships with Dr. Joseph Juran and Dorian Shainin. He was one of the first practitioners to apply LEAN in the Government sector in the mid-90s. Here is an article by Harry, shared with permission (PDF link): Getting Started on a Lean Government Journey Harry was also a Malcolm Baldrige National Quality Award Examiner from 1989-1991, a licensed Professional Engineer and a Certified Quality Engineer. He worked at a NYSE listed, global manufacturer, for 26 years in a variety of capacities: Operations Manager, Division Manager, Group VP and, for his last 3 years, as Corporate VP, Manufacturing. He was the Executive Lean Six Sigma (LSS) Champion: leading the LSS effort and developing the LSS training program, which incorporated the best of traditional Six Sigma (DMAIC), Lean, and a series of Specialized Problem Solving Techniques. He provided LSS training in the US, Europe, Japan and China. For 9 years, he was on the Board of Directors of a Japanese Joint Venture based in Nagoya, Japan. The JV was a key supplier to Toyota and Harry was able to learn about Lean through Toyota. He also had a long term relationship with JUSE (Japanese Union of Scientists and Engineers) which administered the Deming Prize in Japan and had the honor of visiting several Deming Prize-winning companies. Harry holds a Bachelor of Science degree in Materials Engineering from Rensselaer Polytechnic Institute and an MBA in Finance from Syracuse University. For a link to this episode, refer people to www.leanblog.org/198. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. Podcasts Sponsored by KaiNexus

My guest for episode #197 is a hospital leader I really respect, Kim Barnas, author of the new book Beyond Heroes. Until very recently, Kim was a Senior VP at ThedaCare, leading Appleton Medical Center and Theda Clark Hospital. I've seen Kim speak to groups at ThedaCare and a few conferences and she has a lot to teach us about Lean leadership, using her stories and experiences in a way that's very powerful. I hope you'll check out the book. Read a press release about it here. In the podcast today, we talk about topics including her initial reactions to Lean when first introduced to it as a hospital leader, why “heroes” are overrated and sometimes create “chaos” in healthcare, and the importance of moving beyond tools and projects to a Lean culture and management system. 2018 Update: What's Going on at ThedaCare? Kim talks about the need to “create more value” (not just reduce waste), saying “just trying to do more with less makes no sense – you need a plan.” We also talk about programs like GM's “Speak up for Safety,” where she says that speaking up “needs to be a conversation, not a reporting” transaction. For a link to this episode, refer people to www.leanblog.org/197. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode 196 is Jim Huntzinger, founder of Lean Frontiers. Today, we're talking about the Training Within Industry methodology and his new website WhatIsTWI.com. We are discussing topics including what a typical TWI “journey” looks like for an organization, how TWI is such a fundamental Lean concept/method, and some examples of how TWI is helping organizations in various industries, including healthcare. What's the latest in the seven years since our first podcast on this topic? For a link to this episode, refer people to www.leanblog.org/196. Previous podcasts and related links: #8: (10/31/06) Jim Huntzinger, Founder of the Lean Accounting Summit #15: (1/7/07) Jim Huntzinger about the “Training Within Industry” program #33: (11/17/07) Jim Huntzinger, on the latest Lean Accounting Summit Training Within Industry: What Rosie the Riveter and IV Med Prep Have in Common Podcast #104 – Dr. Peter Patterson (@IDrPete), Lean in Histopathology\ Society for Health Systems Talk on TWI For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus

