Throwback Thursday: This Hospital CEO Was Never Going to Get Lean

throwback blame baby

I have many experiences in healthcare that I haven't blogged about. I try not to write posts that say, “Hey, you won't believe what happened yesterday,” for a number of reasons. But, sometimes, my memory gets jogged and a story comes back to me. That's what I'm sharing today as a Throwback Thursday.

A while ago, I was brought in to work with a health system and its management team. They had done the pilgrimage to ThedaCare, a great Lean healthcare system in Wisconsin. They had been “implementing Lean” for a number of years.

But, as Dr. Deming used to say (and I cited recently):

“I think that people here expect miracles. American management thinks that they can just copy from Japan–but they don't know what to copy!”

It's tempting to visit a place like ThedaCare and then mandate “everybody must have huddle boards.” Then, a bunch of huddle boards get purchased and installed… and maybe not used.

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It's another thing for executives to realize that they have to change the way they manage. There's a great quote that ThedaCare folks readily share, including Kim Barnas in her book Beyond Heroes:

Telling everyone to put up huddle boards is “changing the way people work.” That doesn't mean the CEO and senior leadership team are changing the way they manage.

So I was in a discussion with the CEO and leadership team. We were discussing definitions of their “True North” and, thankfully, quality and patient safety was a topic.

The VP of Nursing and Quality was talking about a recent “sentinel event,” where a patient specimen was lost somewhere along the way, most likely in the lab.

There was some good discussion about identifying the root cause and the need to take corrective actions that would prevent similar occurrences. The problem wasn't going to be solved in the board room, but the discussion wasn't focused on blame and punishment, but rather getting people to investigate.

iStock_000001615240XSmall finger point

I could see the CEO getting visibly impatient and squirmy.

He blurted out, with a somewhat angry tone:

“But…. but…. sometimes people are just going to be idiots!”

Well, there you have it.

Can a leader change if they have decades of accumulated “blame and shame” habits?

That's not a Lean thinking CEO. Is that a CEO who has a fighting chance of changing their approach and leadership style? Or is that a CEO who is likely to be tuned out and marginalized by those who are budding Lean thinkers?

What would you do or say in a situation like that?

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.

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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. For the hospital’s sake, let’s hope that the CEO was just having a bad day.

    But point taken. Over the years, I’ve learned to predict the success of an organization’s Lean journey by observing leadership’s temperament and style.


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