Hospital Resume Journey and Tough Love


Lean Leap to Health Care #6 (click for Part #5) by Scott McDuffee

“With this resume, you will never even get looked at from anyone at a hospital,” she said, tossing my resume back at me. “And, what's a Lean Change Leader? That's not even a hospital title. Change the title to match what continuous improvement positions are called at the hospital. What are all those funny words (Japanese)? Nobody is going to know what you are talking about; they will never see these skills as transferable. Use the language of a hospital or target a different industry.”

Ouch! Tough love on an already battle scarred resume!

Note to self: resume opinions breed like bunnies – I need to be careful what I listen to or I will be rewriting mine until next Easter. On the other hand, this was one of many opinions indicating my resume was too “lean” and not enough “hospital”. Like many things in life, it can often take time to find the balance.

In the beginning, my resume was a “one-size-fits-all”, one page document. After all, it had been written for internal promotions; it didn't have to be good because people already knew my work and reputation. Thinking “less is more” I had crammed over 20 years of production, quality systems, training and development, performance consulting, employee relations, compensation, superintendent, value steam manager, lean promotions manager, production manager, Ops VP, yadda, yadda, yadda, on to one page with some hefty numbers as “accomplishments” at the top and assumed I'd just be out of work for a few weeks of good fishing.

Eventually, my resume multiplied both to cover plant manager type jobs, lean internal consulting jobs, and my rapidly growing passion for lean in Health Care. At this point, my hospital resume was really “Frankensteined” together from rough and tumble manufacturing pieces informed vaguely by my friends in Health Care, volunteering, and research but it was still not cohesive.

When I heard the tough love at the top of the page, and reflected on the comments Coach Mike and some of you had shared – I REALLY needed to take it to heart. As an old adage says, “sometimes you have to test the water with both feet.” I was ready to jump into lean hospitals wholeheartedly and it started with the paper that represented me.

Since I was already combing the web looking for lean and continuous improvement openings in Health Care, I had many position descriptions at my fingertips. However, the positions which fit did not have consistent titles or job requirements.

As I grew in my e-Networking, it was wise to check with the folks at, a community of leansters moving to, or already in, Health Care. The discussion forum suggested the following titles and more are used to describe the role I am looking for: Quality Improvement, Process Improvement, Performance Improvement, Process Excellence, Management Engineering, Service Excellence, or more directly Lean Coach, Lean Facilitator, or Lean Engineer. WHEW!

Even the lean positions tended to describe the objectives using hospital language. My favorites spoke of solving challenging and complex problems, creating visual measurement systems, working hands-on for process improvements, developing people and leadership, sharing best practices across functional and geographic boundaries, and most importantly, improving value from the customers' perspective. Hold it, I thought, that isn't just hospital language – this is what I do!

An important and obvious question comes to mind. Are my skills transferable? The more I study the move to Health Care I am sure of it. When I volunteer, I can see it. When I take hospital walks, I can feel it. When I research and talk to those already at hospitals about the successes, challenges, and applications, I know it.

Sure, I have adjusted to cultural resistance before. Try being the only American in the room trying to teach managers and engineers in Germany how they can improve their processes another 60% after they had just run an improvement event the week before.

Or, try being the “guy from corporate, here to help” and build the trust and rapport to enable transformations of process and management systems as an outsider, including asking the top leaders to do their jobs differently. Then try to teach people that the processes they have nurtured and developed can be done ten times better without “calling their baby ugly” – add to the scenario a “yankee” accent in a North Texas factory.

So, I had better get working on the resume. I changed the top paragraph from backward looking (“have done“) to forward looking (“can do”) using the language mentioned above plus referring to improved patient, employee, and physician satisfaction. The position descriptions also frequently used the term “turn-around” for what I would tend to call “through-put” so I made this and similar changes taking care not to misrepresent, but instead to describe exactly what I did through language more easily understood.

Yet this word exchange was not without difficulty and consternation. Besides entire plant re-layouts and the creation of lean management systems (Many of the examples in Creating a Lean Culture by David Mann were my team's experiments and implementations with David's coaching.) there are a couple of major things I am known for professionally in the lean community.

These include “Heijunka Scheduling” and “Gemba Walking,” Japanese words that are obviously cumbersome on a hospital resume. The transition consultant who gave me the tough love cringed at these words and so did Coach Mike.

Heijunka is something I have expertise in and passion for; I may have a chance to write about it for AME's Target Magazine later this year. However important to me, I am choosing to totally remove this term from my resume because I frankly don't yet understand how applicable it is in a Health Care environment. Hate to see it go but its gone.

Gemba Walking was removed but I need to replace it with something better because it is absolutely relevant for Health Care. Some hospitals use a process called “management by walking around” and others describe it as “rounding” but these are not nearly as purposeful as Gemba Walking with the exception maybe of Quint Studer‘s approach. Gemba, for those of you who aren't familiar is “where the action is”, “at the point of contact with the customer”, or “where value is added from the customer perspective”.

Gemba Walks bring together three essential elements 1) mentoring and teaching of clear expectations and the application of improvement principles, 2) engaging thinking via questions to see processes with new eyes, and 3) assigning on-the-spot improvement actions to make a difference immediately.

Gemba Walks also help to drive actions based on the ever important question, “What do you need to serve our customers better?” In fact, it may have been Mark Graban who said, “Lean is a misleading word, especially for Health Care. If instead they would have called it, “More time with patients,” everyone would embrace it.

