Podcast #184 – John Toussaint, MD on CEO Challenges & Enduring Excellence, Lean Leadership, and Shingo




It's great to have Dr. John Toussaint back for episode #184 of the podcast (see links to previous episodes below). He is, of course, CEO of the ThedaCare Center for Healthcare Value and the author of two Shingo Award-winning books, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry and Potent Medicine: The Collaborative Cure for Healthcare.

In this podcast, we start by hearing John's thoughts on some of the top issues that healthcare CEOs are facing today, such as changes in payment structures and Accountable Care Organizations. We also talk about the “Enduring Excellence” program that Paul O'Neill and John are leading to teach healthcare senior leaders about Lean culture change and their important role.

This podcast was produced in conjunction with the  Healthcare Value Network as a continuation of their previous podcast series.

For a link to this episode, refer people to  www.leanblog.org/184.

Past episodes with Dr. Toussaint:

For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS  or via Apple Podcasts.

Podcasts Sponsored by KaiNexus

If you have feedback on the podcast, or any questions for me or my guests, you can email me at leanpodcast@gmail.com or you can call and leave a voicemail by calling the “Lean Line” at (817) 993-0630. Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

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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. Dr. Toussaint talked about the handful of Lean skills that a CEO has to have. It would be fun to know what that handful consists of.

  2. Today, I was listening intently to Dr Toussaint’s interview and was encouraged when he mentioned Atrius, yet discouraged to hear him say that Atrius had “gotten a little worse” in their ACO performance even though they are doing good things in Lean. A couple points need clarified:

    >> 1) They are not “worse” – Please see link to the article where Dr Lindsey explains this

    >> 2) It is also important to note that not all groups of Atrius have adopted Lean as their transformational approach. Harvard Vanguard was the Pioneer of Atrius’ Lean work and they represent about 90% of Atrius’ Lean efforts. In actuality, THEIR ACO results were a reduction in cost of this population of 4.5%. This number is comparable to John’s communication of Thedacare results, but even more impressive given that Harvard Vanguard is a multi-specialty group practice faced with negotiating with hospitals on lengths of stay, admits, and re-admits .

    >> 3) Atrius quality results for this year were reported to them by CMS as “spectacular” when compared to other Pioneer participants.

    Thanks for allowing me to share.


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