Another Hospital CEO Talks Lean Culture


Here's a great article with a number of quotes from William Considine, the CEO of Akron Children's Hospital in Ohio. The article, from the Akron/Canton Smart Business publication is titled “William Considine embraces Lean Six Sigma to improve Akron Children's Hospital.”

I get accused sometimes of overstating the importance of having the CEO on board — well beyond that, actually driving Lean and being willing to help set expectations for culture and behavior in the organization. Maybe you shouldn't just give up and quit if that senior leadership isn't on board, but it certainly makes a huge difference.

Considine seems to get it:

“We all know that culture eats strategy every day,” he says. “You can have the best strategy in the world, but if you don't have a good culture, you're going to have a hard time implementing that strategy. Lean Six Sigma is a real investment in culture. It communicates to your people that you really value them and what they do.”

The article highlights some classic examples of how a hospital was able to avoid multi-million dollar construction efforts through Lean. Instead of falling back on the old easy “more people, more space” solution, they improved the process by engaging the staff in the perioperative services area. This saved ACH $3.5 million, but it also got people engaged in improvement.

Considine emphasized this point:

“We're going to them and saying, ‘You know your work better than anybody. We want to empower you and give you the resources to look at ways to improve your efficiencies,'” Considine says. “And they love being a part of it.”

The CEO talked about getting others on board with Lean — he didn't do it in a “thou shalt” top-down, command-and-control manner:

“One thing you need to do is respect everybody's opinions and I do,” he says. “At the same time, advance positive energy in what we're doing. I find people want to be around positive energy.

“You know how you feel when you're in a room with a bunch of naysayers. Quite honestly, people don't want to be around negative energy. I don't give it a lot of credibility. If people want to voice it fine, I don't hover around it though. I move on to that positive energy and, ‘OK, we'll take that input. We'll process it, and we're going forward.' The large majority of people go forward.”

There's an interesting and challenging balance to strike — when to listen and build consensus (which might take forever) and when to put a stake in the ground as a leader… while still respecting people's opinions and feelings.

He also, in the article, talks about the need to focus on the positive and what people do well, not just the negative things and the waste.

He also talks about the balance between having a formal Lean Promotion Office (they have one) and just letting Lean happen organically:

“The key is you want to empower the people,” Considine says. “You don't want to have so much structure there that it's bureaucratic. Keep it simple.

“The thing is you want the people on the front line to say, ‘Hey I got this idea. I do this job every day and I think I can make this job, these processes, a little simpler, more efficient.'”

There's a lot covered in the article – celebrating successes, communicating, and building on your successes. They also share a huge success in reducing waiting times for MRIs (from 25 to 28 days to just 3). A good uplifting piece for a Friday, I think.

Disclosure: Akron Children's Hospital is a member in the Healthcare Value Leaders Network, an effort in which I'm involved.

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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. Great example. Senior leadership support and understanding is incredibly helpful. You can make progress without it. But eventually it becomes very difficult to work on the system without senior leadership support.

    This example is also nice in showing that lean six sigma can work. So often organizations using the buzzwords don’t have success. And it helps show different organizations can take different tactics. Many people don’t like having a separate “improvement” office – as it can be seen to isolate it from everyday work. I think a separate, small, office, can help push improvement (especially in the first few years).


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