Tag: Six Sigma

Things That Make Me Worry About My Colonoscopy: Patient Safety

Things That Make Me Worry About My Colonoscopy: Patient Safety

Officer at periscope in control room of submarineSorry to get all Katie Couric on you, but I’m going to have a colonoscopy on Friday. I turned 40 last October and I have some family history that leads my doctor to get one done now rather than at 50.

Unlike Katie, I won’t be broadcasting mine live, but I’ll share some articles and reflections on the process and, being process focused, what could go wrong. It’s a very necessary procedure, but there are, sadly, some very unnecessary and preventable risks.

What Lean is Lacking: Disco Medallions?

What Lean is Lacking: Disco Medallions?

Disco ball

When we lament why Lean hasn’t been more widely embraced as a new management model in healthcare (or other industries, for that matter), it’s good to ask “why?” We can identify gaps and propose countermeasures that might help solve this problem.

As much as I believe that benchmarking isn’t as useful as many think it is, I did see a recent innovation in the Six Sigma world that we might want to consider… or maybe not.

The Truth About Data and PDSA/PDCA from a Toyota Publication

The Truth About Data and PDSA/PDCA from a Toyota Publication

Going down? (Azrieli Tower's staircases) Out there in the Lean and quality improvement communities, you sometimes hear some silly things. Sometimes, I want to attach the “Lean As Mistakenly Explained” (or L.A.M.E.) label to what’s said when it really seems off the mark from what Lean is really all about. Davis Balestracci, a columnist for Quality Digest, passed along something he heard from a “Lean guru” (whatever that means):

“In my opinion, any approach should also involve the use of data in some way, shape, or form. I once had a lean sensei (local “guru”?) vehemently make the point that lean does not involve data at all.”

What??

By February 20, 2014 5 Comments Read More →
Parallels and Learning Between Aircraft Engine MRO and Human Healthcare

Parallels and Learning Between Aircraft Engine MRO and Human Healthcare

Screen Shot 2013-10-06 at 6.59.55 PMMy wife is a leader in a business (not GE) that does aircraft engine “MRO” work – maintenance, repair, and overhaul. I’ve been able to visit her shop floor (her “gemba”) and we noticed similar parallels between their work (bring engines back to prime “health”) and what’s done in healthcare. This parallel was also explored in this recent article from GE Healthcare that was published by The Guardian in England: “What lessons can healthcare learn from industry?

There are interesting and sometimes humorous parallels between engine MRO and human healthcare:

Lean Sigma = Lean Plus Six Sigma or Six Sigma With Just a Little Lean?

Lean Sigma = Lean Plus Six Sigma or Six Sigma With Just a Little Lean?

plus minusI had a conversation recently with a healthcare quality leader about her excitement about Lean.

She said that she wanted to learn more about Lean and wanted to get certified.

She then added, “I thought I’d get Lean Sigma certified, because then I’m getting both [Lean and Six Sigma].”

Here’s what I told her:

Podcast #187 – Joe Swartz, Co-Author of the “Healthcare Kaizen” Books

Podcast #187 – Joe Swartz, Co-Author of the “Healthcare Kaizen” Books

MP3 File (run time 32:10)

Joe-Swartz-Photo-WebJoining me for episode #187 is Joe Swartz, my friend and esteemed co-author for our books Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements and The Executive Guide to Healthcare Kaizen: Leadership for a Continuously Learning and Improving Organization. You can learn more about our books here.

Joe is Director of Business Transformation at Franciscan St. Francis Health System in Indianapolis (his full bio is here). In the episode, we talk about his background with Kaizen and how he got into healthcare. Joe discusses how Franciscan got started with Kaizen, some of his favorite Kaizen examples, why it would have taken too long to engage everybody through Lean Six Sigma projects, what they are teaching managers about leading in a Kaizen culture, and the work that still needs to be done in their cultural transformation.

By September 26, 2013 1 Comments Read More →
Don’t Let Looking at Data Blind You From Seeing Reality

Don’t Let Looking at Data Blind You From Seeing Reality

A couple of red traffic lights against a blue skyI recently read an article (a case study) about “Lean Six Sigma” in a publication. It’s not online, so I can’t link to it, nor do I really want to call them out by name.

I didn’t like the article, in part, because it used the old, tired (and wrong) idea that “Six Sigma is for quality” and that Lean is only about “faster and cheaper.”

