Highlights from Shingo Prize Conference, Day 1


I'm here at the Shingo Prize conference for the second year in a row. Lots of good networking and talks/panels. I'll share a few quotes and highlights, along with a picture of my friend and sometimes guest blogger, Adam Zak.

This post (and part 2, to come) will include:

  • Notes from Bruce Hamilton's talk
  • Former HHS Secretary Michael Levitt's comments on healthcare
  • A few follow ups on the healthcare panel discussions
  • Dr. Stephen Covey

First off, I'm seeing a lot of familiar faces — Adam Zak, Norman Bodek, Bruce Hamilton, Bob Miller, Naida Grunden, and other Lean friends. I also got to see Gwendolyn Galsworth and her new book called “Work That Makes Sense.”

The Shingo Prize folks let me have a little space to be able to talk to people about blogs, Twitter, etc. Here's Adam Zak in that modest space, to left. I also met Kevin Tame in person for the first time, as he's my student assistant for the two days. I also met Dr. David Jaques for the first time in person (check out our podcast here). I'm leaving some people out, I'm afraid… there's a good crowd here.

Bruce Hamilton

Yes, he's known as “the Toast guy” from his popular DVD, Toast Kaizen. He shared some of the background of how the video even came to be. The story would make a great podcast if I can talk him into it. It was contrived as a product to sell, it was developed as a way to get execs and leaders in his company to start thinking about Lean.

Bruce knows more about Lean, TPS, Shingo and Ohno than just about anybody around. He showed a picture and video clip of Shigeo Shingo visiting his United Electric factory in 1988 or so. Dr. Shingo's first question was always:

What is the function here?

He was asking about purpose. What is the purpose of this work and this area. What a great starting point question.

Bruce recalled how Shingo said these were the priorities for improvement:

  1. Easier
  2. Better
  3. Faster
  4. Cheaper

Why “easier” first?   Because it leads to the next three and it gets staff engaged in improvement. He considered customer satisfaction and employee satisfaction to be two pillars for success.

Bruce emphasized how he was taught that Lean is about “critical direct observation” at the gemba. Bruce asked,

When we go to the gemba, do we actually see anything?

You have to learn to see waste, you can't just do drive-by gemba visits.

Some other quotes:

From Shingo:

Understanding derives from intellect but action comes from emotion.”

From Taiichi Ohno:

“Before strategy, there must be philosphy”

Bruce emphasized the Toyota triangle that's often shown in training, as I've drawn it below:

I think that helps illustrate that thinking alone is not enough. You also need technical methods (dare I say “tools”?). People development, of course, is in the middle.

From Hajime Oba (of Toyota):

Most organizations do not get the benefits of TPS because management does not understand TPS.

Great historical perspective and refreshing of core Lean points by Bruce!

Michael Levitt, former Governor and Secretary of Health and Human Services

Levitt made a number of key points that I agree with, regarding healthcare. He pointed out how our current system does not reward quality or efficiency. Poor quality often gets paid for as highly as good quality. That point was no surprise.

What was sort of a surprise was his theme of networks. Levitt said a few times:

Collaborative networks are the new frontier of human capability.

We can't continue living in silos – organizations that are siloed from each other, or the silos within organizations. We need Networks for sharing, learning, and collaboration. Levitt said “networks aren't a fad.”

I think Governor Levitt would love hearing about our Healthcare Value Leaders Network efforts, so I am hoping to follow up with him through the Shingo Prize leadership.

Levitt also said we “need better management” in healthcare and that the incentives are all wrong – we get paid for doing more of everything.

Levitt, a Republican, was saying many of the same things about how our system is broken, how we need to reward healthcare value and quality — the exact same message that we hear from Dr. Donald Berwick, currently nominee to head Medicare and Medicaid — but Berwick is being painted by some Republicans as a far-left liberal. It's sad to see how polarized our political system is these days…

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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. Mark: I too thank you for sharing.

    Interesting but puzzling quote from Shingo to Bruce on the priorities for improvement. I would have thought “Safer” would be number one.

    Also, why just customer satisfaction and employee satisfaction? Why not stakeholder excitement?

    “Understanding derives from intellect but action comes from emotion” sounds nice, but I wonder how accurate it is. I can think of plenty of things I am or have been very emotional about, but have failed to follow up with any action, and other things I have acted on without any real emotional push. Psychologists sometimes like to distinguish between three aspects of mind: cognition (intellect), affect or affection (emotion), and conation (will), with action derived from the last.

    Does “Technical” in the Toyota triangle really refer to tools? I always interpreted that as specific technical process knowledge (e.g., how to make a car)–as opposed to, say, knowledge of improvement techniques, systems thinking, and so on.

    Just some questioning thoughts…

  2. Hi Simon – thanks for the comment. I’m not a psychologist — I don’t even know the word “conation”!

    Maybe safety wasn’t included because it’s implied as something that should be embedded in everything. Some people make 5S into 6S by adding safety. To me, that’s silly, because safety should be a principle that’s embedded in anything you do (like I don’t list “breathing” as a priority for the day)?

    As for the “technical”, I’ve learned it as the ‘things that you do’ in your work or in improving your work. Maybe that’s wrong, I’d have to go to a more primary source on that.

  3. Good summary Mark … I had 2 key “ah-ha’s” from the Shingo conference … in the discussion where you were part of the panel (1st 10 years), 1) there was the realization that not everyone sees the health care crisis as the same crisis (physicians, administrators, the general public), 2) dialogue with Dr. Brent James (he would make a great pod cast interview). The importance of aligning healthcare payment systems is crucial. As Deming pointed out, improving quality leads to lower cost, but won’t necessarily mean you’ll stay in business unless you are not penalized for your improvement efforts. Currently, clinicians (and hospitals) are actively paid to harm patients.
    .-= Mike Stoecklein ´s last blog ..Lean Thinking, Dr. Deming, Health Care Improvement and Life-long Learning. =-.

  4. Mike! See, dang it, I knew I was leaving someone out. Great seeing you again and thanks so much for your participation in the panel discussion.

    I am definitely going to share notes from Dr. James and I would love to try to do a podcast with him.

    I thought that was a provocative statement, that was a direct quote from Dr. James that they are “actively paid to harm patients.”

  5. There were too many highlights to name them all here, it was an excellent conference. I enjoyed the overall focus on the cultural elements of lean, most of the sessions I was in didn’t even mention tools, which is a direction I like to see.

    It was good to see you there Mark, and to meet you Mike.

  6. I saw that you posted it and I am excited to listen to it. Dr. Covey has lots of excellent insight, I like to see that he has partnered with The Shingo Prize; I think they compliment each other quite well.


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