Kim Barnas on Beyond Heroes: Lean Leadership and Hospital Management Systems

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My guest for episode #197 is a hospital leader I really respect, Kim Barnas, author of the new book Beyond Heroes

Until very recently, Kim was a Senior VP at ThedaCare, leading Appleton Medical Center and Theda Clark Hospital. I've seen Kim speak to groups at ThedaCare and a few conferences and she has a lot to teach us about Lean leadership, using her stories and experiences in a way that's very powerful. I hope you'll check out the book. Read a press release about it here.

In the podcast today, we talk about topics including her initial reactions to Lean when first introduced to it as a hospital leader, why “heroes” are overrated and sometimes create “chaos” in healthcare, and the importance of moving beyond tools and projects to a Lean culture and management system.

2018 Update: What's Going on at ThedaCare?

Kim talks about the need to “create more value” (not just reduce waste), saying “just trying to do more with less makes no sense – you need a plan.” We also talk about programs like GM's “Speak up for Safety,” where she says that speaking up “needs to be a conversation, not a reporting” transaction.

For a link to this episode, refer people to  www.leanblog.org/197.

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

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) 372-5682 or contact me via Skype id “mgraban”. Please give your location and your first name. Any comments (email or voicemail) might be used in follow ups to the podcast.

Transcript

Mark Graban: Hi, this is Mark Graban. Welcome to episode 197 of the podcast for April 29, 2014. I apologize, it's been over a month since the last episode, but got a couple of great ones coming up, including today's discussion with a hospital leader I really respect. Her name is Kim Barnas. She is the author of a brand new book called Beyond Heroes that's just been published by the ThedaCare Center for Healthcare Value.

Until very recently, Kim was a Senior VP and a leader at ThedaCare, the health system where she was leading Appleton Medical Center and Theda Clark Hospital. She has a lot of great experience, a lot to teach all of us, I think, regardless of industry, about lean leadership and lean culture and what we can do from a really practical perspective. So I certainly hope you'll check out the book. Kim is also doing a free webinar for the Lean Enterprise Institute on May 6th and you can find links to that, to the book, to the upcoming Lean Healthcare Transformation Summit that I'll be attending and participating in in June. Kim's going to be a keynote speaker there. So if you go to leanblog.org/197, there's a bunch of links for a lot of free things you can take advantage of. Spend $35 on the book and if you've got the budget for it, the Lean Healthcare Transformation Summit. It's now the fifth annual event. This is by far the best Lean Healthcare conference of the year. So I hope I'll see you there.

Anyway, back to the podcast. Kim and I are going to talk about, you know, why the idea of heroes can be overrated or actually create chaos in healthcare, back to the title of the book, Beyond Heroes. We're also going to talk about–put her on the spot a little bit–asking her what she would do if she was leading General Motors. GM has a new “Speak up for Safety” campaign that the CEO announced and I'm kind of skeptical about. I've blogged about that recently, but Kim has some really good thoughts about how to get the environment to a point where it's not just about employees speaking up, but about leaders listening and collaborating with people. So lots of great insights from Kim. But again, go to leanblog.org/197 for links.

Well, Kim, hi. It's great to talk to you and it's a real pleasure to have you as a guest on the podcast. Thanks for being here.

Kim Barnas: Well, I'm delighted to be invited and excited about our conversation.

Mark Graban: Yeah. Well, I think we've got so much to talk about between the great things you've been doing at ThedaCare, what you've been sharing and teaching with people through articles and talks, and now the new book, Beyond Heroes, that is now available and we'll talk about how people can find that later and I'll have links on the blog. I had a chance to read an early version of the book and really, really enjoyed it. I think it's a book that's going to be very helpful to a lot of organizations. So congratulations on that, Kim.

Kim Barnas: Well, thank you. It certainly was a labor of love, had lots of help and support, and I want to thank you for that. You were one of those folks that gave me some good advice, but I tried to take this book and make it a story so that it's a little bit less academic and a little bit more about our journey and the stories that I think will help people learn.

Mark Graban: And I think it hit the mark. Those stories are powerful and make this really real for people in other organizations. And so before I talk about the book, I'm curious to maybe start and I'm curious to hear some of your reflections about when you first learned about Lean, you know, where you were in the organization. I'm guessing, correct me if I'm wrong, that you were at ThedaCare when this was all getting started. I'm curious to hear about what role you were in and some of that early journey of how you reacted or what your early experiences were about Lean.

