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

Joining me for episode #180 of the Lean Blog Podcast is Dan Florizone, who served from 2008 until last month as Deputy Minister of Health in the Canadian province of Saskatchewan. Dan has just recently transitioned into his new role as the Deputy Minister of Education and he will also focus on the application of Lean principles across all departments of the government. Dan previously had over 25 years of healthcare management experience, including a five-year stint as CEO of the Five Hills Health Region. Dan and I first met a few years back when we were at a Lean healthcare conference hosted by Cindy Jimmerson. I really enjoyed talking with Dan and have closely followed the Lean healthcare transformation work being done in the province. In the episode, we talk about Dan's introduction to Lean, his 2005 visit to Seattle to learn more, and how Lean is part of their “patient first” model. Lean has been a shift from “traditional cost cutting” to a “patient-centered, not provider-centered” approach to care. Lean has helped change their leadership model, where “the barrier to our change was thinking,” as Dan says. For a link to this episode, refer people to www.leanblog.org/180. 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 Additional links and info: Saskatchewan Intro to Lean Healthcare page PROVINCE ACCELERATES LEAN JOURNEY TO IMPROVE HEALTH CARE LeanBlog.org post: CBC on Lean in Saskatchewan Hospitals LeanBlog.org post: Lean in a Moose Jaw Hospital LeanBlog.org post referencing “lean design” work in Saskatchewan Follow Trish Livingstone (@LeanSaskHealth) on Twitter

My guests for Podcast #179 are my friends Judy Worth and Tom Shuker, two of the co-authors of the book Perfecting Patient Journeys, which was published earlier this year by the Lean Enterprise Institute. About the book: “Perfecting Patient Journeys” is a guide for leaders of healthcare organizations who want to implement lean thinking. Readers will learn how to identify and select a problem, define a project scope, and create a shared understanding of what's occurring in the value stream. Readers will also learn to develop a shared vision of an improved future, and how to work together to make that vision a reality.” We'll talk about their book, what types of value streams and “extended value streams” are being worked on in healthcare (including “end-to-end” flows), breaking down silos, improving quality and cost as a result of taking time out of the value stream, and more. For a link to this episode, refer people to www.leanblog.org/179. Other links and info: Downloads and templates from the book (see the “downloads” tab) A review of the book by John Miller at the Gemba Panta Rei blog A review by Tim McMahon on his blog Conflict of interest disclosure: I received a free copy of the physical book and e-Book from the Lean Enterprise Institute and I am formerly an employee of LEI. 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 Podcast #178 is Drew Greenblatt, President and Owner of Marlin Steel Wire Products, a manufacturing company based in Baltimore. I was really impressed with Drew's keynote talk at the recent AME Southwest Region conference here in San Antonio. Drew's company is successfully competing against cheap Chinese imports by using Lean and “theory of constraints” methods, being passionate about serving customer needs, and making a commitment to (and investment in) his employees. Whether you're a manufacturer who is considering “re-shoring” your production (or avoiding off-shoring) or if you're an organization looking to success by partnering with all of your employees, I think you'll find Drew inspiring. Drew and Marlin Steel Wire are featured in this month's Fast Company magazine Check out Bill Waddell's recent blog post about Drew and Marlin Wire. Inc. Magazine article on Drew Video of Eli Goldratt's last speech, shared by Drew online For a link to this episode, refer people to www.leanblog.org/178. 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

My guest for Podcast #177 is a returning guest, Bob Emiliani. In this episode, we're talking about one of his latest eBooks: Nobody Is Exempt From Improvement. Check out our previous podcasts together – Episodes 132, 77, 48, 38, and 30. Bob is a professor at Central Connecticut State University and a prolific author on Lean management. Also check out his new book – “The Lean Professor.” For a link to this episode, refer people to www.leanblog.org/177. 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

Show notes: https://www.leanblog.org/176 Remastered June 20201 Today, we discuss his latest book, The Harada Method: The Spirit of Self-Reliance. Joining me once again for episode #176 is my mentor good friend Norman Bodek, who has been a guest many times here. You can also learn more about the book and Norman's workshops at his website, PCSPress.com. As always, it's great to hear Norman talk about his interests and what he has learned in his trips to Japan, including Takashi Harada's work. For a link to this episode, refer people to www.leanblog.org/176. For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS, through Android apps, or via Apple Podcasts. You can also subscribe and listen via Stitcher. Please leave us a review and rating!

