An Industrial Engineer as Hospital CEO


Last Friday at SHS/ASQ, I heard a talk by Michael Riordan, the CEO of the Greenville Hospital System in South Carolina.

He is one of what must be a very small number of Industrial Engineers who made it to the CEO level at a health system. I wonder if there's any study that shows how those hospitals perform compared to MD CEOs and CEOs with other healthcare administration backgrounds. I'm sure there aren't enough data points to be statistically significant.

Riordan made a number of great points about leadership that might sound “like lean” or at least philosophically aligned with Lean.

One dysfunction that Riordan highlighted is a real big-picture problem:

“We are paid for what we do, not for keeping people healthy.”

Healthcare is still often a very piece-work system, what some call “sickness care.”

Riordan said his goal was “Creating a culture of engagement and curiosity”, not just focusing on engineering and measures. This reminds me of the goals of organizations like ThedaCare and the University of Michigan Health System, who talk about having every employee be a problem solver and a process improver. If you're engaged and you're curious, that's a good start toward working on quality and process improvement.

He also added a somewhat provocative thought:

“I'm not there to make our employees happy.”

But real engagement leads to employee satisfaction and patient satisfaction, Riordan says. I think this is the essence of the idea of “Respect for People.” It doesn't mean being nicey-nice all of the time. Engagement, respect, and collaboration on improvements that matter to employees are more important than being nice and making people happy. We can make pepole happy, superficially, in a number of ways that don't lead to long-term sucess for the organization.

Riordan added:

It is OK to say “no” to employees. Don't leave them hanging. Treat them like adults, they can handle it.

Again, this sounds like Respect. Don't give them lip service… provide servant leadership to meet their legitimate needs, but don't necessarily say yes to just anything.

Riordan reminded me of the philosophy from St. Elisabeth in The Netherlands. The Dutch talked about their philosophy of Lean leading to “loving care.”

Riordan said that, in order to be most effective:

“We need to connect our employees to purpose and love.”

I think that's really important in healthcare, that emotional and social connection that people can make to their work.

The final idea he raised that was interesting was his question about the things in your organization that are “the undiscussables“?? To drive meaningful improvement, Riordan said you should list the undiscussables out. Why not discuss them? What would happen? What could happen?

I was impressed with Riordan's leadership style and what he's trying to encourage in his organization…

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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. Sounds like great stuff, Mark. I like how he describes the balance between servant leadership and running the business. I would certainly work for this guy.


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