Good gravy, how do people NOT realize that the Toyota Production System and Lean are about both flow AND quality? For direct evidence that Lean/TPS is about both,  see Toyota’s website on “jidoka” and “just in time.”) The article I read is, unfortunately, an example of L.A.M.E. or “Lean As Mistakenly Explained.”

The article talks about a scenario where a city government wants to reduce traffic accidents at one particular intersection. Since an accident is a “defect,” they called on the Six Sigma belts to gather data do a bunch of statistical analysis (assuming, it seems, that a quality problem must be the domain of Six Sigma). It took time and a bunch of meetings to plan for this formal exercise. It’s a “hard problem” that’s “hard to solve,” the author said.

By September 10, 2013 18 Comments Read More →
Guest Post: Lean and Six Sigma (and My Son) Require Skills-Based Learning

Guest Post: Lean and Six Sigma (and My Son) Require Skills-Based Learning

Mark’s Note: Today’s guest post is by Joe Swartz, my co-author for the book Healthcare Kaizen and the newly-released book The Executive Guide to Healthcare Kaizen. I’m hoping Joe will be a regular contributor in the future and I’ll be doing a podcast with him soon (update: listen here) about his experiences at the Franciscan St. Francis Health System. Also, check out this video about their Kaizen approach. You can also read a journal article we co-authored.

Joe SwartzI was recently reminded about the difference between knowledge-based learning and skills-based learning.

My seventeen-year-old son was preparing for his driver test and asked me to help him learn to parallel park a car.   I set up some trash cans on our side street to act as a car in front and a car behind.   Then, I used my Job Instruction Training skills as I walked him through parallel parking, teaching him the steps, the key points, and the reasons why.

Then, he demonstrated what I’d taught him and parked the car within six inches of the curb on his first try.   He’s a quick learner and is in the top five percent of his high school class.   He said, “Okay I’ve got it.”

My Article on Lean Healthcare, Employee & Patient Safety in QHSE Focus

My Article on Lean Healthcare, Employee & Patient Safety in QHSE Focus

Screen Shot 2013-07-22 at 11.34.16 AMQHSE Focus, an iPad magazine, asked me to contribute a piece on Lean healthcare.

They published my piece titled, “Employee & Patient Safety: The Only Moral Place to Start with Lean in Healthcare.

You can read a PDF of the article, thanks to the publishers at QHSE Focus. The PDF also contains the table of contents to the publication, which includes an excellent piece by Michael Balle on the “irreconcilable differences between Lean and Six Sigma”). You can get a free issue of QHSE via the iTunes store (further issues by paid subscription).

Podcast #181 – Ron Pereira, Talking Lean and Six Sigma

Podcast #181 – Ron Pereira, Talking Lean and Six Sigma

MP3 File (run time 30:30)

Ron-Pereira-1My guest for Podcast #181 is a good friend, Ron Pereira of Gemba Academy, an outstanding provider of online Lean (and now Six Sigma) education. You might also know Ron from his blog posts (and now, also, a podcast) at LSSacademy.com. I was recently a guest on episode #8 of his podcast series. Ron was also the guest host for episode #143 of my podcast, where he interviewed me with follow up questions from a webinar I did for Gemba Academy on SPC.

Before I moved to San Antonio, Ron and used to live just about five miles apart in Keller, Texas and would meet for coffee regularly… but, today, we are talking via Skype. We’re talking about his background with both Six Sigma and Lean and about how these methods can be used together. Ron tells a story about a time he used statistical methods to solve something that might have been difficult with standard Lean approaches.

For a link to this episode, refer people to  www.leanblog.org/181.

Conflict of interest disclosure: Gemba Academy is a formal partner of

Recent Dilbert Cartoons Related to Improvement & Recognition

Recent Dilbert Cartoons Related to Improvement & Recognition

Two recent Dilbert cartoons resonated with me on themes related to improvement and employee recognition.

Below is the first part of the strip (view the whole eight-panel Sunday cartoon here) talks about a comment Lean and Kaizen theme of having a “bias for action.” This is often talked about in a week-long “Kaizen Event.” Having a bias for action means the event week isn’t spent just analyzing and brainstorming… actions are important, but need to be taken in a systematic way, as opposed to just wildly trying things.

Dilbert bias for action

#Lean Healthcare: The Really Good, the Sort of Bad, and the Ugly

#Lean Healthcare: The Really Good, the Sort of Bad, and the Ugly

I had a speaking engagement yesterday for a large system, with the audience consisting mainly of hospital CEOs and CFOs. I was able to be around for the entire morning, which included a really outstanding kickoff talk by the system CEO (talking about process improvement as a key strategy) and followed by two internal P.I. people who gave an outstanding talk.