My guest for podcast #175 is Mike Taubitz of the firm Sustainable Lean and FDR Safety. Mike is a retired GM employee (including a stint as Global Safety Director) and we met at the Michigan Lean Consortium conference in 2011. We quickly discovered our shared interest in Dr. Deming, Lean, and, most importantly, safety improvement. I hope you enjoy our chat about his background and lessons from his career, the integration of Lean practices and safety improvement, lessons from Paul O'Neill and other great topics. Like my dad, Mike is a graduate of the then General Motors Institute (now Kettering University). Some key quotes: “It's not just what you do, but why.” 5S is not just neat, clean, and organized – it's about team identifying waste and developing standards We are “a nation of solution seekers” instead of working on “foundational thinking.” For a link to this episode, refer people to www.leanblog.org/175. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for podcast #174 is John Hunter, a long-time friend and fellow blogger – at his Curious Cat Management Improvement Blog and, more recently, as a blogger for the W. Edwards Deming Institute. John has recently published a book through LeanPub.com titled “Management Matters.” In this episode, John joins us from Malaysia, where he has been living, and we talk about his quality background – growing up in Madison, Wisconsin, influenced by his dad (William Hunter), Brian Joiner, George Box, Dr. Deming, and others. John also talks about his book and work, why long-term thinking is such a rare commodity, and some of the lessons from Dr. Deming that mean the most to him. For a link to this episode, refer people to www.leanblog.org/174. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for podcast #173 is Alan Gleghorn, CEO of Christie Clinic in central Illinois. Alan is one of the keynote presenters at the upcoming Lean Healthcare Transformation Summit, to be held June 5-6, 2013 in Orlando. Alan has been CEO for 14 years, leading Christie Clinic in their Lean journey that started in 2005 when he saw ThedaCare's current CEO Dr. Dean Gruner present at a conference. In this episode, Alan talks about how they got started with Lean, what they learned from Autoliv and the Shingo Prize assessment process (being the first healthcare organization to do that). He also talks about his Summit keynote and how their work with Accountable Care Organizations is leading to better value and outcomes for patients. For a link to this episode, refer people to www.leanblog.org/173. You can also listen to an interview I did with Alan two years ago for the Healthcare Value Network podcast. This podcast was produced in conjunction with the Healthcare Value Network as a continuation of their previous podcast series. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Joining me for episode #172 is Jerry Bussell, previously a guest on episode #137. Today, we're talking about his recent book, Anatomy of a Lean Leader. I just saw Jerry talk about the book yesterday at the AME spring conference here in San Antonio. Jerry talks about how he defines a “Lean leader” and why President Abraham Lincoln fits into that description. He'll talk about some of the modern CEOs he would put on the list of great Lean leaders, including the owner of the NFL's Jacksonville Jaguars. Visit the website for Jerry's book here. For a link to this episode, refer people to www.leanblog.org/172. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #171 is Chad Walters, a friend and a Lean consultant. He is owner of Lean Blitz Consulting in Augusta, Georgia, a firm focused on continuous improvement for small businesses and sports organizations. I'm a big fan (and frequent commenter) on Chad's blog and he's contributed guest posts here on my blog. He has been cited and mentioned on ESPN.com and CNBC.com. Today, we talk about how Lean principles can apply to sports operations, including the stadiums and events you attend. We'll talk about concepts of value and waste from the sports fan perspective, specific challenges in the sports and entertainment fields and some examples related to baseball (play ball!, the season just started) and The Masters, which starts Thursday. For a link to this episode, refer people to www.leanblog.org/171. More about Chad Walters: He has run projects for the Atlanta Braves, the Salvation Army, Automatic Data Processing (ADP), Eaton Corporation, The Dannon Company, and the South Bend Silver Hawks among other companies. He has been practicing Lean and continuous improvement for over eight years, is a Six Sigma Black Belt certified by the American Society for Quality, and received his MBA from Indiana University's Kelley School of Business, where he was a member of the Kelley MBA Sports & Entertainment Academy. Posts of his we talk about: Enforcing Standardized Process & Major League Baseball Pace-of-Game The Masters: Concession Stands 2013 BCS National Championship and Silly Rules About Parking The Dayton Dragons — Note from Chad: “The Dayton Dragons have not won a Midwest League title, confirming what I stated in the podcast. However, they have 913 straight sellouts, which stretches back far past eight years as I originally stated. I'm estimating their sellout streak at about thirteen years and still going.” Joe Garagiola Jr. is the Senior VP of Standards and On-Field Operations for MLB. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #170 is Stephen Parry, joining us from England. He is a keynote speaker at the upcoming Lean Kanban North America conference in late April. I will also be a main stage speaker at the event. Parry has experience leading Lean transformation efforts in industries ranging from telecommunications, IT, shared services, financial services, and the public sector. He is the author of the book Sense and Respond: The Journey to Customer Purpose. In this episode, we talk about his experience, how Lean engages employees to provide value to customers, and the differences between LINO (Lean In Name Only) and Real Lean. For a link to this episode, refer people to www.leanblog.org/170. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Joining me for Episode #169 is Leonard L. Berry, PhD, Distinguished Professor of Marketing in the Mays Business School at Texas A&M University. We are talking about his article that he co-authored with John Toussaint, MD Mayo Clinic Proceedings: 201CThe Promise of Lean in Health Care201D (PDF) - which I blogged about earlier. In this podcast, Len talks about his time being embedded in ThedaCare and the lessons he learned there... for example, why is it incorrect to assume that "standardized work" means something stifling? This episode is produced in partnership with the Healthcare Value Network. To point others to this, use the simple URL: www.leanblog.org/169. You can find links to posts related to this podcast there, as well. Please leave a comment and join the discussion about the podcast 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 #168 is Carolyn McCulley, from CityGate Films, and she is a co-director and producer of the upcoming documentary called "Breaking the Wall of Silence." Through March 31, you can sponsor this project through the Kickstarter website (with a minimum contribution of $15) and I hope you'll join me as a supporter of this important work. Learn more at www.leanblog.org/168. As Carolyn discusses with me, the film does not just focus on the problems of patient safety and poor healthcare quality... it focuses on the positive steps that MedStar Health (a large system in the Washington DC area) is taking to transform its culture to reduce systemic patient harm. This focus is why she calls this a "hopeful film" as opposed to being alarmist. To point others to this, use the simple URL: www.leanblog.org/168. You can find links to posts related to this podcast there, as well. Please leave a comment and join the discussion about the podcast 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 #167 is Clare Crawford-Mason, the producer of the landmark 1980 NBC documentary that featured W. Edwards Deming, “If Japan Can Do It, Why Can't We?” You can view the documentary here. I was fortunate to meet Clare and her husband Bob back in 2007 or so when I was teaching a Lean healthcare seminar near their home in Washington, DC. Clare and Bob led the efforts to create the “Deming Library” video series. They also created the PBS special “Good News: How Hospitals Heal Themselves” and the companion book The Nun and the Bureaucrat. We've talked for years about doing this podcast and I'm glad to finally being able to share this with you. Early in the podcast, Clare talks about meeting Dr. Deming and the production of documentary, which is a fascinating story and glimpse into his personality and work. Show notes and links: Atul Gawande MD article: “Testing, Testing” Deming Institute Time piece on “Why Healthcare Costs are Killing Us” The Nun and the Bureaucrat/Good News…How Hospitals Heal Themselves Book/DVD Set via Amazon For a link to this episode, refer people to www.leanblog.org/167.