Kim Barnas: Well, it's kind of fun to reflect on those days because I learned so much and I knew so little about Lean. And in fact, I considered myself one of those spontaneous people that lean would never be able to tame me. So it's kind of fun to look back and be in this position today. So when we started Lean and John Toussaint brought it to ThedaCare, I was a vice president in the hospital division, and one of the first value streams was our open heart value stream. So my first Kaizen event, my first value stream experience, was with our open heart team. We actually had brought in a consultant to teach us Lean, and the focus of that group was to really be on Value Stream analysis and Kaizen events and Two Ps, Three Ps and projects that came out of those.

One day, when I was really struggling with this language, I had my little lexicon book in front of me all the time. We had a new sensei who joined us, and he said to me, “I don't know anything about healthcare.” And I said, “I don't know anything about Lean.” So here's the deal: “If you teach me Lean, I will teach you healthcare.” And so that was José Batalhão, and we started our journey together. And I still consider him my personal sensei. But he helped me understand how deep Lean can go. And he helped me understand how it really helps develop our people and build our people into stronger participants in the process to own the work and to see improvement as an opportunity for them rather than a burden.

Mark Graban: Yeah, because I think there's a concern there that, you know, taking on new roles, new responsibilities in a lean leadership style is adding new things to people's plate. This is something I end up talking with people about a lot. And I'm kind of curious, from your own experience or what you've seen with other leaders, is there kind of a period where it is a bit of an extra burden because we're learning something new, it's uncomfortable, and then we kind of work through a cycle where it becomes more comfortable?

Kim Barnas: I think you summarized it really well. I think in the beginning because you're on a learning curve and it's a big change. It's kind of exhausting, and it's kind of trying to understand how this fits with my real work. And until people recognize that this becomes your real work, it feels additive. And so you have to create the capacity in your day and in the day of your peers and your employees to make sure that they have the time to learn and experiment with it and celebrate it. And then when it becomes part of their thought process, it changes the culture.

Mark Graban: So, yeah, I think that's a really interesting point. That idea of creating the capacity. There's some things I'll let you talk about that ThedaCare, I think, has gotten fairly well known for in terms of creative ways or systemic ways to try to free up time, if you can talk about that, and some of the other ways you actually create that capacity.

Kim Barnas: Well, in the beginning we took people offline, we hired facilitators, and we gave them the time to learn through the Kaizen process, which by the way, I think is critical. I'm going to talk later about our management system, but we don't believe you can have a management system without the rest of the lean package. That's just part of it. And so John was really elegant in his perception that we needed to develop our leaders. And so many of our leaders left their leadership role to become facilitators and that created the capacity for them to learn. And then as we moved into our events, we pulled people offline for the week to do that work. And then we created time to teach them in the work. We made them the communicators and the owners in the work. What we also did in the beginning was rather than taking the waste out and cashing it in every time, sometimes the cashing in was investing in our people to create time in their day to do improvement work. And that was a pretty significant investment and it really paid off.

Mark Graban: And then later on, at what point there's the famous “no meeting zone,” or I don't know if that's the exact term that's used, but can you talk about that as a different way of freeing up time?

Kim Barnas: Yes. That came later as we decided we were going to develop a management system. One of my concerns was how are we going to have the time to do this work? And so the leadership team in the hospital at that time had a conversation about it. And I said, “I think we need an hour or two a day to learn how to manage and how to work on improvement.” And one of my colleagues said, “I agree, I think we should have a no meeting zone.” And I said, “I think it should be from 8 to 10. We should start our day that way.” And the COO at that time, Matt Ferman said, “I agree, let's have a no meeting zone from 8 to 10.” So that's the scientific method that we used to get to the no meeting zone. And it was profoundly effective. It still exists today. That was in 2008. I believe that we formally set that. And what we do in the no meeting zone is we go to Gemba, we work on projects, we influence each other, we look at our huddle boards, we do our stat sheets, we have conversations, and we may still have a meeting here and there. So the goal is 80% of the time you're in the Gemba, 20% of the time you may have to go to a system meeting, or you may have to meet with physicians, because that's the time that they have available. But it is very effective, and it's been very much embraced in the hospitals.

Mark Graban: So I guess the scientific method aspect of it was there was this hypothesis that creating that no meeting zone would be helpful. And that's what played out through those experiments.

Kim Barnas: Exactly.