I tweeted some of the highlights and top quotes, which I’ve collected here in this Storify page.

Apple Expected 10% Bad iPhones from Foxconn?

Apple Expected 10% Bad iPhones from Foxconn?

It's Just NaturalI’d read before that Apple’s supplier (Foxconn) was having trouble assembling iPhone 5s to Apple’s standards… but this article contains some shocking stats: “Apple Returns Millions of Defective iPhone 5 Smartphones.”

Millions… 5 to 8 million defective phones returned. Foxconn has only been able to achieve an 80% quality rating… suggesting 2 in 10 have some sort of problem. What were Apple’s expectations? Shockingly low.

Live Blogging AME Spring Conference: 17 Years of Lean at Autoliv

Live Blogging AME Spring Conference: 17 Years of Lean at Autoliv

autolivI’ve been fortunate to have the chance to visit an Autoliv factory in Utah – a great Lean company that makes air bags and protective devices for cars and passengers. I was really impressed with Autoliv, as were the healthcare leaders from across North America who visited as part of the Healthcare Value Network efforts. Like healthcare, the work done by Autoliv is a matter of “life or death” with a very strong mission and sense of purpose. The HVN visitors were very impressed with the quality culture and the prompt management support that’s made available when a problem occurs in a production cell.

At the AME Spring Conference in San Antonio, I saw a presentation by Thomas Hartman, a Senior Director at Autoliv:  “17 Years on Lessons Learned: Building and Sustaining a Lean Culture.”  

I’m “live blogging” the presentation in this post and will update it as the talk goes. Unless in  italics the comments are quotes or paraphrases from Thomas.

Horrible Misinformation about Lean from Minitab

Horrible Misinformation about Lean from Minitab

Yikes!Hat tip to Kevin Meyer for sending me a link to this ridiculous post from the website of Minitab, the maker of statistical software that’s used by Six Sigma belts: Lean, Six Sigma, or Lean Six Sigma? I’m sure my comment there won’t be published, so I’ll share my thoughts here.

Just Call it “5S Six Sigma” Instead of “Lean Sigma,” Please

Just Call it “5S Six Sigma” Instead of “Lean Sigma,” Please

My whole career, I have worked with the Lean methodology (aka the Toyota Production System). I’ve just really never done much with Six Sigma. I’ve read about Six Sigma and I took a Green Belt course when I worked at Dell in the late 90s. I’ve studied and used statistical methods (especially what I learned in my Industrial Engineering studies and at MIT), but I’ve never done anything I would call Six Sigma in my career.

I have respect for Six Sigma as a discipline, just as if I were a chef, I would have respect for pastry chefs. They can co-exist in the kitchen and you might both use whisks, but you have slightly different training to do different things – these roles aren’t interchangeable and neither are Lean and Six Sigma. That’s one reason I get riled up about so-called “Lean Sigma” or “Lean Six Sigma.”

By October 22, 2012 24 Comments Read More →

Updated – Weekend Fun: Political Parody Ad & Rebuttal

I don’t know about you, but I’m sick of politics. I try to be an engaged citizen… but both parties drive me nuts. The cable news networks are all beyond ridiculous. This presidential election cycle takes way too long. There is no truth, just spin… people get their own beliefs and biases reinforced by their favorite news network and the Facebook friends they haven’t hidden. Blah.

So, to amuse myself, I created this fake political battle – a November election between Lean and Six Sigma.

The first ad, from a fake Super PAC called “Six Sigma Horizons.”

Enjoy. I’m sure a rebuttal ad from the Lean PAC will be coming soon — ah, it’s here now.

By August 31, 2012 2 Comments Read More →
Notes from Meeting Masaaki Imai

Notes from Meeting Masaaki Imai

What a great time on Thursday with Masaaki Imai! We were hosted by a non-profit organization, SightLife, that has used Lean to improve the way they collect, process, and ship corneas to transplant patients around the world. It’s a bit of a cliche’ to say that Lean allows us to see the world through “new eyes” — but SightLife literally makes that happen.

In attendance were many friends, including Brian Buck and fellow author Naida Grunden. Jon Miller and Mike Wroblewski from Kaizen Institute were there, as well (with Mike presenting). I was able to thank Mr. Imai for what I have learned from, giving him a copy of my latest book and accepting a copy of his, as seen in the picture at the bottom of the post.

Some highlights from Mr. Imai’s remarks: