The Nun and the Bureaucrat


I blogged earlier about an excellent “Lean Healthcare” DVD called “Good News: How Hospitals Heal Themselves”. Please call or email your local PBS station and ask them to air it, as many other PBS stations have done.

I'm still waiting to receive the companion book, called “The Nun and the Bureaucrat”. The introduction to the book can be found here (pdf link from

As I've been doing lean work in the healthcare field, it is a mind-stretching challenge for healthcare employees to think about other types of processes, including manufacturing as inspiration for improvement in their work. It's not easy, but it's good to look outside for lessons, as you then view your own operations differently.

My challenge to the lean manufacturing readers out there…. learn and read about lean healthcare. Read about how people are adopting TPS in a different environment. You might gain some lessons that you can apply back in your factory. You might be inspired to enter the healthcare world yourself. We need the help.

Another resource that I'll recommend again is the fantastic book, “Hardwiring Excellence.” It's not about “lean” per se, but the leadership style espoused by the author would apply anywhere. Here was a hospital CEO going “on rounds” to the “gemba” (in this case, the hospital, not the factory floor) and asking employees “what needs fixing?” “What can I do to serve you?”

Can you imagine your plant manager doing that, yet alone your CEO? Are YOU doing that as a lean leader of any level?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


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