Joining me for episode #195 is my friend Steve Montague from LifeWings. Steve and I met initially through our shared interest in Lean and, like Ron Pereira, we discovered we both lived in Keller, Texas (I've since moved to San Antonio). Steve is a retired Navy pilot and currently flies for a major commercial airline. He's also been involved, through LifeWings, in the movement to bring aviation safety practices (and culture) to healthcare via "Crew Resource Management" or "TeamSTEPPS." He's also been on the forefront of combining Lean and TeamSTEPPS, something we both agree is a great idea. In honor of National Patient Safety Awareness Week, we talk about topics including: - Steve's background with CRM in aviation and healthcare - Why CRM isn't just about checklists, but also learning how to "communicate more assertively" in the cockpit or operating room... - How Lean and CRM / TeamSTEPPS fit together conceptually - How standardization and iterative improvement fit together There's so much we could talk about, so we barely scratched the surface on this topic. If you have questions, we can do another podcast. Please post them as comments on this post. For a link to this episode, refer people to www.leanblog.org/195 -- go there for some links and material that Mark wrote to share with the listeners (and he'll have a guest post soon that expands on the thoughts in the podcast). Please leave a comment and join the discussion about the podcast by visiting the blog page for this episode. For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes. You can also listen to streaming episodes of the podcast via Stitcher: http://landing.stitcher.com/?vurl=leanblog If you have feedback on the podcast, or any questions for me or my guests, you can email me at [email protected] or you can call and leave a voicemail by calling the "Lean Line" at (817) 776-LEAN (817-776-5326) or contact me via Skype id "mgraban". Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

My guest for episode #194 is Paul Piechota, Director for the Center for Competitive Change at the University of Dayton School of Engineering. Piechota has authored over 30 publications with such titles as Transforming the Enterprise, Getting to the Future First!, and Establishing a Method for Process and Culture Change in the Military. His most recent publication is the book titled, Keeping Your Business in the U.S.A.: Profit Globally While Operating Locally. In this episode, we'll talk about topics including how the university is using Lean and Six Sigma to improve their own operations, how they are getting students involved, and their attempts to engage professors to improve their work in the classroom. This all follows up a blog post I wrote about their press release on this topic. For a link to this episode, refer people to www.leanblog.org/194 -- go there for some links and material that Mark wrote to share with the listeners (and he'll have a guest post soon that expands on the thoughts in the podcast). Please leave a comment and join the discussion about the podcast by visiting the blog page for this episode. For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes. You can also listen to streaming episodes of the podcast via Stitcher: http://landing.stitcher.com/?vurl=leanblog If you have feedback on the podcast, or any questions for me or my guests, you can email me at [email protected] or you can call and leave a voicemail by calling the "Lean Line" at (817) 776-LEAN (817-776-5326) or contact me via Skype id "mgraban". Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

My guest for episode #193 is Mark Jaben, MD, talking about our brains, Lean, and change. Mark has been a guest blogger for me before and it's great to talk to him today about his research and experiences. In our conversation, Mark talks about "the troublesome features of our brain's operating system" (such as our "hidden brain"), how the A3 problem solving process fits with the way our brains work, and how to deal with "resistance" to change. Mark has also helped talk to some healthcare organizations about KaiNexus and we both presented at a conference last year. For a link to this episode, refer people to www.leanblog.org/193 -- go there for some links and material that Mark wrote to share with the listeners (and he'll have a guest post soon that expands on the thoughts in the podcast). Please leave a comment and join the discussion about the podcast by visiting the blog page for this episode. For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes. You can also listen to streaming episodes of the podcast via Stitcher: http://landing.stitcher.com/?vurl=leanblog If you have feedback on the podcast, or any questions for me or my guests, you can email me at [email protected] or you can call and leave a voicemail by calling the "Lean Line" at (817) 776-LEAN (817-776-5326) or contact me via Skype id "mgraban". Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

Joining me for podcast #192 is John Torinus, author of the excellent book, The Company That Solved Health Care: How Serigraph Dramatically Reduced Skyrocketing Costs While Providing Better Care, and How Every Company Can Do the Same. John is the chairman of Wisconsin-based Serigraph Inc., a graphics parts manufacturer with ownership in ten plants in the U.S., Mexico, China and India with over $130M in annual sales. John has served as business editor and columnist at the Milwaukee Journal Sentinel. John is collaborating with the ThedaCare Center for Healthcare Value for a new workshop: “Solving the Employer Healthcare Crisis,” to be held in Phoenix on January 28 (and hopefully again in the future). In this episode, we talk about how Serigraph has kept healthcare costs under control while improving the health of their employees. How do concepts of consumer choice, data transparency, and focusing on preventive care help to “engage all employees in the healthcare challenge”? For example, 90% of their diabetic employees have their disease “under control” as compared to about 30% nationally. What is this “grass roots revolution” in healthcare? For a link to this episode, refer people to www.leanblog.org/192. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus

