Preventing “Mid-Project” Blues?


I was recently invited by to participate by giving a response to the question “How to beat the mid-project blues?” – looking at Lean as a project (or looking at projects in the midst of a Lean transformation.

I'm currently in Orlando at the annual Institute for Healthcare Improvement National Forum on Quality Improvement in Healthcare. At the end of his workshop today, Dr. John Toussaint said healthcare is too oriented around projects…

John added:

” Lean isn't a project! It's a completely different way to think in healthcare.”

He is absolutely correct.

My answer to the “blues” question was this:

I'd ask ‘why are we in a so-called slump?' We should think about the root cause of that apparently lack of enthusiasm instead of blaming people for not being enthusiastic. Maybe people aren't getting the support they need from leadership to really make change happen? Maybe solutions and improvements were dictated to them in a top-down way, so they naturally don't feel ownership of the ideas.

To prevent slumps, we need to mindful of what would cause them and then, from the beginning, not do things that de-motivate people. As Dr. W. Edwards Deming would say, you can't motivate people, you can only avoid de-motivating them.”

What are your thoughts on this? Your reaction to my statement or what the others said at

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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. I agree with the statement that Healthcare is too “project-centric”. This inhibits Lean and Six Sigma from achieving any real long-term transformation. By definition, projects have a distinct beginning and end. So, even if Lean healthcare “projects” are successful at addressing some current issues, the environment is continually changing. Without ongoing vigilance achieved with true Lean transformation, before long, performance and quality will inevitably start to decline.

  2. I agree with your quote from Deming, and if this is a systemic “mid-project blues” which it seems to indicate it is then look at why people are de-motivated in the middle of projects (and what needs to be removed that is de-motivating them). It could well be many projects shouldn’t even be projects. That may eliminate a bunch of problems.

    But for those that are left as projects figure out why people are being de-motivated and then take steps to improve, then see if it did improve, and if so then (go around the cycle a couple more times to improve the solution, if that is warranted) then adopt those steps more broadly. I am going to call that John’s Plan, Do, Study, Act cycle â„¢ ® © ö

  3. I have always found that one of the problems that causes mid-project blues is that at about that point you have torn appart the existing system or process, and you are standing amongst the rubble, the naysayers are in full chorus claiming it will fail, it is at that point you really need a visionary leader, he has to constantly repeat what the result will look like. Ideally he would shoot a few naysayers (only verbally) and quiet the rest. One of the underrated attributes of leaders is not motivating people, but actually keeping them focused on the finish. In any event the middle is the most dangerous part, the excitement has worn off and the end isn’t in sight yet.

    Greater leaders never try to pump you up here just focus you on the goal.

    This is also the part of any project, game, or anything really that the finishers in life step up, by nature they hate starting anything, but get out of their way from now on, they know what the goal is and they have a need to get it done. Problem is we often fill teams with starters, and omit the finishers after all they are rarely trying to endup on any project or team, their nature hates starting anything, but they cannot leave something halfway finished.

    No baseball team has nothing, but starting pitchers, they always have, middle relief pitchers, and one or two finishers, because you only win the game if you can stay in it the whole game. Unfortunately to often the teams i see getting picked are full of starters, but total lack anyone that truly hates unfinished jobs. When you pick the team you need a variety of people not just by skill, but by nature. Most businesses have that guy who never seems to start anything, but he is constantly being given one assignment after another to finish, why because he gets it done. To often the groups that lead change activities are full of starter types, but they are easy to discourage, at this point if there is no finishers involved someone had better bring one in or the project will get stuck in the rut and fail.

    That happens to be my nature I hate starting anything, but give me something barely started, and I will attack it with everything I have got till its done. An ideal team would actually be half and half, the finishers are silent early, but when the rest are getting the blues they are now consumed by only one fact, getting to the finish, nothing else matters.

    • Great point. There are personality typing surveys you can use to determine who the starters and who the finishers are in an organization or a team. Very useful for team selection. You do need a mix (amongst many dimensions).


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