LeanBlog Video Podcast #2 – Kevin Frieswick, Error Proofing Handwashing


I'm still experimenting with video podcasting, after my first attempt with Jamie Finchbaugh. LeanBlog Video Podcast #2 is content you may have seen and heard before — the video from Kevin Frieswick and MetroWest Medical Center with the device for error proofing hand washing on the way into patient rooms, combined with some excerpts of audio from LeanBlog Podcast #65.

It's a video world, so hopefully this gets Lean content to a new audience. I'm trying to keep these under 10 minutes so I can also post them on YouTube.

Any video podcasts will also have the audio versions available if you're subscribed to existing feeds. While some said the first video podcast didn't add much since it's just talking heads, I think seeing someone talks adds a bit of their personality that doesn't come across in audio.

I have four video podcasts coming up with Norman Bodek and two that I recorded just yesterday with Matthew May about his upcoming book In Pursuit of Elegance: Why the Best Ideas Have Something Missing.

Here is a YouTube version of the video:

As always, feedback and constructive criticism are welcome.

For audio podcast episodes, please visit  www.leanpodcast.org. For video podcasts, visit my  YouTube Channel.

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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. I heard a story on NPR yesterday about elementary school teachers teaching children to properly and effectively wash their hands. Part of the method includes having them sing the alphabet song all the way through to ensure the proper washing time. Adult versions were experimented with and the most popular was the “bridge chorus” from Queen’s Bohemian Rhapsody.

    BTW–raise your webcam level a little to eliminate the Big Brother Effect in your intros. Good vid-cast.

  2. Mike – when you say “Big Brother” effect, is that the TV show or Orwell you’re referring to?

    I’ll get better with lighting and webcam angles… glad you like the content at least.

  3. […] Everything they can do except always washing their hands. Do people forget? Yes, we’re human, we forget. That’s why, in the Lean philosophy, we design systems that are error proofed, so it’s harder for people to forget. That’s why hospitals (well, 20% in the U.S.) use surgical checklists so steps aren’t forgotten. One hospital did an experiment with error proofing handwashing – ensuring that, except in an emergency, that you have to wash your hands before the tollgate goes up to enter the room (video can be seen here or go here for an interview with the creator of this device). […]

  4. I can see that boom being broken off by the first patient or maintenance trolley that passes it. Good idea, but will need something more robust.

    How about infrared beam or something that will go beep at you if you don’t dispense the gel, but is not going to get itself broken if failure occurs. Because a broken poka-yoke is two process failures, the actual process failure and the poka-yoke. Multiplying your problems.

  5. Mark (and, of course, Kevin) – great podcast, great example of taking “systems improvement” in healthcare from theory into practice, and one of the only physically real systems improvement ideas I’ve seen for one of the most frustrating and dangerous problems in hospitals. A thought: have you considered using a “light-based” barrier instead of a physical barrier (the wand)? The wand seems to introduce multiple, physical failure points – plus, it might make suggest to some a theme of ‘incarceration’ in a WWII-kind of way. Maybe a prominent red-light/green-light kind of thing; another addition could be a recorder that captures video whenever someone passes through the red-light zone… just some thoughts. Really great work as it is, though! Please carry on!

  6. Mark –


    This is similar to the equipment setup used by The Dannon Company in Minster, Ohio for poka-yoking handwashing. People enter the plant through a soap dispenser turnstile. Immediately after the turnstile is a motion-activated sink and bank of Dyson hand dryers.

    Their setup overall can be defeated because the double doors leading to the corral with the turnstile are both an entrance and exit, and someone can open the enter door then pull open the exit door and bypass the corral all together. It is a rigid system that takes about 45 seconds to enter-soap-lather-rinse-dry before heading to the floor so it can be annoying to use it multiple times a day.

    • Thanks for sharing the parallel, Chad.

      I think we’d agree that good error proofing has to be designed so that it can’t be easily circumvented.

      Hospital staff complain about the amount of time it takes to wash/gel their hands so many times each day. Responsible management and good system design would have that time built into their day. Nurses, doctors, etc. shouldn’t feel pressured to cut corners on hand hygiene because there isn’t enough time in the day.


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