Healthcare Kaizen: You Mean Everyone Isn’t Doing This?


I've done a number of radio interviews recently to talk about our soon-to-be-released book Healthcare Kaizen. I haven't posted them all here, but check out this page for links to what is already been aired (MP3 files).

In at least two interviews (the ones focused most broadly on the Kaizen methodology, I've been asked a variation of this question at the end of the interview:

This sounds a lot like common sense. You mean everyone isn't doing this?
– KOMO FM (Seattle) Radio Host

In the interviews (and the book), Joe and/or I talk about these key concepts of Kaizen:

  • Everybody should be involved in improvement
  • Managers must collaborate with employees, rather than just saying “yes” or “no” to ideas
  • Lots of small ideas can make a big impact on patient care and the organization's long-term success

Masaaki Imai wrote about Kaizen in 1986. Dr. Don Berwick wrote about Kaizen for healthcare in the New England Journal of Medicine in 1989.

There are lots of organizations that TALK about continuous improvement as a goal or an ideal.

Some of them put this up on the wall in mission, values, or vision statements (as shown in a slide I used last week at the event with Mr. Imai):

There are some organizations (like ThedaCare and the University of Michigan Health System, among others) who state a goal of 100% of employees being problem solvers every day (as shown in a slide borrowed from John Toussaint, MD):

If this is such common sense, why isn't everybody doing it? What are the barriers? What is your organization doing about these barriers to make Kaizen and continuous improvement a reality?

What do you think? Please scroll down (or click) to post a comment. Or please share the post with your thoughts on LinkedIn – and follow me or connect with me there.

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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. …. we are still not quite there where we wish to be.
    What may stand in the way?
    Current incentive system?
    Lack of trust across hierarchy, and amongst peers?
    Low involvement of workforce?
    Money for consultants, little benefit, positive feedback for employees engaging in the process?
    Micro politics amongst the workforce?
    Why should we change the current behavior (that is good for some), and if we want it to change, how to make it happen?

  2. John –

    So, my short answer to the “why isn’t everyone doing this?” question usually has two parts:

    1) the cultural habits of managers and organizations (kaizen isn’t complicated, it’s just different… the idea of truly valuing the ideas of front-line staff and collaborating rather than judging).

    2) people say “we don’t have time to do kaizen” — but that should be the first problem statement (“how do we free up time?) rather than being an excuse. If you want to make kaizen happen, you’ll find a way.


  3. Mark, “Why not?” is a great question. Leadership understanding of Lean is helpful, but you don’t have to be fully committed to a Lean journey to make this work. What is necessary is a certain level of respect for employees, long-term focus and a willingness for personal change. These attributes can sometimes be hard to find.


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