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Doctors Bash “Taylorism” and “Toyota Lean” in the New England Journal of Medicine

Doctors Bash “Taylorism” and “Toyota Lean” in the New England Journal of Medicine






In the article posted today, Pamela Hartzband, M.D., and Jerome Groopman, M.D. (the later the author of the popular book How Doctors Think), rant about all sorts of things… some of which have nothing to do with Lean…






By January 13, 2016 61 Comments Read More →
“If the Employees are Upset, it’s Not Really Lean”

“If the Employees are Upset, it’s Not Really Lean”






How is it that we have two realities out there in healthcare… in parallel, Lean is awesome and Lean is horrible. It depends on where you are, unfortunately. I had an amazing day yesterday with a major health system…











By December 10, 2015 5 Comments Read More →
Maybe We Should Call it “The Many Whys” Instead of “The Five Whys” in #Lean & #LeanStartup

Maybe We Should Call it “The Many Whys” Instead of “The Five Whys” in #Lean & #LeanStartup






There’s no magic about the number five. I’ve seen some people write that five is somehow a “magic number.” No, that’s not really the case. Ask why more than once, probably more than twice…











By November 18, 2015 7 Comments Read More →
Just Ask Why Five Times? Effective Problem Solving for #Lean or #LeanStartup Doesn’t Start or End There

Just Ask Why Five Times? Effective Problem Solving for #Lean or #LeanStartup Doesn’t Start or End There






We don’t just ask why. We start by properly defining and clarifying problems. Jumping straight to Five Whys is like jumping straight to “Learn” in the Lean Startup Build-Measure-Learn cycle.











By November 17, 2015 9 Comments Read More →
Fighting Against “The Way We’ve Always Done It” – Before Lean or With Lean

Fighting Against “The Way We’ve Always Done It” – Before Lean or With Lean






Through our practice of Lean, we’re looking at processes and our management system, looking to identify waste and opportunities for improvement. Lean is about engaging people to have them ask why we do things a certain way or if things could be better (it’s not about finding fault from on high and telling them what […]






By November 9, 2015 11 Comments Read More →
5S: The Good, the Bad, and the Extreme in Japanese Hospitals

5S: The Good, the Bad, and the Extreme in Japanese Hospitals






My two previous trips to Japan have been incredible experiences, both personally and professionally. I’m planning to go back in December with a tour group I’m helping organize with Kaizen Institute. When people go to Japan, I think they are expecting to see perfect Lean practices. But, no…











By September 21, 2015 4 Comments Read More →
Can You Even Consider Kaizen When the Chart Showing Time and Workload Looks Like this?

Can You Even Consider Kaizen When the Chart Showing Time and Workload Looks Like this?






In th KaiNexus webinar that I did with Dr. Greg Jacobson earlier this week (“Making Time for For Continuous Improvement” – view the recording), I shared a graph that shows what could or should be time for continuous improvement in a workplace. The red line shows the amount of time available – this could be hours […]






Moving from “Visuals” to “Visual Management” and to Broader Lean Thinking

Moving from “Visuals” to “Visual Management” and to Broader Lean Thinking






I’ve been studying and working with Lean for 20 years now and I love Lean because I’m still learning and getting better at this craft. I love seeing other people get excited about Lean when it’s new to them, when they see the potential for improvement and the power of Lean. But, sometimes people get […]






Why This Sushi Company Policy Letter Should be Copied by Hospitals – As Long as They All Actually Live by It

Why This Sushi Company Policy Letter Should be Copied by Hospitals – As Long as They All Actually Live by It






I love the Texas-based grocery store chain “Central Market.” It’s like a local version of a Whole Foods, basically. One of their features is a sushi area that’s run by a third-party company, Yummi Sushi. Posted prominently is a letter that outlines their stated approach to quality and safety. Click the photo for a larger […]






We Can’t Ignore “Lean Horror Stories” or That Cheeseburger Ain’t Healthy Eatin’

We Can’t Ignore “Lean Horror Stories” or That Cheeseburger Ain’t Healthy Eatin’