Joining me for podcast #191 is my friend and fellow LEI faculty member Mike Orzen (@MikeOrzen), co-author of the Shingo Award-winning book Lean IT: Enabling and Sustaining Your Lean Transformation. I recently crossed paths with Mike in Columbus, Ohio, because we're both mentoring students in the Ohio State University MBOE program. We have a lot in common, it seems! Mike is also collaborating with the ThedaCare Center for Healthcare Value for a new workshop: “Leveraging Information, People & Systems in Healthcare,” to be held in Phoenix on January 28 and 29. In this episode, we talk about topics including an overview of “Lean IT,” how Lean is different compared to manufacturing and other service settings, how healthcare organizations can benefit from Lean IT, and the potential for kaizen and continuous improvement in IT. For a link to this episode, refer people to www.leanblog.org/191. Mike and I wrote an article in 2011 on using Lean to meet the IHI “Triple Aim” goals in healthcare (PDF link). For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus

My guest for episode #190 is a returning guest (from episode #151), my friend Karen Martin, talking about her (co-authored by Mike Osterling) newly-released book, Value Stream Mapping: How to Visualize Work and Align Leadership for Organizational Transformation. You can order via Amazon and can learn more via Karen's website. In the episode, we talk about topics including how this book fits with her others, some common struggles that people face when mapping value streams, why it's important for senior leaders to be involved with VSM work, how long mapping should take, the publishing value stream, and the use of VSM in different industries. I hope you enjoy the conversation! For a link to this episode, refer people to www.leanblog.org/190. Here is the endorsement I gave for the book based on my reading of a pre-publication version of the book: “Value Stream Mapping is a wise and practical guide that will help you lead transformation efforts in your organization. While some think of value stream mapping as a ‘lean tool,' Martin and Osterling rightly emphasize the strategic value of looking at the big picture and improving your entire value stream from suppliers to the customer and all points in between. The book is full of tips and lessons learned to help you avoid mistakes and maximize the results that you get from the time invested into proper value stream mapping.” You can read the introduction (PDF) or the executive reading guide (PDF) online. You can also view webinars Karen has done on this topic: Value Stream Mapping – Strategy Before Tactics Value Stream Mapping: How to Visualize Work & Align Leadership for Organizational Transformation You can also sign up for a new webinar being done tomorrow, Jan 7 2014: Value Stream Analysis: Beyond the Mechanics – Part 1 (Planning) For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus

Audio remastered June 2022 Episode page Joining me as my guest for episode #189 is Rich Sheridan, CEO and Chief Storyteller at Menlo Innovations, a software development company in Ann Arbor, Michigan. Rich is author of the new book that I'm really enjoying: Joy, Inc.: How We Built a Workplace People Love. Learn more about the author and the book at www.menloinnovations.com/joyinc. You can also download a free chapter here. There's so much to love about his book and what they are doing at Menlo. I think it's great to start a new year, 2014, with a look at a book that gives us hope about creating workplaces where employees are fully engaged and everybody wins – customers, company, and employees. I'll have a chance to visit Menlo in about two weeks when I'll be in Michigan for my public Kaizen workshop, so I'll report back on what I see during that visit. For a link to this episode, refer people to www.leanblog.org/189. Some of the topics I was taking notes on as I read the book (through chapter six): “You can be joyful without being happy all the time” Menlo has built upon “extreme programming” and Kent Beck‘s work there Their “Menlo Way” is worth looking at As Toyota has done, Menlo doesn't mind teaching competitors about their methods (because this serves their mission to reduce suffering in the world, including the suffering in bad workplaces) They work really hard to break down “towers of knowledge” in the organization Menlo emphasizes direct customer contact and understanding their problems and what they need (often better than the customers could articulate on their own in a traditional software approach) Their “high tech anthropology” approach (HTA) starts with understanding customers better and then iterating and testing designs (often starting with crude prototypes and mockups) Their QA process focuses on reducing delays and shortening lead time (along with other approaches that are different than traditional QA) A reader will recognize ideas that are similar to Deming, Lean, Lean Startup, Agile, and more… combined into a powerful and cohesive articulation of culture and strategy