Mark Graban: So I think having a culture of scientific experimentation is different in a lot of ways than a culture of heroes. And I'd like to kind of bring things back to the title of the book, because I think it's an interesting title and a provocative title. Beyond Heroes. You know, a lot of people think, well, wait a minute. Heroes… that's a good thing. Heroes… it's a very positive connotation. They're doing great things. They're going above and beyond. But, you know, why would you say, or tell us about the title, “Moving Beyond Heroes?” Why do heroes sometimes really not make things as effective as they could be? And you're proposing, I assume, some alternatives to that heroic behavior? Can you talk about that?

Kim Barnas: I think there is still a role for heroes in the hospital. I think it's a limited role. I think when you have a physician who's trained to do surgery a specific way and to think in a critical way, something doesn't go well because the anatomy is different, the physiology is different, the equipment fails, you want somebody that can be heroic in terms of taking that next step, but everything around him or everything around that work should be managed by a process. And if you manage the process and the right equipment is in the right place at the right time and it's clean and it's positioned correctly, it makes the flow of all of the work much more effective and doesn't require the nurse or the CNA or another staff person to be heroic in trying to find and grab and clean and move things around.

So when we talk about heroics, we really think about how do we use teams to develop processes and within those teams, how do we experiment with the process and create the standardized work and the standardized process? And then once we have that standardization, how do we see the variation from that process and come back and improve it again as a team so that there's not one hero that comes back and makes the changes that everyone else has to influence? The second aspect of that is we have 6,000, 6,500 people that all we want to make changes every day. If we weren't making changes in a methodical process way, those 6,000 heroes would create chaos. And so it's really important that we understand why the processes are in place. We recognize that you improve from understanding the variation and that you have a controlled experiment for improvement. So you always have the best known way to solve the problem or to do the process.

Mark Graban: And is it fair to say that the part of our brain and our motivation that kicks in to be a hero is now something that's used much more rarely? You know, that… that occasionally there's still going to be time for a hero, but it shouldn't be a regular, everyday thing.

Kim Barnas: Exactly. We want people to use their brain and to use critical thinking. And we think by establishing stable processes and allowing them to improve them, we're actually creating more value. There is still a role for a hero from time to time, but it should not be an everyday occurrence.

Mark Graban: And there's one thing that you said there that maybe I'd like to ask you for an example of. When you say creating more value, I think that's a key Lean idea. Sometimes people get so wrapped up in the idea of, you know, eliminating waste. But can you give an example of where Lean has helped staff physicians, you know, provide more value or the right value for patients?

Kim Barnas: I think about when we are using our collaborative care model and we have used our lean methodology to develop how the team works together with the patient and their family. So when you're part of that team–you're the pharmacist or you're the physician or the nurse, or you're the patient or their family member–when you get together and you follow the protocol of discussion for a care conference so that everybody is on the same page, you not only create value because the patient knows why they're there, what's going to happen next, what their medications are, who their nurse is, who their doctor is, what their care plan is, when they plan to go home and you have one conversation and the pharmacist is there saying, “These are the medications that you're on, and I'm going to help you understand how to take them when you get home.” And everybody's working from the same playbook. It eliminates the redundant work that every one of them had to do in the past by reiterating their part of the care plan and not being connected to a whole process. And so I think it adds huge value to everybody to have that one conversation, but it also removes the waste in the process of reiterating and redoing and reworking those processes based on your particular perspective, nursing or physician perspective.

Mark Graban: Yeah. And is it fair to say, I mean, we talk about… I know there's been goals for productivity improvement at ThedaCare. Sometimes people, I blogged about this recently, people talk about focus on the “doing more with less,” you know, and unfortunately then, you know, people are just thinking about, “Oh, no, you know, less, less people.” But the “doing more” part. I mean, can you talk about instances where perhaps productivity improvement led to increased capacity and maybe being able to do more with basically the same resources, the same number of people?

Kim Barnas: I think that that's a really important concept that you have to have a plan. So just trying to do “more with less” makes no sense at all, especially at the bedside. And so if you say to your team, “Okay, guys, we're going to get 3% productivity improvement, go get it.” If you don't have a plan to do that, you start doing silly things like cutting back hours or cutting back education and those kinds of things. And we have all done, if we've been in healthcare for any length of time at all.