So, in addition to the Japanese words, should I just take all lean language out of my resume? I don't think this is the answer either. A better question may be – Who do I want to get hired by? I don't want to de-emphasize lean, because I believe I am a best fit for an organization which embraces these principles and management systems. However, I need to make the language palatable to make sure I get in the door past the gatekeepers (most gatekeepers don't speak Japanese). If I have to call a kaizen a “Rapid Improvement Event,” so be it. Later, I'll show people what kaizen really means as incremental, organic, and constant improvements – and won't have to call it kaizen then either as some of you have suggested.

As if to contribute to this blog post and feed my resume, I received a call from a lean practitioner from a hospital in the Midwest. He described the lean journey in hospitals as having very similar pitfalls but in a very different environment.

As with anywhere, the key is leadership. In hospitals, lean application is often times more difficult and complex because it is harder to see value flowing to the customer than it is in a factory. But on the other hand, the customer is right in front of you so feedback and improvements can be more immediate.

He indicated many hospitals need to have a stronger sense of urgency – my manufacturing background can be a big help. Even when improvements are initiated in hospitals, the tendency is to spend too much time mapping and planning and not enough time doing. Need to go change things to relieve the pain now – then sustain. This sense of urgency may be one of the most important things a change leader can bring to the hospital organization. YES!

Then he added, it is really important to engage the right people. You want the heart and souls of people pulling in a positive direction. This is not always the case, like at times the clinical side and the accounting do not have their eyes on the same prize. Sometimes it takes an outsider's eyes to see and resolve these conflicting incentives.

He emphasized that I know the audience and speak in their terms. Okay, leave the resume alone without the Japanese words; I don't want to be rewriting until Easter as mentioned.

His comments re-invigorated my excitement about lean continuous improvement in Health Care. Wherever I land, I need to adjust to the current culture before I lead it; I may just as well start with my resume.

The best fit for me will be a lean hospital…but I'll leave the Japanese words at home.

(Click here for Part 7)

Scott McDuffee is an experienced Lean professional who is currently searching for a new career opportunity. He is based in Mansfield, TX.

What do you think? Please scroll down (or click) to post a comment. Or please share the post with your thoughts on LinkedIn – and follow me or connect with me there.

Did you like this post? Make sure you don't miss a post or podcast — Subscribe to get notified about posts via email daily or weekly.

Check out my latest book, The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation:

Get New Posts Sent To You

Select list(s):
Previous articleLeanBlog Video Podcast #3 – Norman Bodek, Part 1
Next articleSave $1 Trillion in Healthcare Costs with Lean and the Toyota Production System
Scott McDuffee
Scott is a Lean Change Leader who has worked in multiple manufacturing sectors. He blogged primarily about his steps taken to investigate switching into healthcare in 2009.


  1. Hi Scott,
    I think you’ve bought up a really good point here that is one of the biggest issues with the majority of us in the lean community. Before I begin, this is by no means directed only at your post. I had read a number of posts lately where people argue over the exact translations of particular words and I suppose this is my response to all of them.

    We all seem to have this tendency to refer to everything we do with the Japanese terms. So many lean practitioners / consultants / experts all continue to try and preach the lean gospel while also having to translate Japanese to English. This really annoys me as the vast majority of people (as you quite correctly noted) don’t speak Japanese. If we really looked at our process of convincing people / change management in the advantages of lean we could argue that its NVA including this translation step. You used the example of “Gemba Walking” and that all the other options “are not nearly as purposeful” I’m sorry but I don’t agree with this statement. You have a clear understanding of what the Gemba is in your mind, and as they say perception is reality. If healthcare employees have a more familiar word in their culture (and it can be developed into the same meaning) then we should be using these. It allows for a smoother transition and less resistance from the fear of the unknown. To be honest using the Japanese terms feels a little elitist to me, like where trying to have some “in” club, and let others know that what we do is more special then what it is. At the end of the day were trying to teach people to embrace the fundamentals and concepts of lean. I think its more important we look at what the customer (the healthcare workers) values and less about our own perception of what the value is of some Japanese words.

    I hope I didn’t annoy to many people with this post, although I’ve got the fire extinguisher at the ready… I can see the flames already coming.

    Best Regards,
    Clint Bird

  2. Scott, really to good to hear about your resume make-over. As a good lean practitioner I know you will continue to refine it until it delivers the results you seek!

    In response to Clint, I am terribly conflicted on the matter of language. I find the Japanese terms can be an obstacle and a distraction, though “elitist” may be going a little far. I agree that we should speak in terms that people understand. But language is so critically important. Obama touted $2 trillion in “savings”, even though that figure is a reduction in the rate of cost increase. Hmm, yeah I guess “savings” is catchier. There are plenty of other examples–staking out the language of the debate establishes the high ground.

    Lean is a different paradigm, it has a different vernacular, that can be an advantage–except it completely conflicts with my belief that we should speak to people in their own language! Another reason language is important is to maintain a coherent body of knowledge. If we all use different names for (the same) thing, we end up with confusion (which is one reason that many hospitals have eliminated many abbreviations BTW). I don’t have a final answer and I’m concerned about being too Anglo-centric with our focus on the English language, but I like the middle ground taken by 5S. The original five Japanese words have been translated–on a generally consistent basis–into five English words that (as far as I know) pretty much have the same meanings. I am always looking for insightful lean practitioners to do more of that–give us compelling English language versions of the Japanese terms that then become widely adopted. Scott, any suggestions??!

  3. Great comments!

    5S is a strong example of the essence of what you both see as important – keeping the principles yet adapting the language to the audience.

    These powerful “one word” (or close to it) exchanges can be very helpful.

    We just need to do better than the misconceptions “lean” gives when we choose other translations.


Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.