My guest for episode #166 is Julie Bartels, Executive Vice President, National Healthcare Information at the ThedaCare Center for Healthcare Value. In this episode, we are talking about their new program, the Healthcare Clinical Business Intelligence Network (CBIN). Julie tells us about “business intelligence” and how data and transparency relate to Lean improvement efforts. Why is “the devil in the details” in making more data available to payers and patients? Listen to find out. Read an FAQ document about the CBIN or see this PDF document. You can also learn more on the Center's transparency page. For a link to this episode, refer people to www.leanblog.org/166. Learn more about the Healthcare Value Network, the ThedaCare Center for Healthcare Value, and their annual Lean Healthcare Transformation Summit (registration now open). For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #165 is Chris Vogel, President & CEO of Compass Affiliates. I've met Chris before at an LEI Lean Transformation Summit and he is doing a learning session at this year's Summit, to be held March 13 and 14 in Orlando. Chris specializes in the Development of Lean Leaders and Administrative Lean. He has over 15 years of Lean Administrative and Process Improvement experience. During his 15 years at Wells Fargo, Chris led and used Lean to transform a division of Wells Fargo with 1,200 staff members. In our discussion, we'll talk about applying Lean to settings outside of manufacturing, including mortgage processing and government. I think this discussion will help reinforce the idea that Lean is Lean and Lean leadership is Lean leadership, regardless of the setting. In the episode, Chris says that “standardized work is misunderstood… it's not equal to creating documentation and it's not a constraint.” He emphasizes that standardized work is exactly the thing that allows people to “customize more quickly” when they have to. For a link to this episode, refer people to www.leanblog.org/165. Learn more about the Healthcare Value Network, the ThedaCare Center for Healthcare Value, and their annual Lean Healthcare Transformation Summit. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #164 of the Lean Blog Interviews Podcast is Rachelle Schultz, CEO of Winona Health (based in Winona, Minnesota). Rachelle was a part of the CEO panel that I moderated at last year's Lean Healthcare Transformation Summit and her comments on leading a health system's Lean transformation were well received. In this discussion, she says, “Everything I do has to drive Lean,” as we talk about how her system is using Lean in these challenging times and what the impact has been – quality, satisfaction, financial. This episode is produced in partnership with the Healthcare Value Network. For a link to this episode, refer people to www.leanblog.org/164. Learn more about the Healthcare Value Network, Catalysis, and their annual Lean Healthcare Transformation Summit. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #163 is Dr. Gregory R. Johnson, the Chief Medical Officer at Parkview Health in Fort Wayne, Indiana. In this episode, we talk about how Parkview is using Lean to cope with today's challenging environment, how Dr. Johnson encourages Lean thinking among physicians, and the role of standardization in medicine. Dr. Johnson says Parkview is moving toward “having everyone operating in a Lean way, all 8200 co-workers” instead of just doing “Rapid Improvement Events.” This episode is produced in partnership with the Healthcare Value Network. Dr. Johnson and I also talk about Parkview's participation in the Network, including hosting a “gemba visit” by other members. For a link to this episode, refer people to www.leanblog.org/163. Learn more about the Healthcare Value Network, the ThedaCare Center for Healthcare Value, and their annual Lean Healthcare Transformation Summit. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guests for episode #162 are Patrick Vlaskovits (@pv) and Brant Cooper (@brantcooper), previously guests on episode #99. I recently ran into them at the Lean Startup Conference and today we are speaking about their newest book (coming in February) The Lean Entrepreneur: How to Create Products, Innovate with New Ventures, and Disrupt Markets. You can learn more via their website: www.LeanEntrepreneur.co In this episode, we talk about: What is Lean Entrepreneurship? How does Lean create disruptive innovations? Why is it better to fail fast and learn your idea isn't viable sooner rather than later? Why is “follow your passion” really bad advice? What's a value stream in the context of a startup? Why would data “inform decisions” rather than “make” them for you? Their books: The Lean Entrepreneur: How to Create Products, Innovate with New Ventures, and Disrupt Market The Entrepreneur's Guide to Customer Development: A cheat sheet to The Four Steps to the Epiphany For a link to this episode, refer people to www.leanblog.org/162. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Steve Bell, author (most recently) of the book Run Grow Transform: Integrating Business and Lean IT is my guest for episode #161 of my podcast series. Steve is a fellow faculty member for the Lean Enterprise Institute and he is also a founder of Lean4NGO.org, working with non-profits in the developing world. He is also founder of Lean IT Strategies, LLC, coaching IT professionals as they partner with their business colleagues to meet the challenges and exploit the opportunities in the rapidly changing, technology-enabled business landscape. In this episode, Steve talks about: Why “Lean Thinking” is important in IT What is “Lean IT,” including some success stories How do agile, scrum, Lean IT, and Lean Startups fit together? His upcoming LEI workshop in San Francisco this February Lean4NGO initiative Steve's Other Books: Lean Enterprise Systems: Using IT for Continuous Improvement Lean IT: Enabling and Sustaining Your Lean Transformation For a link to this episode, refer people to www.leanblog.org/161. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for podcast #160 is Joseph S. Guarisco, M.D., FAAEM, FACEP. Dr. Guarisco is currently Chairman of the Department of Emergency Medicine and System Chief of Emergency Services for the Ochsner Health System. Dr. Guarisco is a keynote speaker at the upcoming Society for Health Systems conference (which I'll be attending) and we are both part of the American Academy of Emergency Physicians annual scientific assembly in February (where I'll be co-presenting with my Healthcare Kaizen co-author Joe Swartz on E.D. process improvement strategies). Here is a Q&A, hosted by SHS, with Dr. Guarisco. In this episode, we talk about Dr. Guarisco's process improvement efforts at Oschner and how that was made necessary by Hurricane Katrina and the aftermath, where demand TRIPLED in their E.D. We also chat about standardized work and variation reduction fit in with the practice of medicine and improving E.D patient flow. For a link to this episode, refer people to www.leanblog.org/160. Conference links: Society for Health Systems American Academy of Emergency Physicians Emergency Department Practice Management Association For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. 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) 993-0630 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. Guest Bio: Joseph S. Guarisco, M.D., FAAEM, FACEP. Dr. Guarisco is currently Chairman of the Department of Emergency Medicine and System Chief of Emergency Services for the Ochsner Health System. He joined Ochsner as a staff physician in the Department of Emergency Medicine in August, 1980. In July, 1990, he pursued a fellowship in anesthesiology at Ochsner. In July, 1992, he returned to emergency medicine as Chairman and Medical Director of the Emergency Department and is currently serving in that position becoming System Chief Emergency Services in 2007. Dr. Guarisco has extensive experience in ED informatics automation pertinent to the design, development and implementation of ED information systems. He has published and lectured widely on the use of automation in workflow redesign and ED process improvement and is well known for his work in physician performance profiling and data driven ED management. The 2005 Ochsner Clinic Foundation award for outstanding achievements in patient satisfaction was awarded to the Department of Emergency Medicine. Additionally, Dr. Guarisco has been recently recognized by Press Ganey for innovative use of data and process design in improving patient satisfaction at Ochsner and is the winner of the Press Ganey 2005 National Success Story Award. In 2008, Press Ganey awarded the Ochsner Health System the Compass Award for the largest improvement in patient satisfaction amongst its client base. He has pioneered ED workflow redesign through innovative adaptation of Lean engineering principles to ED patient flow processes. He is also responsible for pioneering web based wait times for emergency departments nationally. Dr. Guarisco has a bachelor's degree in engineering and is board certified in emergency medicine. He is a fellow in both the American College of Emergency Physicians and the American Academy of Emergency Medicine. In 2012, he was named Chair of the American Academy of Emergency Physicians (AAEM) Operations Management Committee.