My guest for Episode 188 has been a leading voice in the Lean community for 25 years, Daniel T. Jones, founder and chairman of the Lean Enterprise Academy, based in the UK. Dan collaborated with Jim Womack on the books The Machine That Changed the World, Lean Thinking, and Lean Solutions and published other books through the LEA. Currently, Dan is helping promote Lean in healthcare and government and is learning about the Lean Startup community by becoming an advisor to the company Elastera. He has also recently joined Twitter as @DanielJonesLean. You can also watch recently-released free videos (via Gemba Academy) of Dan, Jim, and John Shook reflecting on 25 years of Lean and other topics. In this episode, we touch on all of these questions and also take a question via Twitter. For a link to this episode, refer people to www.leanblog.org/188. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus.

Joining me for episode #187 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. You can learn more about our books here. Joe is Director of Business Transformation at Franciscan St. Francis Health System in Indianapolis (his full bio is here). In the episode, we talk about his background with Kaizen and how he got into healthcare. Joe discusses how Franciscan got started with Kaizen, some of his favorite Kaizen examples, why it would have taken too long to engage everybody through Lean Six Sigma projects, what they are teaching managers about leading in a Kaizen culture, and the work that still needs to be done in their cultural transformation. For a link to this episode, refer people to www.leanblog.org/187. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. Podcasts Sponsored by KaiNexus

Episode page My guest for episode #186 is my friend Jon Miller, CEO of Kaizen Institute and long-time blogger at Gemba Panta Rei. Today, we're talking about his upcoming book, Creating a Kaizen Culture: Align the Organization, Achieve Breakthrough Results, and Sustain the Gains (co-authored by Mike Wroblewski and Jamie Villafuerte). I can't believe I haven't had Jon on the show before… hopefully, this won't be the last time. In this episode, we'll talk about “artifacts” of a Kaizen culture and why core beliefs, including safety and security, are so important. What are some of the other core beliefs in a Kaizen culture? Why are some of these beliefs and behaviors “not natural Japanese behaviors” and what are the implications for those of us doing this in other countries? For a link to this episode, refer people to www.leanblog.org/186.

My guests for episode #185 are Karen Dunn Skinner and David Skinner and our topic, for the first time on the Podcast, is Lean in law firms and the legal profession. David and Karen are husband and wife, attorneys, from Quebec, and consultants for their firm Gimbal. I had a chance to meet up with them in Montreal earlier this year, after connecting via social media, and they're a delight to talk to – in person and in our podcast. I think there are a lot of fascinating parallels between Lean in healthcare and Lean in law. There are opportunities to focus on payment for value instead of activity, big opportunities to reduce waste and errors, and to make sure people are doing the right work for their job level. “The way it's always been” seems very powerful in both professions and the “but we don't make cars” objection can be powerful. In the episode, we discuss topics including: How do Lean methods apply in a Law firm? What are some benefits to the clients and the firm itself? How do you get past the “we don't build cars” objection? How widespread is Lean in the legal profession? How did Karen and David discover Lean (and Six Sigma) as attorneys? What's the balance between using Lean and/or Six Sigma in law? How can standardized work and checklists help? Why are legal clients dissatisfied with the pricing and quality of legal work? How do you strike a balance between law being an art vs. being a process? For a link to this episode, refer people to www.leanblog.org/185. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus

