Interviewed for articles in "Becker’s Hospital Review"


    I was recently interviewed by a reporter at Becker's Hospital Review and these are the articles, linked below, written for a hospital and operating room audience.

    5 Key Principles for Hospitals From Toyota's Lean Production System

    This first article came out fine, I think, although I'd take issue with Point #3 that you must “embrace technology” – a focus on technology isn't strictly a Lean approach. That didn't come from me.

    Technology's not bad, but it's not always necessary. Toyota Way principle #8 says:

    Use only reliable, thoroughly tested technology that serves your people and processes.

    You can use technology and be Lean. You don't have to use technology to be Lean. Technology “can” reduce the need for labor, but I've seen many cases where it does not reduce labor because the technology was bad or wasn't integrated well into processes and the way work was done. You can eliminate the labor involved in manual inventory counts with a paper kanban system — technology might help,but it's not a core part of the Lean approach. I've seen hospitals with amazing bar code-driven Lean inventory control, but such technology can actually hamper you if it's not in line with your people or your processes.

    I've seen many labs with automation technology that actually slowed the process and required just as much labor. Same is sometimes true in pharmacies. Nurses are often slowed terribly by poorly designed bar code scanners (for medication) or electronic medical record systems that don't match their workflow.

    This second article was driven more directly from my discussion with the reporter:

    3 Best Practices for Implementing Lean Processes at Your Hospital With the Author of Lean Hospitals

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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. Your second point about gaining support of change agents is key from my experience. I've worked in manufacturing and healthcare and in any environment, having stakeholders that understand the importance and implications of Lean has been invaluable. It ties directly into your third point of starting small as Lean is more than a process improvement methodology and requires, in most cases, a change in management. Starting small can show what 'could be' and encourage others in the organization to be part of the change.

    2. Mark,I agree with all three. I also agree that most of the time hospitals are trying to solve the wrong problems not problems that directly effect staff and physicians as well as patients.We jump to solutions before we have defined the most important problem and we never solve anything meaningful.


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