A returning guest for episode #159 is John Toussaint, MD, the CEO of the ThedaCare Center for Healthcare Value and the author of the books On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry and Potent Medicine: The Collaborative Cure for Healthcare. John was a guest on episodes 54, 62, 72, and 146. Today's main topic is a new report, published last month by the Institute of Medicine, titled “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America.” John was a reviewer of this report and has key insights to share, as always, about the problem and things we can do to improve healthcare around the world. For a link to this episode, refer people to www.leanblog.org/159b/. Helpful links: IOM report main page (with full report, briefs, sides, data, etc.) A pilot workshop I will be teaching at the ThedaCare Center in December on the fundamentals of Lean in healthcare Other workshops by the ThedaCare Center For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for podcast #158 is Art Byrne, author of the new book The Lean Turnaround: How Business Leaders Use Lean Principles to Create Value and Transform Their Company. Art is very well known in the Lean community for his successful run as CEO of Wiremold, having previously worked at GE and Danaher. He is currently Operating Partner at the private equity firm J. W. Childs Associates L.P. In this podcast, Art talks about operations improvement as a business strategy, why the CEO needs to be directly involved in a Lean transformation, why “stretch goals” aren't demoralizing when you have the right leadership and culture, and more. Also, listen to my podcast with Bob Emiliani (who documented the Wiremold story in the book Better Thinking, Better Results: Case Study and Analysis of an Enterprise-Wide Lean Transformation), where he talks about what happened to Lean at Wiremold after the company was purchased and Art left. For a link to this episode, refer people to www.leanblog.org/158/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Show notes: https://leanblog.org/157 Remastered June 2021 Joining me for episode #157 is Nick Sarillo, founder of Nick's Pizza & Pub and author of the new book (out September 13) called A Slice of the Pie: How to Build a Big Little Business. I had a chance to meet Nick and visit one of his restaurants in 2010 after I blogged about an Inc. magazine article about their culture and their approach to operations. It was great talking to Nick about his new book and what I call the “Like Lean” mindsets and approaches that remind me of the challenges and opportunities that organizations face with Lean Manufacturing or Lean Healthcare. I hope you'll take a listen. For a link to this episode, refer people to www.leanblog.org/157/. Some questions, key topics and thoughts: Was it just intuitive to you that getting everybody oriented around that purpose was important? How do you get others to share the sense of purpose? Talk about what you see the “main job” of a manager to be… Describe the process of “trust and track” and why it's better than fear-based management and “command and control?” Why do you think fear-based management is, sadly, so common in so many industries and companies of all sizes? Can you talk about the role of transparency in your daily management and the impact it has on your employees? How does Nick find managers who are “coaches, not cops”? What's the difference between purpose, values, vision, and mission? Why is trust so important in an organization? Why does clarity have to exist around purpose in an organization? Does the younger generation have a higher expectation of leadership today? What are “ops cards” and how are they like standardized work? For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #156 is a friend, Mike Stoecklein, the Director of Network Operations for the Healthcare Value Network. I was able to work with Mike when I was an employee of the Lean Enterprise Institute, working closely with the HVN team and its members. Our conversation is about Mike's reflections on meeting Dr. W. Edwards Deming in the late 1980s, volunteering to assist with some of his famed 4-day seminars around the country. You can read Mike's excellent blog post that was the basis for some of our discussion here. Why are we here? To learn… and to have fun, as Dr. Deming said! For a link to this episode, refer people to www.leanblog.org/156/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Joining me for episode #155 is Jim Benson, co-author of the book Personal Kanban: Mapping Work | Navigating Life. Jim is the founder of a company with a great name, Modus Cooperandi. He is, most notably, the creator of the “personal kanban” approach for managing work. It's not kanban as in material management, but rather a way of visualizing work and setting WIP limits (much as kanban might be used to trigger or limit production in a factory) — but for knowledge workers and anybody! Learn more about this approach on his “Personal Kanban 101” site. For a link to this episode, refer people to www.leanblog.org/155/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #154 is Rick Morrow, a director at Healthcare Performance Partners and author of the book Utilizing the 3Ms of Process Improvement in Healthcare: A Roadmap to High Reliability Using Lean, Six Sigma, and Change Leadership, from Productivity Press (which is my publisher, as well). We talk about the book as well as a favorite issue of mine – why we shouldn't ask patients to inspect the work of healthcare providers. You can learn more about the book and interact with Rick at his website. ADVERTISEMENT: This podcast episode is brought to you by Creative Safety Supply, leaders in Visual Safety, floor marking, label printing and more. Visit their website atwww.creativesafetysupply.com/leanpodcast for a discount. Check out their industrial labeling system and SafetyTac tape products. For a link to this episode, refer people to www.leanblog.org/154/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Joining me for Podcast #153 is Robert Maurer, PhD, Director of Behavioral Sciences for the Family Practice Residency Program at Santa Monica-UCLA Medical Center and a faculty member with the UCLA School of Medicine. We are talking about his excellent book titled One Small Step Can Change Your Life: The Kaizen Way. I discovered Maurer's book when doing research for our recently-published Healthcare Kaizen. Here is my earlier review and blog post about his book. It's really interesting to hear about applying the Kaizen approach in the realm of psychology and therapy instead of the workplace. Maurer writes about the brain chemistry that causes people to “fear change” – except when it's small change. Fascinating stuff and I'm thrilled to have spoken with him a few months back. For a link to this episode, refer people to www.leanblog.org/153/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for podcast #152 is Matt Stewart, and we are talking about his book The Walk-On: Inside Northwestern's Rise From Cellar Dweller To Big Ten Champ. Matt and I are both graduates of Northwestern University. While he played football on a championship team, I was on the field as a marching band drummer. There are a lot of football stories in the book, but our episode focuses on the lifelong leadership lessons that come from the rise of Northwestern's program – how do we motivate people to tackle seemingly insurmountable challenges? Matt's book website: www.MattStewartBooks.com. For a link to this episode, refer people to www.leanblog.org/152. ADVERTISEMENT: This podcast episode is brought to you by Creative Safety Supply, leaders in Visual Safety, floor marking, label printing and more. Visit their website at www.creativesafetysupply.com/leanpodcast for a discount. Check out their industrial labeling system and SafetyTac tape products.

