#TBT: Posts from August 20 in Years Past


Fthrowback 5S toysacebook and their “On This Day” feature is helpful because the platform often reminds me of what happened on this day in years past. It's often family photos, places I've been, or articles I've read.

But, since my blog posts automatically feed into my personal Facebook page, I'm reminded of those posts too.

By the way, you can connect with me and the blog on Facebook via my Mark Graban professional page and the Lean Blog page (which get you updates about new posts via your own Facebook feed, if you want).

Anyway, I thought these posts from August 20 in the past three years were worth revisiting (or just flat out visiting, if you're new to the blog)…

2015: Lean, Staffing, and Respect

So-Called “Just in Time” Retail Staff Scheduling is not Lean At All

This is a problem in retailing and sometimes in healthcare. I really recommend the book The Good Jobs Strategy that talks about the problem and alternatives for retailing… and I think the lessons apply to healthcare.

Listen to my podcast with the author, Professor Zeynep Ton from MIT.

2014: More Nurses or Less Waste?

Why “More Nurses” Isn't the Best Way to Solve What Ails Healthcare

To this day, I'm skeptical of the idea of passing laws to mandate patient/nurse ratios. I do believe that those ratios matter and hospitals should do a better job of scheduling and managing patient volumes as to not overtax or overburden those working in the system.

I'm just not sure passing a law is the best way to solve that.

I'm more certain that “adding more nurses” is, at best, a temporary solution (and an expensive one, at that). Our health system will be more affordable if we can reduce waste in the system to give existing nurses more time with patients… that will increase job satisfaction along with patient outcomes and satisfaction. And, with demographic trends in different countries, getting more nurses might not be possible. Some places have trouble hiring enough nurses as it is, today.

2013: Variation & Customer Needs

Gemba Wine: Variation in Wine Seals and Variation in Customer Needs

Is all variation bad? Not necessarily. What does the customer say? What do they need? What do they value?

I saw a similar thing last week when I volunteered at Garrison Brothers distillery.

Each bottle gets dipped in wax and there's variation from bottle to bottle. They have certain boundaries and quality criteria, but they LIKE to have a little variation because it emphasizes this is a craft product and it's not produced by robots :-)


Is all variation bad? No, but in healthcare, we have too much variation in process and method, which means patients too often suffer as a result.

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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.


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