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?

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  1. RalfLippold says

    …. 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?

    1. Mark Graban says

      Why should we change the behavior? I’d say because it’s good for the patients (or our customers) and good for the long-term health of the organization.

  2. John Hunter says

    Where are your answers to those questions :-( It is sad how much waste we all must suffer with due to our inability to adopt well proven methods.

    1. Mark Graban says

      I will share some of my thoughts later (including a little excerpt from the book)… But wanted to hear from others first.

  3. Mark Graban says

    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.


  4. Bart Sellers says

    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.

  5. Jon Miller says

    Because changes to work brought on by kaizen results in social threat and this if too often poorly handled.

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