Joining me for episode #151 is my friend Karen Martin, talking about her newly-released book The Outstanding Organization: Generate Business Results by Eliminating Chaos and Building the Foundation for Everyday Excellence. Karen is the founder of Karen Martin & Associates and she is previously the co-author of The Outstanding Organization: Achieving Rapid Improvement in Office, Service, and Technical Environments. FastCompany.com has an excerpt from The Outstanding Organization here. For a link to this episode, refer people to www.leanblog.org/151/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #150 is Jeffrey M. Lobosky, MD, the author of the book It's Enough to Make You Sick: The Failure of American Health Care and a Prescription for the Cure. Dr. Lobosky talks about what he thinks is lacking in current healthcare reform efforts driven by Washington D.C. We talk about how he defines the crisis in healthcare – “why are things going bad?” After we diagnose the problem, what are some treatments, cures, or solutions? For a link to this episode, refer people to www.leanblog.org/150/. About Dr. Lebosky: Jeffrey M. Lobosky M.D. was awarded his Bachelor of Science degree in preprofessional studies from the University of Notre Dame and his Doctorate of Medicine from the University of California at Irvine. There, he received the J. Gordon Hatfield Award for Outstanding Student in the field of Surgery. As a surgical intern at UC Irvine Medical Center he was named Resident of the Year. He completed his neurosurgical residency at the University of Iowa where he was the recipient of the Department of Surgery's Outstanding Resident Research Award. Dr. Lobosky currently serves as Associate Clinical Professor in the Department of Neurological Surgery at the University of California at San Francisco and is Co-Director of the Neurotrauma Intensive Care Unit at N.T. Enloe Memorial Hospital. He has served on the Board of Directors for the Joint Section on Trauma and Critical Care for the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. Dr. Lobosky served as one of organized neurosurgery's six representatives to the American College of Surgeons Committee on Trauma which advises national policy makers on health care issues. Dr. Lobosky has received national and international acclaim for his work on injury prevention, has been an invited lecturer throughout the U.S. and abroad and is listed in “Who's Who in American Medicine”. He has served as Chairman of the Board of the National Injury Prevention Foundation and has written a variety of research articles published in national journals as well as several book chapters and articles on the health care crisis in America's trauma system. He has received numerous awards for his contributions to the field of trauma and injury prevention and in 2007 was recognized for his distinguished teaching experience by the students and faculty of the University of California at San Francisco School of Medicine. He and his wife, Diana, reside in Chico, California where he continues an active practice as a founding member of Northstate Neurosurgical Associates. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #149 is Gregory Jacobson, MD, the co-founder and CEO at KaiNexus. We'll be talking about his early work with Kaizen in emergency medicine settings – how did he get introduced to Kaizen principles and how did train others, especially physicians, in getting started with this methodology? In a future episode, we'll talk more about KaiNexus and use of software, but today's focus is on the application of core Kaizen principles (as discussed in my book Healthcare Kaizen). For a link to this episode, refer people to www.leanblog.org/149. Conflict of interest disclosure: I have been on the management team at KaiNexus since 2011 and I am a part owner of the company.

