The power of the (Lean) startup mindset


Lean Startup Article from Canada

Last week, while in Canada, I saw this article in the Globe & Mail: “The power of the startup mindset.”

I was surprised that the word “Lean” didn't appear in the headline (there was physical space for it in the print edition). It was basically an article about the “Lean Startup” methodology, but it didn't mention Lean and it didn't cite Eric Ries and his book The Lean Startup: How Today's Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses.

(I'll be speaking about Lean healthcare at Eric's upcoming conference by the way — hope to see you there).

I'm not sure that “Lean startup” philosophies have become so widespread that it's now the only way that startups are being built. There are still “fat startups,” I'm sure, that work in stealth mode for months or years trying to build the perfect software that they are guessing is wanted by customers.

The article describes sounds what sounds like a classic “minimum viable product” strategy, using iterative development and customer feedback to prove out both the product AND the business model.

When Kira Talent released its first platform, it was little more than a prototype, hampered by a rudimentary interface and numerous bugs. It was, however, enough for the needs of its first customer.

Today, she still doesn't pretend to have all the answers. The close interaction continues, and the ensuing feedback is used to continually optimize Kira Talent's platform, which has undergone many iterations since its inception.

Ms. Cushman is part of a growing group of entrepreneurs who value experimentation and trial and error over the traditional approach of honing products for months before introducing them to customers. These companies understand that innovation is a messy, unpredictable process.

Anyway, check out the article… it suggests that larger companies are learning to use these “Lean Startup” techniques (companies like GE have presented at Eric's event, before).

The same mindset applies to areas like healthcare. Instead of working for months and months trying to develop a perfect process, can we start by implementing something that's better (but not perfect) and then iterate from there? Can we implement and test smaller batches of improvement? This can often be done by breaking large, unmanageable problems (like “patient satisfaction is too low”) into smaller problems (like reducing noise complaints). Many many staff ideas can be implemented and tested (as we write about in our  Healthcare Kaizen series of books) instead of relying on one large project to “fix everything.”

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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. Hi Mark,

    I am a senior at the University of Texas at Austin double majoring in Supply Chain Management and Arabic. I graduate in May 2014 and have accepted a full time position working for Cardinal Health in their EMERGE Rotational program. I am very interested in the application of lean in healthcare and so I frequently read your blog. I notice that a lot of the Kaizen events are based on improvements within hospitals.

    Above you stated:

    This can often be done by breaking large, unmanageable problems (like “patient satisfaction is too low”) into smaller problems (like reducing noise complaints).

    As I start my career in a medical/pharmaceutical warehouse just south of Seattle, I wonder what I can do to break down large, unmanageable problems before they even get to the hospital. Don’t you think many of the improvements made in your kaizen events could be traced back to the distribution centers and warehouses? Any thoughts?

    • Hi Nathan —

      Good luck to you as your start your career in healthcare. Thanks for reading my blog.

      One first thing to keep in mind is that there’s a difference between “Kaizen” and “Kaizen Events.” They are not one and the same. “Kaizen” (good change) doesn’t have to be a formal team-based event. Kaizen can be part of a daily process of small incremental improvements (as Joe and I write about in our Healthcare Kaizen books).

      I hope you are able to directly participate in Lean and Kaizen-based process improvement work at Cardinal. I also hope that includes working collaboratively with your hospital and health system customers.



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