LeanBlog Podcast #76 – Dr. David Jaques, Lean in Surgical Services

jaques-315x157Episode #76 is a discussion with Dr. David Jaques, VP of Surgical Services at Barnes-Jewish Hospital in St. Louis, MO.

In this podcast, Dr. Jaques talks about how he has led Lean efforts that involve physicians in a unique “6/3” format that helps solve tightly-scoped problems without the need to have surgeons and clinicians for a full 4-day kaizen event. We discuss how he got started with Lean, improvements that were made in the “Mass Transfusion Protocol,” and their broader Lean and physician engagement efforts. Really fascinating and innovative stuff. I hope you’ll take a listen.

Click to play:

MP3 File


Dr. Jaques is a skilled surgical oncologist and surgery department administrator. He came to Barnes-Jewish after serving as vice chairman of the department of surgery and director of graduate education at Memorial Sloan-Kettering Cancer Center in New York. He received his medical degree at the University of Michigan, Ann Arbor, which was followed by a distinguished career in the U.S. Army Medical Corps. He served as a combat surgeon in the Persian Gulf War and was later chief of surgery at Walter Reed Army Medical Center as an oncologist. He served as the senior medical officer during Operation Desert Shield/Desert Storm. Honors during Dr. Jaques’ time in the U.S. Army Medical Corps include the Legion of Merit, the Bronze Star Medal, and the Army Commendation Medal.

More on the model:

“A 6/3 event is a two-day event developed at Barnes-Jewish (six hours the first day, three the second) in which the scope of the project is very narrow or specific and the problem clearly defined. The team is prepared to determine the solution during the six hours and has at least one day in between the two work days to try and verify their solution. The last three hours is spent analyzing and finalizing the outcome of their solution.”

For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple iTunes.

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If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com 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.

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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an book titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.


  1. Mark Graban says

    Here are two PDF files that Dr. Jaques has made available — a form that shows the 6-3 structure (hour by hour) and a case study document.

    Case Study

    6-3 form

  2. 6/3 lean in St. Louis :: stacy williams

    […] illustrates the approach and discusses continued efforts after an event. I encourage you to listen. CLICK HERE to redirect to LeanBlog Podcast #76. Share and […]

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