Healthcare Kaizen Events Survey, Part 3


Here is part 3 of the results from my online survey about Kaizen Events in healthcare. You can find Part 1 and Part 2 in previous posts.

One thing to keep in mind, and I'll comment more on this another time, is that “events” are not the only way to “implement Lean.” I don't use week-long events in the consulting work I do in hospitals. But this survey was focused on those who do use events.

This time we focus on the free-form comments from the survey respondents. I've tried grouping them into three categories: Positive comments, tips and tricks, and challenges. I'll number each of them if you want to comment on a specific item.

Positive Comments:

  1. Powerful way to get improvements identified and initiated quickly…difficult to get operational leadership to free up the resources to do work in true Kaizen fashion.
  2. The event approach, along with lean, is a great way to make change more rapid. Back in the old days, we'd form a committee that would meet an hour a week for months on end and never really acommplish much. Now, through a metric driven lean approach, and using a formal kaizen event approach we are achieving real, sustained results.
  3. They're highly effective. The time and energy are significant (they're tough to do!) but worth it.
  4. Lean is the means to improving productivity, use of resources and people, etc. that leads to profitability improvement to the bottom line.
  5. Promotes involvement.
  6. It's all about the interaction of process participants. Often, just initiating effective communication solves long-standing problems.

Tips / Tricks:

  1. Planning and prework by lean expert assigned to area. Lots of Gemba time, understand how the workers feel about their work, their obstacles and how they impact the service provided to their customers. Dedicated external project manager is essential to keep momentum going, continue to visit gemba and ask questions that promote Lean thinking among the staff.
  2. multidisciplinary teams are esential teams can help and stimulate each other
  3. They are a good tool, but should only be used in the right situations.
  4. continuous improvement is key, and sustainment is very difficult
  5. Culture must be accepting of Lean methodology and willing to change
  6. Metric of the event must be easy to capture and automated to determine success of the event
  7. The right end user staff on team is important. The Team chair should Not be the facilitator. Data collection should NEVER be skipped.Exec support is key especially when dealing wiht processes that concern docs.
  8. Communicate to ALL stakeholders.
  9. need to do follow-up to insure sustainability
  10. Communication, communication, communication. Clear goals and measures. Excellent sponsorship required.
  11. Establish metrics early on to help us monitor the impact of the changes after the event. “Go to the Gemba” is worth its weight in gold!
  12. need to have a clear scope for improvement – need to be able to identify the “quick fixes” and what is going to take longer to re-engineer – need to have clear process management ownership – e.g., who is going to be accountable for the changes and continuous improvement, post the event
  13. The results aren't sustained unless there is follow-up to make sure at the end.
  14. Keep it simple

Challenges / Negative:

  1. Challenge to lead the event with right skill mix.
  2. time requirement, generic skills required (problem solving, measurements)
  3. How much can be achieved on multiple levels in a short time frame
  4. Need enough data!
  5. Acceptance of need to change and clearly identifying the owner and getting them to accept their role
  6. It's difficult for people to buy into Lean if there isn't an obvious reason. In today's economy, there is a shared understanding that productivity is survival.
  7. Lack of commitment from the clinical staff
  8. They discourage longterm empowerment. Too much “enabling” by the Lean staff.
  9. We've avoided events because it seems hard to plan for sustainment — what happens after the event ends?
  10. The most challenging part has been communication, trying to notify all units of a change, or change a cultural way of behaving is very challenging given the 24 hour multiple shift nature of the business.
  11. Takes a great deal of training and time.
  12. To change the staff (clinician thinking
  13. We are moving way too fast. It is not easy to get buy in. You can't just force it on staff. Everyone must be on the same page as far as Leadership and it is extremely important that the right person is leading the charge. And it is imperative that they understand it does nto change overnight. These are small incremental changes that take place. The organization must have the philosophy, is it critical. Patience is truly a virtue with this.

If you have others to add or want to comment, be sure to reference something like “C11” for Challenge #11. Use “P” for Positive and “T” for tips/tricks.

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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.


  1. Thanks for executing and posting this excellent survey Mark. The comments shared are excellent.

    We find having reviewed hundreds or thousands of kaizen events that the most frequent way to fail is in planning and follow up. Follow up is much more about leadership and discipline, but planning is very easily fixed by good planning. That’s why we developed an A3 planning document to structure the process of planning more thoroughly based on specific failures in planning which we will be posting an announcing in the coming weeks. This will be a free tool for lean practitioners to aid in their self-lead lean efforts.

    – Jamie F


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