Episode #148 is a conversation with a returning guest, Naida Grunden (previous episode) and her co-author Charles Hagood (of Healthcare Performance Partners), talking about their new book Lean-Led Hospital Design: Creating the Efficient Hospital of the Future. It's an outstanding book and I was happy to endorse it, as did John Toussaint, MD and many others. In the podcast, we talk about what lean-led hospital design entails, including getting staff involved, how to tie processes and space together, and how to collaborate with architects and construction companies to build space and processes that best serve the patients and healthcare professionals. For a link to this episode, refer people to www.leanblog.org/148/. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #147 is a part two of a conversation with Scott Patten and Peter Armstrong from LeanPub.com (listen to part one in episode #140). They want to be THE website for publishing “in-progress books”. In this episode, we are talking about how they are applying the concepts of the Lean Startup methodology to their service and their business. We'll talk about some of my own experiences as an early adopter and later as an actual user — what have they learned along the way and how do they use lean methods to be innovative? Conflict of interest disclosure: I have published two blog compilations via their service, a Best of Lean Blog 2011 book and a Best of 2012 book that is being published incrementally throughout the year. I'm a huge raving fan of their service… For a link to this episode, refer people to www.leanblog.org/147. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #146 is a discussion with a returning guest (#54, #62, #72), John Toussaint, MD, the CEO of the ThedaCare Center for Healthcare Value. Today, we're talking about his latest book, recently released, called Potent Medicine: The Collaborative Cure for Healthcare. John talks about the three aspects of his collaborative cure: patient-centered care redesign, transparency, and payment for outcomes. A lot of the discussion follows on my conversation with Dean Gruner, MD in Podcast #144, talking about the experiments with “Accountable Care Organizations” at ThedaCare and other organizations. John will also be speaking at the upcoming Lean Healthcare Transformation Summit, this June in Minneapolis. We hope to see you there! Links to organizations mentioned in the podcast: Wisconsin Health Information Organization (WHIO) Wisconsin Collaborative for Healthcare Quality (WCHQ) Lean Enterprise Institute (LEI) For a link to this episode, refer people to www.leanblog.org/146. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #145 is a conversation with Natalie J. Sayer, co-author of the recently updated 2nd edition of the book Lean For Dummies. I was able to meet Natalie at the recent ASQ Lean and Six Sigma Conference, where she was also a presenter. While I was a bit resistant at first to the “for Dummies” being associated with Lean (given that “dummy” is a sort of disrespectful word), I came around when I read the first edition and found it to be a fun, solid overview of Lean concepts and a great first read for people who are new to Lean. In the podcast, Natalie shares what's new in the second edition and shares some of her history and experience with Lean, including some time learning at the famed NUMMI plant while working for GM. For a link to this episode, refer people to www.leanblog.org/145. ADVERTISEMENT: This podcast episode is brought to you by Creative Safety Supply, leaders in Visual Safety, floor marking, label printing and more visit their website at www.creativesafetysupply.com/leanpodcast for a discount. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #144 is a discussion with Dean Gruner, MD, the president & CEO of ThedaCare, talking about Accountable Care Organizations (ACOs) and how ThedaCare is using this approach, along with Lean methods, to improve the coordination of care for patients. Dean was previously a guest in episode 119, talking about the “strategy deployment” methodology. Dean will be presenting at the upcoming Lean Healthcare Transformation Summit, June 6-7, 2012 in Minneapolis. I hope to see you there! I'll be attending and moderating the CEO panel again this year. For a link to this episode, refer people to www.leanblog.org/144. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Transcript: Mark Graban: Hi, this is Mark Graban. Welcome to the podcast, episode 144 for April 16th, 2012. My guest today is Dr. Dean Gruner. He is the CEO of ThedaCare. He was previously a guest on episode 119 talking about “strategy deployment” as part of their management system at ThedaCare. Today, we're going to be talking about ACOs or Accountable Care Organizations and how that fits in with a Lean perspective at ThedaCare, related to healthcare reform happening here in the United States. Dr. Gruner is going to be presenting at the “Lean Healthcare Transformation Summit,” June 6th and 7th in Minneapolis. This is an event that's co-sponsored by the Lean Enterprise Institute and the ThedaCare Center for healthcare Improvement. I'll be there. I'll be attending. I'm going to be moderating the CEO panel again this year. I certainly hope to see you there. It's a great event, wonderful speakers from the healthcare value network organizations, just a lot of great attendees, networking, learning and sharing. You can visit leanblog.org/healthcaresummit and that will forward you to the official conference website to learn more and to register. For other episodes, you can go to leanpodcast.org and for Dr. Gruner's previous episode, go to leanblog.org/119. Thanks for listening. [music] Mark Graban: Dean, it's a pleasure to talk to you again. Thanks for joining us here on the podcast. Dr. Dean Gruner: Thanks, Mark, for inviting me. Mark: I think a lot of our listeners, especially those outside of healthcare and maybe even some within healthcare might not know a lot about ACOs or “Accountable Care Organizations.” Would you mind giving us a little bit of an intro about what an ACO is? Dr. Gruner: I'll try. I think the short version is that, there are multiple definitions out there. Everybody has a little different description of what an ACO is. I think of it as a mechanism for a group of providers, whether it's a group of physicians, physicians at hospitals, hospitals or healthcare systems, to be accountable for both the quality and the cost of the care that they are providing to a group of patients. An example today that people might be familiar with is Kaiser. Kaiser provides the premium in their case, but they only provide premium for their health insurance, but then they become accountable for providing all the services that that person would need under the Kaiser umbrella. All ACOs aren't just models like Kaiser, which is what we would call a staff model HMO. There may be groups of physicians in hospitals and other care providers that come together, again, for the purpose of providing the services to patients and assuming some degree of accountability for both the quality of the care that's provided and the cost of the care that's provided. Mark: Part of the idea, if we look at this from a Lean perspective, when you talk about improving quality and cost which, people familiar or experienced with Lean would realize it's possible to do both. Where do these improvements come from? Is it a matter of better coordination between hospital care or primary care.? How do people in different organizations collaborate in an ACO? What are the types of benefits that we're expecting to see?

