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A Japanese Hospital CEO on Kaizen, Innovation & Breakthrough

by Mark Graban on November 15, 2012 · 8 comments

IMG 1641 150x150 A Japanese Hospital CEO on Kaizen, Innovation & Breakthrough leanYesterday, our Lean Healthcare tour of Japan (with Kaizen Institute) took us to our second hospital, this time in Tokyo. The CEO, Shuhei Iida, MD, pictured at left, spent a lot of time with us, talking generally about their “MQI” program – or Medical Quality Improvement. I suggest checking out their website using Google Chrome (which will translate it) or use the Google Translate service.

Dr. Iida talked about the connections between “Kaizen” (small improvements) and innovation (larger improvements) and how, together, they lead to breakthroughs. He also talked about how one is absolutely necessary for the other to occur.

I’ll blog more in the future about his insights and philosophies, but I’ll focus on Kaizen for this post. Dr. Iida has been the CEO for just over 20 years and his hospital receives visitors from around the world, including Europe and Africa. They were on the verge of bankruptcy when he took the job in 1991 and they are now “in the black” and had the money to build a new hospital, while most Japanese hospitals are losing money today, he said.

Their annual “theme” for MQI activities is “think for yourself and take action.” Dr. Iida stated that it’s easy for an organization to talk about change and innovation, but harder to do.

Dr. Iida said, multiple times, that Kaizen (small change) alone won’t transform the hospital or lead to breakthroughs. But, he emphasized that “if you keep doing Kaizen, you will get innovation.”

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Guide and translator Brad Schmit and Dr. Iida

People love talking about “innovation” as a goal (I would add it’s a “sexier” concept than continuous incremental improvement, if you will.)

Dr. Iida said that you don’t plan to innovate — it happens by accident or chance, not by design.

“As you do Kaizen, you increase your chance of innovation, as you stumble into things.  As you keep doing Kaizen, you also look for big jumps.”

The final thought on Kaizen was that “it is not just about improving operations, but also breaking down walls and building a better place.”

Part of building a better place is Dr. Iida’s view that “we are not just interested in improving processes, but also developing people.”

On this topic, there’s an amazing video that was made last night by two Belgian tour members and a member of the tour organizing team. They made this in a bar, using beer coasters, at about 11 pm and midnight last night. It’s brilliant. See their blog post about the video  and follow them on Twitter:

p.s. You can read a detailed blog post about the first hospital that we visited and their 5S program – written by Thomas and Gert.

Mark Graban 2011 Smaller A Japanese Hospital CEO on Kaizen, Innovation & Breakthrough leanAbout LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the VP of Innovation and Improvement Services for KaiNexus.

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{ 3 trackbacks }

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{ 5 comments… read them below or add one }

1 Mark Jaben, MD November 15, 2012 at 10:55 pm


In fact, creativity follows an increasingly better understood neural pathway– relationship based on communication, willingness to engage for involvement, and then furtile ground to learn and even be able to be creative–appear to match to different and sometimes conflicting brain areas.

‘Increasing the chances of innovation’ results when we pay attention to cultivating the neural path– just so happens many, if not most Lean practices do just that. No surprise for this correlation.

‘You can read a detailed blog post about the first hospital that we visited and their 5S program – written by Thomas and Gert.’
5S as a communication strategy and tool—brilliant!

Keep the cards and letters coming!


2 anonymous November 16, 2012 at 9:55 am

Maybe I’ve just become more observant recently, but it seems that much of the current “leadership” thought coming out of Lean discussions includes “developing people”. Can organizations that are stuck on “holding people accountable” as a development scheme really do Lean? Sorry for all the quote marks.


3 Mark Jaben November 18, 2012 at 7:16 pm

It is not ‘accountability’ that is the issue, but the intent behind accountability that matters.

If ‘holding people accountable’ is intended to get people to do something I want them to do, then it would not be compatible with Lean.

But if it reflects people following through on commitments they have been part of formulating and have made in order to learn if their countermeasures perform as intended, and so as to adjust and refine the process being studied, then it is very much in keeping with a Lean approach.



4 Mark Graban
November 20, 2012 at 10:44 am

Yeah, I think anonymous put “accountability” in quotes because that term “hold people accountable” is often just a way of describing bullying management behaviors – including blaming and forcing others to do what we want.


5 Mark Jaben November 20, 2012 at 12:34 pm

Yes, another example of words and phrases hijacked by those managing for conformity, rather than engagement. Just like ‘buy in’, ‘team’, ‘associate’, and ‘naysayer’.


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