Archive for September, 2011

“Lack of Time” for Kaizen is a Problem Statement, not an Excuse

“Lack of Time” for Kaizen is a Problem Statement, not an Excuse

In Search Of Lost TimeAs I’ve talked to and worked with hospitals and their leaders about Kaizen, or continuous improvement, the concepts, mindsets, and methods make sense to people. They understand how Kaizen is different than the outdated and ineffective suggestion box method.

A common response is “Mark, that makes sense… but we just don’t have time….”

I’d like to make the case that “lack of time” should not be an excuse that shuts down the possibility for Kaizen, but rather it’s the first problem statement to which we can apply our Kaizen thinking…

By September 30, 2011 12 Comments Read More →
25% off on Pre-Orders of “Lean Hospitals,” 2nd Edition

25% off on Pre-Orders of “Lean Hospitals,” 2nd Edition

The 2nd revised edition of my book Lean Hospitals can be pre-ordered from Productivity Press for a 25% discount. The book should be available in early November. Click here for more details on the discount offer.

By September 29, 2011 0 Comments Read More →
Everyday Lean: Error Proofing Sidewalk Grates (photo by @karenmartinopex)

Everyday Lean: Error Proofing Sidewalk Grates (photo by @karenmartinopex)

Thanks to my friend and fellow author Karen Martin for taking this picture while in Calgary. Even if you don’t wear high heeled shoes, I think you can appreciate the attempt at error proofing.

Karen and I both wondered if this modification to the grates was proactive or in response to an incident or injury?

By September 29, 2011 11 Comments Read More →

Automation is Not Always the Answer, in Retail or Healthcare

Lately, there have been many stories in the news about supermarkets ripping out self-service checkout scanner, stories like this: “Supermarkets start bagging self-serve checkouts.” 10 years ago, the supermarkets saw this technology as a clear cost savings – reducing labor costs. But, some costs increased, including “intentional and accidental theft, including misidentifying produce and baked goods as less-expensive varieties,” not to mention customers being slowed down or confused. Robots (like these scanners) can’t be a smiling face… but I don’t believe, for a minute, that the supermarkets are ripping the scanners out because they want to provide better customer service. I would guess that the cost savings didn’t really materialize.

So what are the lessons and parallels for hospitals?

By September 28, 2011 10 Comments Read More →
Analogy from “The Lean Startup” for any Lean Journey?

Analogy from “The Lean Startup” for any Lean Journey?

As I’m reading the new book by Eric Ries, The Lean Startup: How Today’s Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses, I’m reading it with an eye for concepts that can be applied more broadly than traditional startup settings.

There’s a segment on page 21 (readable via Google Books) that talks about driving a car versus launching a rocket ship. Ries writes that driving a car includes a feedback loop between the driver and the steering wheel that’s “so automatic that we often don’t think about it.”

Is starting a planning a Lean program for your organization more like driving a car or launching a rocket?

By September 27, 2011 8 Comments Read More →
One-Question Poll on Healthcare Employee Idea & Suggestion Programs

One-Question Poll on Healthcare Employee Idea & Suggestion Programs

I volunteered to give a presentation last Friday for the North Texas Society for Healthcare Risk Management, where  I was able to debut some new material from our upcoming book, Healthcare Kaizen. These continuous improvement methods are a great way for front-line staff and leaders to both identify risks, allowing them to take action to prevent those problems from occurring.

I asked the audience a question that was answered by show of hands. I think we had about 200 people in the room and maybe half were from healthcare (the rest were attorneys). I asked how many had some sort of formal idea or suggestion program for front-line staff.

By September 26, 2011 1 Comments Read More →
Infographic – The Hazards of Hospitals

Infographic – The Hazards of Hospitals

Some people might find this graphic inflammatory, if they are feeling defensive about the state of healthcare and if they feel like they are being blamed personally.

The data in this infographic represents the current state, to the best of the ability of researchers to estimate the impact of poor healthcare quality. To improve, we have to recognize the problem.

The title says, “Why US Hospitals Aren’t Nearly as Safe as You Think” but there’s nothing here pointing the finger of blame at the hardworking, intelligent, caring, well-educated healthcare professions. It’s the processes and systems that are broken, not the people. The people can fix this.

By September 23, 2011 19 Comments Read More →
Interesting Article: Obliquity, the Indirect Path to Success

Interesting Article: Obliquity, the Indirect Path to Success

curveI’ve been reading the book Obliquity: Why Our Goals Are Best Achieved Indirectly  and, while it’s really interesting, I tend to agree with some of the reviews that said there was a lot of repetition of the book’s core concept – that the best way to achieve something is to take the indirect path.

The main point of the book is pretty well covered in this article on obliquity by the book’s author, John Kay.

By September 22, 2011 6 Comments Read More →
“Healthcare Kaizen” Book Update – The Manuscript is Submitted!

“Healthcare Kaizen” Book Update – The Manuscript is Submitted!

It’s a project that my co-author, Joe Swartz, and I have been working on all year… the manuscript is finally complete and sent (as a big batch!) to our publisher. I’m talking about our upcoming book, “Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements.” It will likely be out in April 2012, but you can actually pre-order it via Sign up for email updates and be one of the first to get the free PDF preview of Chapter 1.

Joe and I will both be blogging a lot about Kaizen and continuous improvement for healthcare over the next six months and beyond. I’ll share a little more about the book here in this post.

By September 21, 2011 3 Comments Read More →

Radiology Patient Flow Improvement Using Lean at a German Hospital

This is the first Lean article or case study I recall seeing about a German hospital: “JACR: Lean Six Sigma increases MRI productivity.” The article clearly articulates the benefits for patients, staff, and the hospital –  University Hospital Giessen and Marburg.

