Hospital Looking for a “Sensi”??


A year or two ago, I saw a hospital job posting for a Lean implementer. This hospital wanted every certification under the sun, including “Design for Six Sigma” (DFSS) certification. For what purpose, at a hospital, I have no idea. Seeing that laundry list of qualifications really made me wonder if the hospital even knew what kind of person they wanted or if they would know what to do with them.

Now, I've seen a job posting for a hospital in Montana who wants a “Lean Sensi.” Argh.The proper term, when used, is “sensei.” This term, taken from Japanese, of course, is often used to describe a Lean change agent or coach, even in an American setting. It's a term that I would prefer people not use, as I wrote about here in “10 Things I Wish Lean Practitioners Wouldn't Say in 2010“).

But, if you're going to use it, at least spell it correctly!

What do you think? Simple typo, or a sign that the hospital doesn't know enough about Lean yet to know what they want in an employee to help them with Lean?

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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. Fair enough. But would this be a red flag that they don’t know enough or maybe don’t have enough of a committment to Lean to make good use of a “Sensi”? No way to know for sure until we go and see…

  2. The concern of posting jobs based on certifications is far too common, and rather disappointing. It seems that hiring managers are outsourcing the task of finding the right person to the HR department, and the HR folks are outsourcing the responsibility to the certifying bodies (but of course, who are certifying them?).
    .-= jamie flinchbaugh ´s last blog ..Leading Lean A-Z: K, Be Kinetic =-.

  3. Mark, this has long been a major challenge for us. And a very common problem – not knowing enough about Lean to know what qualifications the new Lean person needs to bring to the table to begin the transformation.

    I’ve been recruiting Lean executives at the manager, director, VP and above levels for over 15 years. We often begin our search for the client’s new Lean executive by completely re-writing the original position specification from the ground up. Reason: all too many of them seem to be a compilation of every possible Lean, Six Sigma, TOC, Demand Flow, etc. buzzword ever created. Very few actually address what the job which needs to be done is, how it’s expected to be accomplished, with what resources, within what kind of time frame, and so on. So we fix that, basically, by using an A-3 form approach to apply some PDCA thinking to the recruitment process. Many companies have told me that the first time they really began to understand why they were about to begin the Lean journey was the point at which they truly understood the details of the new position description. And no, never Sensi (or even Sensei)!

    And that’s the way I see it! Adam Zak

  4. Actually Mark, I think you’re spot-on in being concerned with terminology and awareness here. As you know, I’m working hard on an elegant marriage of lean principles and crew resource management principles. While there is significant overlap between the two, each contributes some unique concepts to a unified approach.

    The reason that I’ve learned the importance of maintaining standards just as you argue, is that I’ve spoken to many healthcare organizations that say, “Yeah, we did teamwork training and it really didn’t make a difference.” My response is some tactful version of, “Of course it didn’t make a difference; training alone has been demonstrated numerous times to be ineffective.” The problem for me and my colleagues is that when someone “does teamwork” superficially, their testimony adds “noise” rather than meaningful, actionable experience and data. Many of the organizations that have “done” TeamSTEPPS are disappointed with the results for the same reason, meaningful change requires a long-term, top-to-bottom commitment to a better way to deliver care and cure. Sound familiar?

    If someone is trying to hire a “Lean Sensi,” they’re likely to get one… and they’re unlikely to add much more than noise to the Lean Healthcare dialogue.

  5. Mark, I think it shows a lack of understanding on the hospitals part, and because of that they probably won’t get what they really need. However, if they were already in the lean mindset, they probably wouldn’t be looking for help.

    I was hired by a company that has done “lean” for a while now but it is definately on the LAME side of things. This was something that was obvious from the beginning of the interview process, but I wanted the challenge and took the job. I now have the opportunity of teaching what they should be expecting from me, and what lean really is (no I am not going to just put kanban everywhere). Not the easiest place to be in, but it sure is fun to see progress. So I think the bad job posting shows a mis-understanding of lean, but this might be a great opportunity for someone to teach them what lean is really about. Is there a risk? YES, but some might be willing to take it. I took the risk in a similar situation, because from my research of the company it seemed like a place where I would have the opportunity to experiment, teach, and learn without too many job security worries. My assumption has remained true, and I really enjoy my “lean sensi” job.

  6. Nice post and begs the question of what hospitals should really be looking for to begin their lean journey.

    I think most simply want to cash in on some kaizen events and/or have someone teach them some lean tools.

    Some others appreciate that the above is superficial lean and want someone to hold senior management’s hand in developing a management/leadership model.

    There are fewer still that appreciate that they need to abandon their management model and move to something entirely different if they truly want to pursue lean.

  7. I work in Human Resources at Mercy Medical Center – North Iowa, Mason City, Iowa, and I am interested in any suggestions of websites, newsletters, etc. that you might recommend for posting job opportunities? We would like to add two full-time positions to our Process Excellence team, and I would really appreciate any feedback that you have to offer.
    Thank you very much for your help,
    Gayla Toebe

  8. Mark:

    I recently interviewed for the position you mention (I also, a few minutes ago, sent you an email concerning the job) and am awaiting a decision on my application for the opening. Having met the people involved in their Performance Excellence program at the hospital, I can tell you that they are a very patient-oriented group that sees Lean as a way to provide the best responses to their customers, needs, both internal and external. They are also aware that they have a lot to learn and a long journey but are not shrinking from it.

    As to the misspelling, during the application and interview process I had several opportunities to review documents from the hospital where the spelling was correct. My guess would be either a typo or an HR mistake.



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