Franciscan Kaizen Video #7: From Kaizen to Innovation in the NICU


kellyToday and tomorrow are the days for our first on-site Kaizen experience at Franciscan St. Francis. I'll be sharing things on Twitter (@MarkGraban) and I'll encourage attendees to do the same. I'm going to be using the hashtag #KaizenLive.

Today, I'll share the seventh video in a series of clips that I shot last October at Franciscan. See all of the videos here.

This video features Kelly, a nurse in the NICU who built upon her success with Kaizen-style continuous improvement to create something that counts as innovation – a new invention. The mattress cover that Kelly describes in the video is something the hospital is going to help apply for a patent on.

I think this video goes to show that opportunities for innovation are all around us if we keep our eyes open and look for problems to solve. I think this fits into the category of innovations that we find by implementing lots and lots of little ideas, as this Japanese hospital CEO said.

It's also a great example of making it easier for staff to do the right thing. The old mattress covers were too hard to use with the heavy mattresses. Instead of just blaming or lecturing staff (or threatening to punish them), Kelly and Paula figured out why it was too difficult to do the right thing and what they could do about fixing it, making it easier.

Here is a transcript of the video. Paula is the manager in the NICU.

Paula: I really want Kelly to share this one with you, because we're actually thinking about going for a patent on this, or submitting it at least to the company.

Kelly: First of all, we had a…I'm the skin care rep for the unit. We had a pressure ulcer on the back of a baby's head. That is a big-time no-no. We don't ever want that to happen. It was very devastating for that to happen.

I work with the skin team. I did a little bit of research and got ahold of the rep about the Z-Flo mattress. These are super, and you can fill them with air-infused fluid. They have no memory in it, so it does not push back against the baby's skin.

It was a perfect, wonderful positioner that we used. When we got it…We don't like change here.

Paula: Really?


Kelly: People don't like change.

Man 1: They all love change here.

Kelly: The mattress was kind of heavy. When we put it in these bags, when you put the mattress in these bags. We have them here. If you want to do a check on the baby, and they've been soiled…

[bell tone]

Kelly: First of all, the mattress cover that came with it…

[bell tone]

Kelly: We like pretty blankets. This is not pretty…

[bell tone]

Kelly: …and it's not soft.

[bell tone]

Even more than that problem…I need to shut that off…was that to put the mattress on, you would have to come pull this out here, so what happens to the baby in that meantime?

You put this on. You don't have to take it out to take the other one off, and it's very heavy, so like this. This is not working very well at all.

What I found was, I would get my baby's positioned really wonderfully, have this on, everything's great, protecting their skin. They're comfortable, parents love it.

I come in the next shift. It's on the side. One, it's getting dirty on the bedside tables. Two, the baby's not on it, getting the benefit from it.

I've got to ask staff, “What's the deal? Why don't you like this?”

“Well, it's a pain to change this. It's not cute. I don't like this, it feels like paper. It's not soft on the baby.” You really can't load blankets over it, because then you don't get the benefit of the mattress itself.

I talked to the rep and I said, “I really am thinking about making my own covers that are pretty.” She said, “Well, you have to use a thin fabric.” I said, “That's fine.”

I went to the fabric store and I found a lot of different cute prints, never [inaudible 2:57] it. I used coupons and got it on sale at JoAnn Fabrics. I found lots of cute baby prints because that's what our staff likes. It's nice and thin so they still get the benefit from the mattress.

Then I said, “I think we need to have a party where we can sew. We're going to bring our sewing machines, whoever wants to. We'll have a party, and we're going to design new mattress covers.” We looked at not just the way that it went on, not just the fact that we wanted to make it prettier. We wanted to see, “Was there was a better way for it to go on?”

We ended up designing…and people also like straps to go over the babies…so some of our other little positioners that we had have had straps to hold the babies in. We designed one that had straps, and the opening, instead of being at the top, ours were lengthwise in the back.

Then, what we can do is, if the mattress is dirty, you can roll the baby from side to side like you would an adult. You take the dirty side off, the baby's rolled over, then you roll the new one on. I'll show you what that looks like when it's on.

You don't have to take the baby off the bed. You don't have to take the mattress off of the bed. It's pretty. The parents love them and it's been a lot of fun.

At first, I was sewing a bunch of them at home myself. I don't have a lot of time. I'm working full-time and going to school full-time. Then, I started thinking, “What can I do to get more help in this?” I made a pattern and I put instructions with them. I had them in a little packet just like you would a pattern that you buy from a store. Then I was like, “Do you sew? Do you sew? Do you sew?” [laughs]

Paula: Anybody in the unit?

Kelly: Anybody in the unit. Anybody that would.


Kelly: My mom had never seen a Z-Flo mattress, but she sews a lot. So I made one cover and gave her to it with a pattern. She had started sewing them now, but she was, “Look, I at JoAnn's, I got some fabric on sale.”

I was really hoping that if the staff joined in and if they made them, they would take pride in it and want to put them on there, “Oh, that's the one that I made,” and want to be involved in it.

Then when you see the difference of the baby laying, all wrapped up and cuddly like this, in a nice mattress. They're so comfortable, the parents were like, “Oh my gosh. That's a huge difference.”

They love it. It's pretty. Do you know any baby that…They're not comfortable for so many different reasons in here. This has made them feel comfortable. It's soothing. It feels like they're inside the womb again, so it's a very comforting thing to them. I think the moms felt good about that, knowing that, “OK.” They all see them, and they're, “Oh my gosh.” They were so agitated, and then I see how they relax in here.

There were so many…I was really wrapped around this, that we were not just developing, getting it to prevent the ulcers, and then getting the staff to buy in. Designing the mattress, getting the fabric on sale, getting some donated…


Paula: …getting people to help clip coupons.

Kelly: Yeah.

Paula: 40 percent off at the store.

Kelly: Like I said, if staff thinks it's pretty, then they have some buy-in with it. If they made some, they're going to be more involved in using it. Then they know [inaudible 6:40] “I want to sew. I want to sew, too.” People like to do things…

What do you think? Please scroll down (or click) to post a comment. Or please share the post with your thoughts on LinkedIn – and follow me or connect with me there.

Did you like this post? Make sure you don't miss a post or podcast — Subscribe to get notified about posts via email daily or weekly.

Check out my latest book, The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation:

Get New Posts Sent To You

Select list(s):
Previous articleWe’re Ready for #KaizenLive on Wednesday & Thursday – Join Us Virtually
Next articleThrowback Thursday: Dr. Deming’s Last Interview & Jack Welch’s Thoughts on Him
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. It was great to get a chance to be in the gemba here this week with Mark and Joe Swartz leading a workshop… Nice to meet the staff there and to see this in person! They are engaged and proud of the ideas they have created – and implemented themselves!

  2. Working with sick infants as well, what a great idea. Kaizen has shown itself to be so rewarding for those involved in it. Thank you for that video.


Please enter your comment!
Please enter your name here

This site uses Akismet to reduce spam. Learn how your comment data is processed.