One of the things that we are doing at ThedaCare, specifically in the hospital division–it's been an experiment that will spread through the system–is every unit has their own value stream map where they're looking at their patient flows and where their opportunities for waste removal are. So when they pull out waste, then how do they create capacity in the schedule of the nurse or the schedule of the physician or the others? So that's how we try to target our productivity improvement. Again, I think it's really important. There's so much happening in healthcare right now, I'm a little concerned about the effect of only taking a productivity approach without a plan on nursing. Nurses have so much that they're responsible for. They are the reason that hospitals exist. They're the touch of the patient. And value is added when they're there to listen, to talk, to educate, to support. And I want to be sure that that's never what gets cut. I want the other things, like a more efficient medication distribution process, to give them an extra 20 minutes or an extra 40 minutes in their shift that they can then spend with patients. So those are the kinds of things that we're looking for.

Mark Graban: Yeah, and I apologize, I'm not one normally to fixate on productivity. Maybe if you can recap for listeners who aren't familiar. I mean, I think one thing that's impressive about ThedaCare is the clear articulation of the True North objectives that include safety and quality. For people who don't know, could you kind of recap at least what the latest iteration of that True North looks like?

Kim Barnas: Our True North metrics, we consider how we measure the health of our organization. And one aspect of True North should never be done at the sacrifice of another. And so at the top we look at it as a triangle and in the middle of the triangle is our customer, our patient, and we actually give her a name. She's called Lori. And everything we do is around Lori. It's to improve the experience of Lori. At the top of our triangle, we're looking at safety and quality, and we have metrics around mortality and safety bundles and those kinds of things at the top. And then on the lower left-hand side of the triangle, we talk about our people, our engagement, how do we take care of our people. And then on the right side of the triangle is financial stewardship, not productivity, financial stewardship. And so we try to keep all of those things in balance and assure that we have metrics around those at a system level and then that cascades down to the divisional level and then it cascades down to the front line. So all of the work that we do that we resource in a significant way has to tie to those True North metrics so that from the frontline staff to the CEO, we're all rowing in the same direction.

Mark Graban: And so on that note, I mean, that's one thing that I've been so impressed by when I've been able to visit ThedaCare is that alignment there. You get that sense people are rowing in the right direction. That seems like such an important aspect of a lean management system. So I was wondering on that note, can you describe maybe some of the origins or how you would define a lean management system as something to build upon? Lean methods, rapid improvement events, really creating that culture.

Kim Barnas: So we were into our journey about two years when we decided to get some exposure to daily continuous improvement. And the way we moved forward with that was to run an experiment where we took one of the facilitators that was trained by our consultants and our sensei. And we picked out a manager and we sent that facilitator and that manager to see to find a problem on their unit and create a way to work that problem daily. So they created visual management. They did an A3 and they were looking at root cause. And the facilitator stayed with that manager for 30 days, and then they left. And the manager was left to manage that process on his or her own. And what we found was other things got in the way. That may have been the priority 30 days ago, but this next 30 days we have another priority, and then we have another priority. And pretty soon that was lost.

So after trying that a couple of different times, I met with my sensei who had worked in other organizations that had some kind of a system. And I'm embarrassed to say this, but it's important that people hear it. He and I went to dinner every time he was here for like a year. And he pulled out a napkin at every dinner and he drew me this picture. And he said, “Kim, this is a cell. And when you improve things in one cell, then you can spread it to two. And if it works in two, then you can spread it to four. And if it works in four, then you can spread it everywhere.” And I would say, “You know, that's really nice. Thank you for sharing that with me.” And being the Socratic sensei that he was, he would never tell me what he really meant.

One day I got it, and what he was trying to say was, you can't just… you can't sustain things by sending a facilitator to lead something and expect people who have no infrastructure to spread it. So I asked him to teach me, in a less Socratic way, more as a subject matter expert, what it looks like in an industry. And so he drew me pictures and we had a lot of conversations and we pulled in another sensei and we actually did a Kaizen-like event where we spent a week looking at what does good look like in an industry that has a structure, an infrastructure to support their lean methodologies. And in particular, we were thinking about how do we sustain the gains that we have been getting from our value streams and our Kaizen events. And so in that event, we actually came up with 56 pieces of standard work that we thought we needed to create to make this system structure begin. A month later, we pulled together 30 other team members and we started writing the standard work. And then we began experimenting with it. So it took us about two years to get to the point where we actually had a foundation of a management system.

Mark Graban: And so then, boy, having a foundation of a management system and all this time, I mean, this is, this is by no means a quick fix. Was it to really change?

Kim Barnas: Yeah, it's not.

Mark Graban: What were some of the next things that moved it along or maybe even in hindsight might have been able to move things along? I don't know if faster was even… would that even been helpful or was it just… did it… was it important that it went along… was it sort of moving at a natural and sustainable pace?