The hospital, using “Lean Six Sigma” was able to “double the percentage of patients receiving an MRI scan within 24 hours, thereby increasing scanner productivity by one-third and probably saving hundreds of thousands of dollars a year.”

By September 20, 2011 1 Comments Read More →
The Positive Trend of “Lean Design” of Space & Processes in Healthcare

The Positive Trend of “Lean Design” of Space & Processes in Healthcare

It’s been nice to see the “lean design” approach taking hold in healthcare the past few years. I think the first book on the subject was a “manifesto” by an architect, David Chambers:  Efficient Healthcare – Overcoming Broken Paradigms

My good friend Naida Grunden has a new book out next year called  Lean-Led Hospital Design: Creating the Efficient Hospital of the Future  and I was able to contribute an essay for the last part of the book.  There is also come material on the work done by Seattle Children’s Hospital in their book  Leading the Lean Healthcare Journey: Driving Culture Change to Increase Value.

Mike Wroblewski, who you might know from his blog “Got Boondoggle?,” is now with the Kaizen Institute  and they have posted an introductory lean design, or “3P” video that’s part of their Gemba Academy  subscription series. Mike provides a nice introduction:

By September 19, 2011 14 Comments Read More →
A Funny Louie C.K. “Whys” Video

A Funny Louie C.K. “Whys” Video

Thanks to Jamie Flinchbaugh for sending this funny video my way. It’s the comedian Louis C.K. in his show “Louie” (or maybe it’s from the earlier “Lucky Louie“). It’s a clip where, after an initial question, his young daughter does nothing but ask “why” maybe a dozen times.

By September 17, 2011 2 Comments Read More →

A Kaizen Quote from Seth Godin

As I did on Wednesday, I’m posting a quote that we collected for our upcoming book “Healthcare Kaizen,” but this time it’s a quote from Seth Godin that we couldn’t really work into the text (or haven’t done so yet).

By September 16, 2011 2 Comments Read More →

Why Does this Hospital CEO Have to Go Undercover? Or Does He?

Update: I edited the post title to add “Or Does He?” See the CEO’s comment below, suggesting that the TV report gave the wrong impression and that he wasn’t really “undercover” in a sneaky way like the CBS TV show.  See also the text from a memo where he announced this program to staff. My apologies to Mr. Musyj for wrongly concluding that he had been shadowing staff as anybody other than the CEO.

The Canadian CBC News had a story (with video) about  David Musyj, the CEO of Windsor Regional Hospital called “Hospital CEO goes undercover.”

My initial reaction, as I tweeted it was this:

“Dear hospital CEOs, if you are going to the gemba (and you should), don’t do the corny undercover thing. Be real, be present. Help. Lead.”

The whole idea of the CBS-style “Undercover Boss” approach is deceitful and nowhere near as effective as real “gemba leadership,” as practiced by CEOs like Dr. Gary Kaplan at Virginia Mason Medical Center and Dr. Dean Gruner at ThedaCare. Kaplan and Gruner don’t need to go undercover, nor do I think they would want to!

By September 15, 2011 17 Comments Read More →
A Kaizen Quote from Taiichi Ohno

A Kaizen Quote from Taiichi Ohno

As I’m working hard this week to finish, with my co-author Joe Swartz, the manuscript for our upcoming book “Healthcare Kaizen,” I’m not taking much time to blog.

But here is the longer version of a quote we are sharing in the book, from Taiichi Ohno, one of the creators of the Toyota Production system. He is quoted in the book The Birth of Lean.

By September 14, 2011 7 Comments Read More →
Release Day for “The Lean Startup” by @EricRies, Stories of Batching

Release Day for “The Lean Startup” by @EricRies, Stories of Batching

Congrats to Eric Ries as his book The Lean Startup: How Today’s Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses  officially goes on sale today. I will post a formal review once I have read the entire book (disclosure: I received a free copy from the publisher).

Eric was nice enough to let me read parts of his manuscript before publication to give some feedback and to contribute a few healthcare examples of “batching” that he incorporated into the book.

By September 13, 2011 3 Comments Read More →

Articles about Industrial Engineers Impacting Healthcare

The long history of Industrial Engineers helping in healthcare goes back 100 years to one of the “fathers of Industrial Engineering,” Frank Gilbreth — and his wife, Lillian! It was Gilbreth who noticed that surgeons spent more time searching for instruments than they spent working on the patient. Gilbreth suggested a “surgical caddy” who would find instruments and hand them to the surgeon.

Today, IEs often take more of a coaching and teaching role, rather than being the expert with the ideas, but the core I.E. principles live on. Credit goes to Todd Schneider of Ohio Health for compiling this list and posting it on the Healthcare Management Engineers Yahoo Group.

By September 12, 2011 1 Comments Read More →
Guest Post: Bin Laden Lost

Guest Post: Bin Laden Lost

A guest post from Steven J. Spear on this solemn day. You can also read it here.


Ten years ago, I watched on television as a plane- stolen from the city in which I live-slammed into buildings in the city that is my hometown.   I later learned that among the thousands killed were former colleagues, a neighbor, and a high school classmate.   We all had such terrible experiences.

Today, 9/11/11, we should mourn-we have to mourn-those who perished.

But we should also remember, Bin Laden lost this contest.   Not just on the day that Navy Seals shot him, but on 9/11/01 when he was likely most sure that he had won.

By September 11, 2011 2 Comments Read More →