It's great to have Dr. John Toussaint back for episode #184 of the podcast (see links to previous episodes below). He is, of course, CEO of the ThedaCare Center for Healthcare Value and the author of two Shingo Award-winning books, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry and Potent Medicine: The Collaborative Cure for Healthcare. In this podcast, we start by hearing John's thoughts on some of the top issues that healthcare CEOs are facing today, such as changes in payment structures and Accountable Care Organizations. We also talk about the “Enduring Excellence” program that Paul O'Neill and John are leading to teach healthcare senior leaders about Lean culture change and their important role. This podcast was produced in conjunction with the Healthcare Value Network as a continuation of their previous podcast series. For a link to this episode, refer people to www.leanblog.org/184. Past episodes with Dr. Toussaint: #159: (10/16/12) John Toussaint, MD on the new IOM report #146: (5/2/12) John Toussaint MD, on his new book Potent Medicine #72: (8/12/09) John Toussaint, MD, Lean and Health Reform #62: (2/23/09) John Toussaint, MD, ThedaCare Center for Healthcare Value #54: (12/2/08) John Toussaint, MD, ThedaCare's Lean Journey For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Podcasts Sponsored by KaiNexus

My guest for episode #183 is Scott Sambucci, who I met at the 2012 Lean Startup Conference. Scott is author of an excellent book, Startup Selling: How to sell if you really, really have to and don't know how. Scott is also founder of SalesQualia, a firm that helps people improve sales performance. His latest project is the Sales Model Canvas, an online tool. Scott and I talk about getting better at sales (something I've honestly struggled with, as an engineer, during my time with KaiNexus). Scott talks about how “sales is a process,” what some of the biggest mistakes people can make with sales, what some common “vanity metrics” are (to be avoided), and how to look out for “vampires and gatekeepers” as you sell. For a link to this episode, refer people to www.leanblog.org/183. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. You can also listen via Stitcher. Podcasts Sponsored by KaiNexus

Joining me for episode #182 are Michael Grogan and Dr. Brenda Dmello, joining me via Skype from Tanzania where they are working together to use Lean to improve health care at the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT). Michael is Irish born and left his career in the United States to work in Africa (which you can read about in his guest post that I published earlier this month). In the episode, we talk about their mission to reduce maternal death rates and “needless suffering” by creating “engaging, problem solving managers” as “everything rises and falls with leadership.” They are developing leaders who can “stop blaming” and treat people with respect, eliminating the “culture of fear” that we see in far too many organizations around the world. Dr. Brenda says, “I don't think it's ethical to allow change to happen so slowly” and that “clinical skills alone” won't solve healthcare's problems. Links about their work: You can make donations toward their work via the Kupona Foundation Mike Stoecklein's blog post about their work Michael's blog post on his first 79 days in Tanzania Register for a webinar by Michael, hosted by the ThedaCare Center for Healthcare Value on August 14

My guest for Podcast #181 is a good friend, Ron Pereira of Gemba Academy, an outstanding provider of online Lean (and now Six Sigma) education. Ron's blog posts can now be found at the Gemba Academy blog. I was recently a guest on episode #8 of his podcast series. Ron was also the guest host for episode #143 of my podcast, where he interviewed me with follow up questions from a webinar I did for Gemba Academy on SPC. Before I moved to San Antonio, Ron and used to live just about five miles apart in Keller, Texas and would meet for coffee regularly… but, today, we are talking via Skype. We're talking about his background with both Six Sigma and Lean and about how these methods can be used together. Ron tells a story about a time he used statistical methods to solve something that might have been difficult with standard Lean approaches. For a link to this episode, refer people to www.leanblog.org/181. Conflict of interest disclosure: Gemba Academy is a formal partner of KaiNexus, a technology company I work with and have an ownership stake in. I have received a free subscription to the Gemba Academy training classes. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.