Kim Barnas: I think that it needed to take us that long because we needed to experiment with it and we didn't really know where we were going, to be honest. We sort of had this vision at the end of what it would look like, but we didn't know what all the pieces were going to be. So I need to be really clear that this is how we developed a management system. We're hoping that by us talking about it and writing the book and sharing the book, that other people can do this much more quickly. And we in fact have seen that where we have actually taught other systems and they're up and running within a year, they're actually running within six months and running smoothly within a year.

So I believe that it needed to take us that long because the way we went about it was we wrote the standard work and then we chose two VPs with two managers each to be our developmental experimental labs. And we'd go and we'd execute the standard work with two facilitators watching us and making notes. Then we'd come back and critique and tweak the standard work. And the next day we'd go back and do it again. And when we thought it was running well enough in one cell, one unit, then we'd spread it to a second cell and see, does it work as well there? And so before we actually got into any spread methodology, we worked with four primary cells and we ran experiments every week.

Mark Graban: And I mean, did, I guess, thinking about experiments. Were most of those experiments successful? Were some of them just okay and you had to tweak it? Were any of them, you know, a quote unquote, failed experiment as part of that learning process?

Kim Barnas: Well, you know, we experienced failure when things didn't go the way we thought they would. But I don't think any of those experiments truly failed. We learned from what didn't work and we made it better. And so when, you know, the best example I can give is when we first started trying to do a stat sheet. We took the VP and the manager and the lead supervisor to ask these questions, and they'd ask these questions and then when we get done, we'd say, “Did that help you? Is that going to help you manage your business any different today?” And they'd say, “No.” And we'd say, “What would help you? What are the questions that would make your day better?” And so we'd go back and we'd experiment with those and then it was okay. So we're asking these questions and we're getting yes or no answers. Is that really what we want? Isn't the purpose of this to get to their critical thinking? So how do we ask questions differently? So how do we… now that we're asking these questions and we're understanding where our problems are, and by the way, we're seeing problems we never knew we had, how do we coach them to improve? And then how do we use the lean tools? How do we teach at that level? A3 thinking in the work. And so it uncovered lots of opportunities. None of them were failures, but we learned that we weren't going deep enough in the beginning and how to go deeper each time we do it. And I would venture to say that if you go see a stat sheet now, after eight years in those units, it looks nothing like it did when we started. And I guess that's the point. We're on a continuous improvement journey and so we continually change.

Mark Graban: Yeah, yeah. And I think that's, I mean, that's a really healthy attitude to try to bring into the organization that a quote unquote, failure is not something to punish people for, but something to learn from and to build upon. And so kind of, you know, thinking, moving things a little bit different direction in terms of, you know, trying to change culture and responding to things. There's been a lot in the news recently about General Motors and the CEO there, Mary Barra has this big push in this program and I get skeptical of programs, but it's called, you know, “Speak up for Safety.” And they're trying to encourage all the employees, if you see a problem, to speak up. And they promise, well, okay, of course we won't retaliate against you and we're going to help you. We're going to respond. But the traditional culture at GM is one where a lot of times people tried to speak up and the system managers culture wouldn't let them. So I'm curious, thinking about culture change in healthcare, there's often similar dynamics of trying to encourage people to speak up and to call out near misses and to do a better job of reporting errors. Do you have any reflections on all the time you've been involved in what helps create a culture where people are speaking up and things are actually being fixed?

Kim Barnas: I think it's very important that the leadership is present in the work and that it's a conversation, not a reporting. And so I would love to say that we were stellar at safety and we're really working hard at that. So, you know, my teams would make safety rounds every day, and as part of our huddles, we always ask safety questions. And solving safety problems is, for some reason, it's harder than you think it's going to be, but it's not because people won't speak up anymore. So let me just talk about an average week at ThedaCare or an average day.

