Here's the latest installment of “Key Tweets,” a (usually) weekly post that summarizes some of my tweets (or retweets) from the week, including pictures and other interesting stuff.
You can follow me @MarkGraban and join the fun and the conversation, but you don't need a Twitter account to view any of this. See the previous installments of Key Tweets.
“Putting out fires is not improvement… only putting the process back to where it was in the first place.” https://t.co/U4eub1GepO #Deming
— Mark Graban (@MarkGraban) April 7, 2017
Hooray, arbitrary target achieved! I should have saved that extra step for tomorrow. pic.twitter.com/df6AO6W8W4
— Mark Graban (@MarkGraban) April 5, 2017
#Lean Hospitals — “Kaizen, Kanban, Kamishibai, Krzyzewski and Other Words That Start with “K”” https://t.co/bp8PjBqLWc
— Mark Graban (@MarkGraban) April 1, 2017
#Lean Hospitals — The new subtitle is:
“Reducing Staff, Slashing Costs, and Boosting the Bottom Line.”
— Mark Graban (@MarkGraban) April 1, 2017
That was an April Fool's Joke, by the way:
April Fool 2011: New "A3" App Utilizes Two iPads & Virtual Sensei Technology – #Lean Blog https://t.co/qVJ78l0GYh
— Mark Graban (@MarkGraban) April 1, 2017
April Fool 2015 – Announcement: Lean Blog is now "#Lean Buzz" with Listicles, Polls, and MORE CATS! https://t.co/ht7oxqmHD4 cc @DoctorMuda
— Mark Graban (@MarkGraban) April 1, 2017
Remember Toyota’s Secret: The A3 Report? Here's a link to a free download: https://t.co/Zwxab7ClxT @Toyota pic.twitter.com/dPwqvfgWYV
— MITSloan Mgmt Review (@mitsmr) April 2, 2017
Another $150 raised for @batzpatientsafe – thanks @MikeLombard @Rushconsulting & other #Lean authors!!! https://t.co/BpfKVUeZK1
— Mark Graban (@MarkGraban) April 3, 2017
The customer is always right? Unless they disagree with the chef? https://t.co/ZQ9UndSzGc
— Mark Graban (@MarkGraban) April 3, 2017
#Extrinsic #Incentives Kill #Creativity https://t.co/JJ6Ep0PNmj webcast with @DanielPink
— The Deming Institute (@DemingInstitute) April 3, 2017
Is this value added, necessary waste or pure waste (overprocessing)? #lean https://t.co/blTR0BSTxw
— Mark Graban (@MarkGraban) April 3, 2017
That's why management can't just delegate everything to staff. Leadership is responsible for the system and improving it at high level. https://t.co/e3hM7ND3QI
— Mark Graban (@MarkGraban) April 3, 2017
2 years ago — Guest Post: The one thing Lean #SixSigma got wrong about Lean – #Lean Blog https://t.co/yeFrGwlAz9
— Mark Graban (@MarkGraban) April 3, 2017
What do better metrics look like? Why is this important? @markgraban teaches us how at #HCsummit17 https://t.co/CMUHhhI5fk pic.twitter.com/HZYmuq68oA
— Catalysis (@HCValue) April 3, 2017
"Safer vehicles are more expensive to repair." Unintended or surprising consequences in a system… https://t.co/sitq3dROam
— Mark Graban (@MarkGraban) April 4, 2017
If you're going to reach out to me for advice, don't tell me "#lean & #sixsigma are just tools…" My only advice would be stop saying that.
— Mark Graban (@MarkGraban) April 4, 2017
Wait, what now???? This is not accurate –> “The "zero-defect" culture in the DNA of every health systems” https://t.co/1WNMsqQ6ul
— Mark Graban (@MarkGraban) April 4, 2017
A friend who is an RN resigned and is looking for a new job. Can she find a better culture? #patientsafety pic.twitter.com/Q95idqKfOn
— Mark Graban (@MarkGraban) April 4, 2017
Is "we don't have budget to improve" the new "we don't have time to improve?" #lean #kaizen
— Mark Graban (@MarkGraban) April 4, 2017
“Bigger is sometimes just bigger. You have to be able to make things work.” https://t.co/rTilfy202f
— Mark Graban (@MarkGraban) April 4, 2017
“deeply concerned that the elimination of their positions will compromise the quality of care that patients deserve” https://t.co/9Wm3pRCOmB
— Mark Graban (@MarkGraban) April 4, 2017
This is a very important topic. "Motivational Interviewing" is a fascinating approach. #lean https://t.co/vA5gvkUjI3
— Mark Graban (@MarkGraban) April 4, 2017
When the description of a #lean book promises "repeat Gold Metal performances." #GoldMedal #Editing pic.twitter.com/WYgUftSg9C
— Mark Graban (@MarkGraban) April 4, 2017
The WSJ does a time study of the NCAA men's championship game https://t.co/L0GMQqPsVm
— Mark Graban (@MarkGraban) April 5, 2017
Gillette learns they are not entitled to raise prices forever; value is defined by the customer https://t.co/kwXEp8C8AK
— Mark Graban (@MarkGraban) April 5, 2017
My iPhone concerns back in the da in 2009: pic.twitter.com/2moJqSqSIV
— Mark Graban (@MarkGraban) April 5, 2017
Read – "Everyone wants to do things better, but not if it means losing sight of their day jobs." Meaning they wont make any effort ;-)
— Mark Graban (@MarkGraban) April 5, 2017
Great comment from a guy I really like & respect, re: a hospital saying they don't budget for improvement. #Lean pic.twitter.com/hhw7amFkwd
— Mark Graban (@MarkGraban) April 5, 2017
"Great" hospitals or just well known?? What's the point of these lists? https://t.co/25NVL04DIP
— Mark Graban (@MarkGraban) April 5, 2017
A friend texts about team having to double enter data into 2 EMR screens. 2nd is "to track productivity." No productivity report generated.
