Mark Graban: Announcement on My Future Professional Direction (2011)


Today, I'm announcing an evolution of my work life: doing less with the Lean Enterprise Institute, doing more consulting and speaking, and starting to help build an exciting startup company, KaiNexus.

The first 16 years of my career has been an interesting journey: General Motors, Dell, Honeywell and a total of 10 years in the “lean manufacturing” world, with a transition in 2005 to “lean healthcare” consulting and writing. From 2001 to 2004, I had a detour through a lean-focused startup company, Factory Logic, and I've always enjoyed the small organization setting and the opportunity to build new things, like the Healthcare Value Network that I've helped build over the last two years.

So, please forgive me for writing a blog post about myself. Since I often get asked, usually in a friendly way, “So, um, what exactly do you do?”, this blog post is a chance to talk about that…

Lean Enterprise Institute / Healthcare Value Network

First off, I am ending my formal role as a Senior Fellow at the Lean Enterprise Institute after two full years, but I will continue as an LEI faculty member. With this change, I will be scaling back my involvement with the Healthcare Value Network to a few limited projects, such as the continued marketing of our new strategy deployment DVD.

I certainly still strongly support both organizations and I have enjoyed my contribution to expanding the Healthcare Value Network from 14 to 36 (soon to be 48!) member organizations, participating in our Lean Healthcare Transformation Summits (including the 2nd Summit, held last week), as well as working on healthcare workshops and publications. It's been great to be a part of the LEI team and to work with the great people at ThedaCare and the ThedaCare Center for Healthcare Value. They are doing amazing things to improve healthcare around the world.

Constancy, Inc. – Consulting and Speaking

Moving forward, I will be expanding my Lean healthcare consulting work through my company, Constancy, Inc. Additionally, I will be taking on more speaking engagements, represented now by the BrightSight Group. I'm also writing my upcoming second book, Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Improvements, due out in spring 2012.

KaiNexus – Making Improvement Easier

Now to the startup news – my title at the company will be “chief improvement officer,” a hybrid role that combines development of the company's sales process and its implementation strategies. As with any startup, it's a chance to wear the proverbial “many hats.”

KaiNexus “makes improvement easier” for healthcare by facilitating improvement communication throughout the entire organization.   While heavily based on Lean and kaizen philosophies, it is built for the realities of today's complex healthcare organizations, helping better facilitate staff and physician-driven continuous improvement efforts.

Earlier this year, I was introduced to Greg Jacobson, MD, one of the co-founders of KaiNexus through a mutual connection – another emergency room doctor who is a reader of Greg started the company with Matt Paliulis, an experienced IT business consultant, based on Greg's experiences as a resident and faculty member at Vanderbilt University Medical Center.

Here is a quick overview video with Greg.

One thing that was a challenge for Greg was being a healthcare professional who worked nights, always having ideas for process improvement at times like 2 a.m. But who do you talk to, with no managers or chiefs around? Does that idea get lost forever, due to the extreme busyness of the emergency department, or is there a process and infrastructure for managing those ideas and opportunities for improvement? I think we all recognize that traditional suggestion boxes don't work.

You can read more of the history KaiNexus, but the short version of the story involves Greg being given a copy of Masaaki Imai's classic book Kaizen and building an early version of the software. After early versions were used within VUMC, Greg and Matt worked to commercialize the technology, licensing the idea and starting the company to build what is now their full software release.

Why am I joining the KaiNexus team? There are a number of reasons… for one, there's an opportunity here to help spread the message that front-line staff engagement and daily continuous improvement is a critical aspect of Lean. Far too many organizations associate Lean as only being about  sporadic and episodic projects or events. I think KaiNexus can help accelerate the acceptance of daily kaizen in the healthcare world. It's also a chance to be part of the management team for a startup that's going to do things in a very different way than the other startup I worked for – but I'll write about that more in the future.

Here is a short video, recapping this announcement, that is part of our online press release:

So Why Software?

You might ask, “why software?” When I've taught and implemented continuous improvement and kaizen systems in healthcare, I've always used very visual and manual systems, like what you see pictured here from a hospital lab. These are paper cards and the interaction between team members and managers is typically done face-to-face or via comments and notes left on the cards.

One pain point my clients have seen comes back to Greg's 2 a.m. dilemma – hospitals are 24/7 workplaces that are greatly distributed in time and space. This means we can't rely on face-to-face communication as the only approach. There's a role for the smart use of technology and electronic communication, something that's been proven out through the early use of KaiNexus at VUMC. I know also that many other hospital systems have gone down the path of building their own intranet systems for managing kaizen. We hope these do it yourselfers will consider KaiNexus as a standard platform that goes well beyond what they could build in house.

Another reason I'm getting involved is that Greg and Matt are keenly aware that software is not a silver bullet. An effective kaizen system requires building the right leadership style and culture. While software can help prompt some of the right behaviors and responses, technology can't change an organization's culture by itself. With KaiNexus, I see a unique opportunity to blend classic Lean approaches with new web-based technology, done the right way.

Wrap Up and Request for Feedback

In addition to all the topics that I normally blog about, including general kaizen principles, Lean healthcare, and Lean leadership, I will give occasional updates about the company and what we are doing. Just as this was not an official “LEI blog” while I was working for them, this will not be a KaiNexus company blog.

I'm very interested to hear your feedback about my announcement and as I share more about KaiNexus over time. Please post a comment below or send me a private email.   And please follow us on Twitter and LinkedIn and “like” us on Facebook to receive more frequent updates.

Thanks for reading my blog, in general, and for reading this post.

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Check out my latest book, The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation:

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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,

    You have inspired and helped many who truly believe in better ways. My best wishes to your continued career success and impact in healthcare and the lean life.

    Jim Baran
    Owner, Career Kaizenâ„¢

  2. Welcome to the wonderful world of software development! Now, mayhap, my blog/twitter will be of more use to you :)

    Congratulations! New roads are always exciting. Let me know if there’s anything I can do to help out.

    • Thanks, Andrew. I was part of a startup before, from 2000 to 2004, although that was very much the traditional path, as opposed to the newer “lean startup” ideas that make so much sense. I will definitely be following that world and blogs like yours more closely, although I’ll still be rolling up my sleeves for lean healthcare work. It will be interesting to see what lessons are transferable across the healthcare and software boundaries.

  3. Here in the Dining Services Dept at the University, we have hung a large whiteboard in the work area, provided markers and labeled it the Lean Idea Board. Staff can post an idea anonymously or leave their name. If we implement their suggestion and it works, they receive a prize.

    I have enjoyed following your blog and learned a lot. Best of luck to you in your new venture.

    • Thanks, Kay. I hope you’ll check out the Kaizen book when it comes out in early 2012.

      To be a Lean idea board, the bias of supervisors and leaders really needs to be toward approving every idea or working with people to find something that does work. This should work and feel different than an old traditional suggestion box, where managers just vote yes or no without dialogue with the employees.

      There are many pro’s and con’s to giving prizes or rewards for ideas… something else we are covering in the book.

      Either way, I hope your method gets people engaged in improving their processes!

      Thanks for reading.


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