Repeating the Same #Lean Mistakes Over and Over? Why?


Recently, when I posted a bit from the old 1984 NUMMI Team Member Handbook (more still to come on that), it allowed me to connect with Tom Wilson, a retired GM leader who spent time at NUMMI in the 1980s.

In looking through his LinkedIn profile, I saw some slides he posted about lessons learned from his career.

This jumped out at me:

One GM failure... implementing "Lean things" without understanding. Biggest GM failure was making Lean a program and not incorporating it directly in daily life.

This all seems so familiar 30 years later.

The full context of his slide:


I can understand why he was frustrated.

Organizations, in healthcare and other industries, too often implement Lean tools (Lean things) without understanding the intent (what problem are you solving?) and the underlying philosophy of the tools.

This often leads to situations that are L.A.M.E., not Lean.

Too many organizations today still often view Lean as a program.

It's too often:

  • Training for front line staff and managers (as if the problem is them)
  • Projects and events
  • Tools and random “implementations”

Why is that still so common today? Why doesn't healthcare learn from the lessons and mistakes made in manufacturing and other industries?

Because we're different?

Tom added some comments to my post about this on LinkedIn:

“It's easier to try to implement THINGS and say “yep, we did it” than it is to change people's thinking and corporate mindset! Plus, when you make it a separate EVENT rather than trying to incorporate “lean” into the daily work, it's much easier! Implement visual controls for example! Easy to see….. but WHY?”


“The “THINGS” or “PROCESSES” are very important , but mean nothing unless the organization understands WHY and embraces the changes! Many times LEAN is looked at as a threat…. to jobs, the old methods of doing things and the security the old methods bring! Keys are WHY WHY WHY they need to be done and how does the organization benefit!”

Asking “why?” is certainly a good Lean habit.

How else can we learn more from the lessons of GM and NUMMI? See these past posts:

NPR on the “End of the Line” at NUMMI and My Story About an Interviewee

Yesterday, at Mary Greeley Medical Center in Iowa, we heard people who get it – those who bemoan Lean as tools… they realize Lean is not just a program. As somebody said, “Once you label it a program, employees will tune out since they think it's another program of the month.”

Their CEO doesn't just support Lean, he understands that safety and quality start with him. That gives Mary Greeley a huge advantage that many health systems don't have.

I'll blog more about this event soon, too, but here's one picture. You can see more quotes at #iowalean on Twitter.


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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. From LinkedIn:

    John T Bushling: Mark Graban, as you indicated, ‘they’ want to implement tools with little or no understanding. (We read the books, went to a seminar or two and hired a short term consultant to make pretty visuals.) They want to ‘be’ Lean but what they mean is they want a program with ‘showtime’ charts and graphs and a couple of Power point presentations to show proof of projects. A lot of head knowledge and no heart knowledge. No offense to consultants (I do that). The problem is that typically they want a whirlwind consult but don’t want to spend the time to ingrain into the culture. Unfortunately, healthcare, in many quarters, is copying the same cycle with similar outcomes.

  2. Great post. asking Why is a very simple step that so many managers and leaders miss.
    Toyota Seniors as very good at asking the right questions in the right order particularly after a problem .
    ‘What have we learnt’
    ‘Could this problem / opportunity exist anywhere else. ( Yokoten )

    These 3 questions are always repeated and are also the basis of the summary of A3 reports.
    This technique is not industry specific. It is a very simple management process that improves safety, quality, delivery and ultimately cost.

    If you would like to know a little more about ‘YOKOTEN’ I have recently posted a short blog that may help.

  3. If I remember correctly at NUMMI GM had a plant manager at NUMMI, more than one over time . However Toyota was running the plant.

    Toyota had Effectiveness.

    GM had Efficiency.


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