On Monday morning, my leadership team meets at our huddle board, our visual management. We talk about what happened last week. How are we driving performance? Have we improved? Where did we fall down? What do we need to do differently? And now that we know that we've got this, where can we go and see it? The second question is, “Are there any safety concerns?” And so we bring our safety officers with us and we take our managers and we all divide up the hospital, we go to different floors and we're looking for safety issues in a way that says, “How can we help you?” So people are pretty comfortable speaking up at that point. When we see safety issues, we then bring that to the stat sheet in the morning, on the next day, and also to the huddle. Of course, if it's an imminent safety issue, we do something on the spot. Safety is number one. So it comes to the huddle board. So let's say we noticed that there was a cord hanging in front of the bed of the patient where there was a blood pressure cuff. The safety issue is that somebody could knock that off. They could hit somebody in the head, they could break the equipment, they could, you know, it could fall and hurt a patient. So if you see that and you go to the huddle, which is a couple hours later, and say, “This is what I saw, how can we make this better on your unit?” And if it works, then how do we spread it somewhere else? “Is there somebody who has a particular interest on your unit that would like to help us solve this safety problem?” And you know, you never, whoever brought you the concern, you never assign the follow up to them because once you do that, no one will ever bring you anything again. So when someone brings forward a defect, we ask for volunteers and then we offer the resources to help them solve it. So we give them a facilitator to support the A3 thinking and the root cause analysis. The manager may join them. If there seems to be some sort of a power differential in terms of working with another unit to get it done, we decide whether this is a big enough project that we could just do it. It takes three steps or less. Or do we need to have an event because it involves another floor? So there's a lot of discussion about how do we support the improvement. There's not a blaming aspect to it in any way.

Mark Graban: Wow. And any interest in going and helping GM with all this?

Kim Barnas: Are you volunteering?

Mark Graban: I'm trying to volunteer you or I'm nominating you. They could probably use some help because that's an organization much bigger than 6,500 people. So it's a much bigger culture change challenge.

Kim Barnas: It's hard to move.

Mark Graban: Yeah. Well, final, final question after putting you on the spot with GM talk. Gosh, we're talking about healthcare and maybe this is a question that applies to people even if they're not in healthcare. If you would have advice for, you know, aspiring lean leaders, let's say there's people who are in the middle of their organization. Their director, their vice president. They've done great things with lean, you know, locally, within a department or a value stream. But they're, you know, they think, “Gosh, you know, the organization's not moving fast enough. We don't have that support from the top.” What would your advice be to them?

Kim Barnas: Well, I think it's very hard to move forward without the support from the top. The way that you get support from the top is you show them results. And so what we found with our lean management system was we started with those four cells and when all of them were doing better on their metrics than everyone else, then people wanted to know what was the magic. And so they said, “VPs.” And so then we had a next class with eight managers in it. And when they started doing really well, more people wanted to come. So, you know, positive results garner support and garner pull. And I think it's really important to not push these kinds of things, but to create the environment where people see the benefit and pull for it. So my advice is to start somewhere and to show results and engage your one-ups and find ways to celebrate and present your work to them. But when you start seeing those results, other people will take notice.

Mark Graban: Well, thank you for sharing that advice. And to wrap up here, again, the book is called Beyond Heroes and I really recommend people who are either working in healthcare or just interested in healthcare. So it's a really well-done book and I want to thank you and applaud you for that. Kim, I know you and all the other people at ThedaCare who help share these stories. Can you talk a little bit about where the best ways people can find the book, other resources and information about it?

Kim Barnas: Well, my understanding is that it will be on sale at the Center. The website is createvalue.org on the 29th of April. I know there's some planning for it to be available through Amazon at some point and there will be a Kindle version at some point. I don't actually have firm dates on that yet, but it will be available for purchase on the 29th. The website is createvalue.org.

Mark Graban: And if people have questions or want to follow up with you, can they contact you through the center or through the website there for the book?

Kim Barnas: They should contact me through the center.

Mark Graban: Okay. And again, that's createvalue.org. Well, again, Kim Barnas, it's… I'm so happy we're able to finally have you as a guest on the podcast. When we started talking about this, I thought, “Oh no, wait, no, I haven't interviewed you yet.” So I'm really happy that we had the chance to do that. Hopefully we can do this again sometime because there's so much more I think we could delve into. Hopefully you'd be open to that.

Kim Barnas: I would be totally open to that and welcome it. So thank you so much for inviting me and I hope I added some value today.

Mark Graban: I'm sure you did, and I hope I didn't create too much waste in the process for us getting there. But thank you. Thanks for a really good interview. Appreciate it.

Kim Barnas: Thank you.


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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 latest book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation, a recipient of the Shingo Publication Award. He is also the author of Measures of Success: React Less, Lead Better, Improve More, Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean, previous Shingo recipients. Mark is also a Senior Advisor to the technology company KaiNexus.

2 COMMENTS

  1. Hi Mark, excellent Podcast, it created a lot of value for me.

    Hope the book is in the kindle version fast.

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