My Four Hypotheses for Friday’s DFW Healthcare/Industry Lean Gathering


Coming off of an outstanding 2011 Lean Transformation Summit (blog posts to come), John Toussaint, MD, is doing a huge favor for the Dallas-Fort Worth area (my home). John has stayed over to participate in a meeting we are holding this morning in Fort Worth.

We will have about 20 healthcare leaders from different organizations and about 12 industry leaders with significant Lean experience.

Since it's hard to have a well-defined plan for what will happen after the meeting, I have four hypotheses that I will share at the meeting. I'll also share them here and we can test the hypotheses over time.

My hypotheses:

1) Leaders can learn and share Lean lessons across industries.

John is going to talk about his experiences as CEO of ThedaCare (as described so well in the book On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry). John received a lot of coaching and mentoring from people like Dan Ariens (CEO of Ariens Inc), George Koenigsaecker, and others. This was senior leader-to-senior leader mentoring and learning that was very influential on ThedaCare and John as the CEO.

The learning now goes both directions as some manufacturing leaders have come to ThedaCare to learn from one of the leading Lean hospitals. This learning, of course, doesn't mean that somebody is blindly copying another industry or another organization. But, we think sharing will be good.

2) Getting leaders together in the meeting (a petri dish) with John Toussaint (as a catalyst) will lead to at least one ongoing mentoring relationship across industries.

Our hope for DFW is that some of the experienced industry leaders can mentor some of the healthcare leaders, but the learning can go both directions. A sub-hypothesis would be that, currently, healthcare has more to learn about Lean from industry right now than vice versa, but that can change over time.

3) Collaboration can be done in a way that is truly win-win for industry and healthcare

This is not an opportunity for industry to “beat up on” healthcare. This is an opportunity to partner – finding ways to reduce cost and improve quality, something that's good for industry (as a payer for healthcare) and their employees.

John Torinus, the CEO of a printing company Serigraph, writes about this sort of collaboration with healthcare organizations (including ThedaCare) in his outstanding book The Company That Solved Health Care: How Serigraph Dramatically Reduced Skyrocketing Costs While Providing Better Care, and How Every Company Can Do the Same (full review coming soon).

Through these collaborations, healthcare organizations will have some friendly “positive pressure” placed on them, but they well also have some mentoring and a method for improvement – good for the healthcare organization, the clinicians, and their employees.

4) This mentoring will help move Lean healthcare forward in DFW in a meaningful way

It will be interesting to see what discussion comes from the meeting. Will there be mentoring? Will the group that meets all keep in touch, in some way? Will organizations share what they have learned, within the group, or in some forum? Will organizations report results? Will we do another meeting like this again? We are hoping to spark some naturally sustaining efforts, without forming a formal organization (although why not a DFW version of the Pittsburgh Regional Health Initiative?)

Depending on how this goes, my meeting planning collaborators (TMAC) and I are willing to share our plans and experiences if Lean leaders in other cities would like to try to repeat this experiment. We can't promise John Toussaint as the catalyst, necessarily.

My selfish hope (in case my family or I need healthcare) is that the DFW area could be one of the leading Lean healthcare centers of excellence in the country. It seems that our area has some catching up to do, compared to Seattle, Iowa, Minneapolis, etc. But let's give it a try.

What do you think about this?

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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 news, Mark. We are doing something similar with our Iowa Lean Consortium in June, where we are inviting senior leaders from all industries to a day of discussion, exchange, and sharing. I will be curious to see how your effort goes, and if there are lessons we can take from your sessions to enhance our upcoming event.

  2. Exciting stuff Mark. I am hoping A Seattle Lean Consortium is started (I can’t seem to find one on Google if it already exists). I know there is somthing similar in Bellingham from Paul Aker’s radio show recently. Is there a checklist to start one that you know of?

    I really like the first hypothesis. Toyota Kata highly stresses the need to have a mentor. I think hospital leaders need mentors from within healthcare and other industries to help them along – even if they are far along their journey. While a mentor helps greatly with learning, it also helps keep organizations humble. (I recently listened to Pascal Dennis’s excellent Big Company Disease webinar and was inspired )

  3. Dean – yes, let’s definitely compare notes on the efforts going on in Iowa.

    Brian – we aren’t necessarily looking to create a formal organization here, ala the Michigan Lean Consortium, although that is in the realm of possibility. I can connect you with the MLC leaders, if you are interested in that for Seattle or Washington State.

    My brief update on yesterday:

    John Toussaint did a great job of sharing his experiences and challenging the local DFW attendees to improve – in thought-provoking ways. One hospital attendee said she left feeling “inspired” to go back and do more and to collaborate more whole heartedly.

    It remains to be seen what will come out of this, but there was a palpable feeling in the room of common ground – especially in terms of strategic goals and leadership challenges with lean. This wasn’t a place for tool talk. :-)

    There are definitely going to be some exchanges of site visits – the hospital leaders visiting factories, and vice versa.

    We are trying to keep tabs on what happens without being directive or trying to run things centrally.

  4. Sounds great. Although, the health care system in Canada makes for differing motivations at certain levels, as unlearn more Lean is a big part of the solution. The focus on mentoring is terribly important, because I have been inspired by On the Mend and other excellent books but being inspired without coaching leads to frustration. Mentoring is key. I hope that everyone comes away with that kind of connection. I look forward to the day I can convince my hospital to get a mentor and coach for the Emergency where I work.
    Btw just know that this stuff is happening and being able to read these blogs and articles is inspiring. Thank you

    • Thanks, Marlon. Glad you have been able to find inspiration here and in On the Mend.

      Are there local hospitals near you in Canada that have already had success with Lean in emergency patient flow? Have you been able to share examples with your leaders? Not that we want people trying to copy exactly what another hospital did. Being inspired by what others have done seems to be the right way to look at it.

  5. Definitely agree that all lean practitioners need a mentor, ideally outside their own industry. Inspiration, and breaking ‘groupthink’

    I work in services but love being taken around factories and hospitals looking at how people have used the gray matter to produce ideas. My industry doesn’t lack for people, or money, or even experts, but coming up with new ideas from diverse sources is what matters.

    A mentor doesn’t do your thinking for you – but can show through experience whether you are still doing your own thinking – and inspire you out of the traps that regularly appear along the path.


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