John Toussaint, Mayo Proceedings, on “The Promise of Lean in Health Care”


As he mentioned on his blog, John Toussaint has co-authored a piece that was published in the Mayo Clinic Proceedings:

“The Promise of Lean in Health Care” (PDF).

John is excited that the article will be read by many physicians, given where it was published.

The piece was co-authored with Leonard L. Berry, PhD, from Texas A&M. Professor Berry was “embedded” at ThedaCare for a year, studying the use and the impact of Lean management and improvement methods there and at other health systems.

Click on the image below to read more:
Screen Shot 2013-01-10 at 8.36.30 AM

The article gives a great deal of attention to the need to engage all employees in the improvement of their own work – otherwise known as Kaizen. Leaders need to change their leadership styles to shift from being top-down to being a coach and mentor.

From the piece:

Lean is a cultural transformation that  changes how an organization works; no one  stays on the sidelines in the quest to discover  how to improve the daily work. It requires  new habits, new skills, and often a new attitude  throughout the organization from senior  management to front-line service providers

Leaders must:

For Lean to take hold in an organization  and transform its culture to one of continuous  improvement, senior management must relinquish the role of master problem solver to those  who are closer to the problems to be solved to  benefit from their knowledge of the focal process, to give them hands-on experience in  using Lean methods and to see first-hand the  performance improvement and teamwork this  can create, and to promote an attitude that  what exists can likely be improved.

Respect for workers is critical:

Lean, in a sense, turns leadership upside  down, with front-line workers doing much of  the innovating and managers trusting them  to do it and supporting them. Respect for  the potential of front-line workers to have the  brainpower and commitment to improve the  work must pervade the organization. Respect  flows downward, not just upward.

Be sure to read the whole article.

Also, check out the education offerings from John and the ThedaCare Center for Healthcare Value, including my workshop – Lean Fundamentals for Healthcare Leaders.

Here is a video of Toussaint talking about the article:


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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. Good stuff, Mark. I had the opportunity to visit ThedaCare in December. It’s great to see what they’ve been able to accomplish live and in color. Our tour guides added some small subtleties that, if you are paying attention, indicate how deep in the organization the continuous improvement philosophy is embedded.

  2. Mark, thanks for highlighting this article-it’s excellent! It does an especially fine job of melding the science-oriented and culturally focused duality of lean. I think clinicians will value the clear expression of how lean is based in the scientific method and at the same time appreciate the cultural and organizational elements that are critical to success.


  3. Mark, a great article filled with all that hospitals could be. It is also a sad reminder to me that my hospital isn’t even close and that there are a lot of institutional and cultural barriers still to overcome. However, it gives me hope for the future!


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