When people ask me why I do what I do, my first answers are: improving patient safety creating better workplaces for people It’s as simple as that. Those are the important problems that I’m passionate about (and have been able to help fix, at least in some local situations). At a more global scale, too […]






“Accountability” Shouldn’t Mean Blaming People for Things Out of Their Control

“Accountability” Shouldn’t Mean Blaming People for Things Out of Their Control






“Accountability” is a word that’s easy to throw around in an organization. It’s often pretty meaningless (or not well understood). What does it really mean? People say things like: “We need a culture of accountability.” “We need to hold people accountable.” read more






By February 23, 2015 5 Comments Read More →
Strategy Deployment as a Series of Hypotheses or Predictions (Part 1)

Strategy Deployment as a Series of Hypotheses or Predictions (Part 1)






Note: I’m actually doing TWO free webinars on January 27. One is for Becker’s Hospital Review, sponsored by Kronos on the topic of “Lean: Transforming Healthcare Delivery by Uncovering Opportunities Within Your Workforce.”  (Learn about the other here). I hope you can join me. read more






By January 14, 2015 9 Comments Read More →
Managing With Red/Green Charts is Like Driving By Looking at the Rear-View Mirror

Managing With Red/Green Charts is Like Driving By Looking at the Rear-View Mirror






There’s an expression that was used by Dr. W. Edwards Deming, and also by Dr. Don Wheeler, that says managing through metrics (and comparisons to targets) is like driving by looking in the rear-view mirror. Deming said: Taking action on the basis of results without theory of knowledge, without theory of variation, without knowledge about […]






By September 2, 2014 17 Comments Read More →
Why Lunch Can Be Annoying at the Sensei Cafe

Why Lunch Can Be Annoying at the Sensei Cafe






Last week, I published my first cartoon collaboration with a skilled artist (and medical assistant), Carrie Schurman. You might call that cartoon “Strategy Dog-ployment.” None of us expect this to be a weekly thing, but sometimes you strike when inspiration hits. Here is our latest collaboration, the “Sensei Cafe.” read more






By August 27, 2014 6 Comments Read More →
To Create a Culture of Continuous Improvement, Put Away the Gavel!

To Create a Culture of Continuous Improvement, Put Away the Gavel!






I am giving a new webinar on Wednesday, hosted by the ThedaCare Center for Healthcare Value (to promote a public registration workshop on Kaizen that we’re doing in October). The webinar’s theme is: “Practical Continuous Improvement Leadership: Coaching, Not Judging” I’ll give a bit of a preview of the webinar in this blog post. read […]






By August 26, 2014 4 Comments Read More →
Proof That Nelson from The Simpsons is Not a Good Kaizen Coach

Proof That Nelson from The Simpsons is Not a Good Kaizen Coach






If you know me, you know I’m a huge fan of The Simpsons. The show has been on TV for 25 of my 40 years. The cable channel FXX is having an “Every Simpsons Ever” marathon, showing all 552 episodes over 12 days. I’m watching it here and there, especially my favorite episodes from the […]






By August 24, 2014 5 Comments Read More →
Why “More Nurses” Isn’t the Best Way to Solve What Ails Healthcare

Why “More Nurses” Isn’t the Best Way to Solve What Ails Healthcare






There are certainly many serious problems in healthcare. Let’s look at nursing, in particular. It’s a rewarding job, but it’s far more frustrating for nurses than it needs to be. Nurses often don’t have enough time in the day (or in a given hour) to do all of their work the right way in the […]






The One Where a Dog Reviews the Strategy Deployment Metrics Wall

The One Where a Dog Reviews the Strategy Deployment Metrics Wall






I’ve had some cartoons on the blog before, including a few “Doofus & Leanies.”  I can’t draw at all, believe me (although I sometimes do my own simple digital graphics). I’ve been fortunate to partner up with other artists before and today’s cartoon is a new collaboration with Carrie Schurman, CMA (AAMA), a workflow facilitator at […]