Like podcast #133, this episode is a Q&A that follows up a webinar I did for my good friends at Gemba Academy recently, on the topic “Using Statistical Process Control (SPC) to Make Better Management Decisions.” You can view a recording of the webinar here or on the Gemba Academy website. You can get the slides here. This might seem like an esoteric topic, but it's one I've found to be VERY practical and helpful in my career and with my clients. Some feedback I got included, “That wasn't nearly as boring as one might have expected.” :-) Update: This topic is something I later explored in my 2018 book Measures of Success: React Less, Lead Better, Improve More. For a link to this episode, refer people to www.leanblog.org/143. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode page Episode #142 brings us a returning guest (#115), Eric Ries, author of the best-selling book The Lean Startup: How Today's Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses. In the book, Eric cites the work of Taiichi Ohno, including the “5 Whys” problem-solving approach. In this podcast, Eric shares his story about finding Ohno's work (including the Lean classic Toyota Production System: Beyond Large-Scale Production) and how it has influenced his work with startups. For a link to this episode, refer people to www.leanblog.org/142. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. Eric: It's been incredibly influential. I think I would go so far as to say it has changed my life. It's actually just a coincidence. It's a funny thing how these things work. To set the stage a little bit, I had founded a company called IMVU in 2004. I was really into a lot of the ideas that are called Agile software development, which have their origins in Lean, but a lot of the works I had read about them, Toyota was not specifically mentioned. Lean principles were not mentioned. I didn't know the theory of Lean or anything like that. I knew nothing about manufacturing. I've actually, to be totally honest, never set foot in a manufacturing plant in my whole life. I have no idea any of that would be relevant to me. I had this intuition that we should be going a lot faster in a startup and doing practices that even in the Agile world were considered a little bit extreme. We've had the chance to talk about them on other occasions, things like continuous deployment or putting software in customers' hands much faster than was previously considered possible. I had this problem which was I had no way to explain to anybody why that was going to work. People would look at me like I was completely crazy. I could see that it was working, so I was very stubborn. I had this intuition. I said, “We're going to do it no matter what.” It was working, but we're always hiring new employees. The company's growing. We're bringing on investors. We had investors that when they were doing their due diligence for the company, pulled out because they didn't like the answers I was giving them about how we built the technology. They would bring their experts in, experts trained in more traditional software development methodologies, and they'd be like, “This kid is crazy. Doesn't know what he's talking about. This is not the way it's done.” This is a continuous point of stress for me and my co-founder. [laughs] You got to remember, at the time, I was by far the youngest person on the team. I was often younger than the employees I was hiring and training them in this method. It's not like it was an easy situation to be in, but I really believed it was right. I was reading everything I could get my hands on for ideas about, first of all, was I actually right or was it a fluke? If it was right, how could I possibly explain it? I read some cases about Toyota, the business school cases, so I was a little bit familiar with it. There was this thing called Toyota Production System. That's all I knew. I figured I should be educated about it.

Show notes: https://www.leanblog.org/141 Remastered audio June 2021 Episode #141 is a chat with Norman Bodek, as he shares his recollections of working with Taiichi Ohno, one of the creators of the Toyota Production System. Norman met and worked with Ohno in Japan and then published the translation of Ohno's classic book Toyota Production System: Beyond Large-Scale Production in 1988. For a link to this episode, refer people to www.leanblog.org/141. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #140 is a discussion with Scott Patten and Peter Armstrong from LeanPub.com – they want to be THE website for publishing “in-progress books”. We'll be talking about lean publishing and how that's different than self publishing and about how leanpub.com works. In the upcoming part 2 of the podcast, we'll talk more about how they are applying the concepts of the Lean Startup methodology to their service and their business. Conflict of interest disclosure: I have published a number of books through Leanpub. I'm a huge raving fan of their service and the way Scott and Peter have worked with me as I learned and used Leanpub.com. For a link to this episode, refer people to www.leanblog.org/140. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #139 is a conversation with Dave Munch, MD, the Senior Vice President and Chief Clinical Officer for Healthcare Performance Partners (HPP). Before joining the consulting firm, Dave was a senior C-level clinical leader at Exempla Lutheran Health System where he led their Lean Production applications for more than five years, resulting in substantial improvements in both clinical and non-clinical processes. Today, we are talking about important Lean mindsets and systems principles, including making it safe for people to surface problems in the workplace and aligning management behaviors and methods at all levels so we can use Lean to achieve our most important objectives in healthcare. Dave is also a speaker at the upcoming Lean Healthcare PowerDay event, produced by HPP. Hope to see you there! Conflict of interest disclosure: I will be a paid speaker at the Lean PowerDay event. For a link to this episode, refer people to www.leanblog.org/139. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #138 is a discussion with Al Norval from Lean Pathways, talking about his new publication titled: “The Lean Manifesto: Back to basics – how a Lean business system creates value by engaging everyone in improvement.” It's a free six-page document and you can download it here. The manifesto is a fun, upbeat guide to the basics of the Lean methodology and management system, including a brief history of Lean, as well as its foundational concepts, and a discussion of why “just in time” is not the right place to start. Conflict of interest disclosure: I have a business relationship with Lean Pathways where I sometimes work with their healthcare clients. For a link to this episode, refer people to www.leanblog.org/138. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. 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) 993-0630 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. About Al Norval (from the Lean Pathways website): Alistair Norval is a professional engineer who developed his skills at Eastman Kodak Company, where he helped design and implement the Kodak Operating System, based on the principles of the Toyota Production System. In this capacity, he received in-depth personal training with leading international senseis. Following that, Alistair helped guide Celestica International, a provider of Electronic Manufacturing Services, with their lean journey at multiple site value streams in Asia. More recently, Alistair has been guiding clients on their lean transformation while achieving significant business results. His clients include the Medical, Consumer, and Professional Services business sectors. Alistair has been a manager of manufacturing, product and process engineering, and has helped launch several plants. His experience covers both continuous chemical processes as well as discrete manufacturing. He has applied lean methods in new product development and the supply chain. His passion is to apply lean thinking across the enterprise so as to achieve consistently superior results.

Episode #137 is a chat with Jerry Bussell, founder of the Jacksonville Lean Consortium. I've met and talked with Jerry many times through LEI, so I'm thrilled to finally get him on the podcast. Jerry is a retired Medtronic executive (leading Lean efforts in a unit that won the Shingo Prize); he's now doing work with healthcare quality improvement, he's writing a new book, and he's speaking at the Lean Transformation Summit next month in Jacksonville. Jerry is also friends with Sami Bahri, DDS – and he's also a patient of the “World's First Lean Dentist” (click here for my podcasts with Sami, episodes 29, 69, and 82). For a link to this episode, refer people to www.leanblog.org/137. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts. 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) 993-0630 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. About Jerry Bussell (from the Lean Transformation Summit site): Sporting a license plate reading “Leanjax,” Jerry Bussell is the past chairman and founder of the Jacksonville Lean Consortium, a group of companies and government agencies improving business performance by sharing knowledge about implementing lean principles. Recently retired as vice president, Global Operations, at Medtronic Surgical Technologies, Bussell is president of Bussell Lean Associates, a lean management advisory service for CEOs and their executive teams. He is also an executive advisor to Underwriters Laboratories' Center of Continuous Improvement and Innovation. Bussell received the prestigious Medtronic Wallin Leadership award for transforming Medtronic ENT's traditional manufacturing operation into a nationally recognized model of lean manufacturing. Under his leadership, Medtronic ENT/NT received an IndustryWeek Best Plants award for North America in 2002, a Shingo Prize in 2003, and a Shingo Silver Medallion recipient in 2009. In 2005 Bussell was inducted into the Shingo Academy for his contributions to operational excellence. He is a past chairman of the Board of Governors for the Shingo Prize and is a member of the Champions Club with the Association for Manufacturing Excellence. Bussell holds a bachelor's degree from St. John Fisher College and a master's degree from Baylor University. He is currently writing a book on lean leadership lessons from Abraham Lincoln that will be available in 2012.

Our guest for episode #136 is Paul Akers, President of FastCap and author of the book 2 Second Lean. Remastered August 2021 Here, we are talking about the new book and how small improvements that save two seconds in your daily work can contribute to an engaging and fun “Lean Culture.” You can also view a video recording of the discussion here on YouTube. Paul was previously a guest on episode #122, talking about LeanAmerica.org, so please check that out too. For a link to this episode, refer people to www.leanblog.org/136.

Our guest for episode #135 is Dan Markovitz, author of the new book A Factory of One: Applying Lean Principles to Banish Waste and Improve Your Personal Performance. If your New Year's resolutions include improving your own personal productivity, Dan is a great person to talk to about the application of Lean principles to your own professional work – whether you work in an aspiring Lean organization or not. Dan was previously a guest on episode #52, so please check that out too. For a link to this episode, refer people to www.leanblog.org/135. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #134 is a different topic than usual. Instead of strictly talking Lean, today's discussion is about broader issues of healthcare quality and our United States military. Joining me are Daniel Sullivan, President and General Manager of the The Sergeant Thomas Joseph Sullivan Center (SSC), a non-profit organization that is dedicated to improving health outcomes for current and former military personnel, especially those who are suffering from emerging, complicated, or currently unexplained post deployment health concerns. Named in honor of a fallen marine, the Sgt. Sullivan Center promotes the health security of America's troops and the principle that none should be left behind. Also joining us is Gregory Jacobson, MD, a college friend of Daniel's and the co-founder and CEO of KaiNexus, also a board member of the Center. The Sergeant Sullivan Center is named for Daniel's brother, Sergeant Thomas Joseph Sullivan, a veteran of the Iraq war, who died suddenly in his northern Virginia home at age 30, four years after returning from deployment. With his medical problems originating during his deployment in Iraq and continuing in the years following his return home, Sgt. Sullivan suffered a progression of unexplained health complications that included chronic pain, swelling, cardiovascular disease, and severe inflammation. His autopsy revealed life threatening problems that medical tests had not detected. Today would have been St. Sullivan's 32nd birthday, so I am sharing his story here. For a link to this episode, refer people to www.leanblog.org/134. More About the Sergeant Sullivan Center: Their website Sgt. Sullivan's story and a video Speech on healthcare quality by Gregory Jacobson, MD For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode #133 is hosted by Ron Pereira, from Gemba Academy, as he leads me through additional Q&A as a follow up to our recent webinar on my upcoming book Healthcare Kaizen and some of the concepts from the book on the theme of “Putting the Continuous Back in Continuous Improvement.” You can view the recording via this link. Two of the main themes were that “kaizen” is not always about weeklong events and that suggestion boxes are not the same as the kaizen approach. Kaizen ideally involves everyone in continuous improvement, facilitated in ways that are better than the slow, batchy, non-collaborative suggestion box approach that many have tried and struggled with before. For a link to this episode, refer people to www.leanblog.org/133. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts

A returning guest for episode #132, we are joined by author and professor Bob Emiliani. Today, we are chatting about some videos he recently posted to his website… 10-year-old videos that document executives from Virginia Mason Medical Center, now considered a leader in Lean healthcare, visiting a Lean manufacturing company, Wiremold. You can view the videos on Bob's site or read some summaries via this blog post of mine. In the podcast, Bob reflects on those videos and we talk about some of the lessons learned – what healthcare executives can learn about Lean leadership from manufacturing leaders. For a link to this episode, refer people to www.leanblog.org/132. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

My guest for episode #131 is Paul Borawski, the CEO of ASQ, the American Society for Quality. Today, we are talking about ASQ, their recent World Quality Month events (November), and other topics including: Their “YouQ” video contest (vote on the submissions now via Facebook) The ending of federal funding for the Malcolm Baldrige National Quality Award (as I blogged about) Paul's blog post on the passing of Bob Galvin and Steve Jobs I'm also happy to be presenting (about Healthcare Kaizen) at the 2012 ASQ Lean & Six Sigma Conference, to be held in Phoenix, February 27-28. Hope to see you there! For a link to this episode, refer people to www.leanblog.org/131. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.