— Mark Graban (@MarkGraban) April 5, 2017
Not sure it's a bragging point to say hospital "quality committees" are better now because they get attention at board level. #patientsafety
— Mark Graban (@MarkGraban) April 5, 2017
"Every board thinks their hospital is delivereing high quality care. Thy really believe that." Show me the data. Facts over opinions.
— Mark Graban (@MarkGraban) April 5, 2017
Data trends are much more useful than color coding or comparison to average. Are we improving? How can you tell? #Deming #patientsafety pic.twitter.com/b8h6KAg8ln
— Mark Graban (@MarkGraban) April 5, 2017
Does a hospital really need cost/benefit analysis to inspire #patientsafety improvement? Sounds like "No mission, some margin."
— Mark Graban (@MarkGraban) April 5, 2017
Just heard: "These are real dollars" from improving #patientsafety." THEY ARE REAL LIVES!!!! Stop talking ROI. Sheesh.
— Mark Graban (@MarkGraban) April 5, 2017
"Real dollars" gets more attention than real lives apparently. And this is a webinar about #patientsafety. Awful.
— Mark Graban (@MarkGraban) April 5, 2017
Presenter says staff want to do the right thing for patients. YES. Then they claim sharing the $$ cost of infections will inspire. NO
— Mark Graban (@MarkGraban) April 5, 2017
It's shocking to hear a hospital executive say they need to keep staff focused on #patientsafety. Staff would say it's opposite problem.
— Mark Graban (@MarkGraban) April 5, 2017
Sometimes, hospital staff & lower-level leaders hear these exact phrases FROM their CEOS https://t.co/p0h1yNQCiR
— Mark Graban (@MarkGraban) April 5, 2017
Book on #lean management shouldn't recommend leaders ask why daily metric is below average. That's bad statistics, poor management. #Deming
— Mark Graban (@MarkGraban) April 5, 2017
"When Warren Beatty botched the Oscars." – says @LeBatardShow. Except that isn't at all the right explanation. It was a system failure.
— Mark Graban (@MarkGraban) April 5, 2017
Nobody is ever really clear about what is meant by this. But the phrase gets used so much. pic.twitter.com/pdC3oEDtYm
— Mark Graban (@MarkGraban) April 5, 2017
And THIS is the failure of so-called "accountability culture." Honest reflections from @LeanDotOrg @LantechCom book pic.twitter.com/ozZ3087XtN
— Mark Graban (@MarkGraban) April 5, 2017
"Ride-hailing services are cheaper and more predictable than ambulance services" https://t.co/c5rugKPvTb
— Mark Graban (@MarkGraban) April 6, 2017
Variation always exists: “CAUTI rates improved but were not sustained, with infection rates fluctuating up and down” https://t.co/et78hhnwkY
— Mark Graban (@MarkGraban) April 6, 2017
I might start looking for a new MD if the office continues to NOT respond to prescription refill requests. Every time. Have to nag. pic.twitter.com/L58gCnOQaZ
— Mark Graban (@MarkGraban) April 6, 2017
“Apple’s dual obsessions with design and miniaturization were at odds with long-term performance and utility.” https://t.co/i36fQJaUOs
— Mark Graban (@MarkGraban) April 6, 2017
If you embrace PDCA from #Deming, also take the "understanding variation" concept from him and stop overreacting to each below average day
— Mark Graban (@MarkGraban) April 6, 2017
The "bullwhip" or "beer game" effect pic.twitter.com/wqiPnuuNak
— Mark Graban (@MarkGraban) April 6, 2017
"When you have a solution to problem that's causing pain for someone – you have a responsibility to act… with all urgency." @quint_studer
— Mark Graban (@MarkGraban) April 6, 2017
More from @quintstuder on #leadership – #Lean pic.twitter.com/3GAxSW7tYb
— Mark Graban (@MarkGraban) April 6, 2017
#LEAN: “Leadership and Execution are Always Necessary." – @claylinkous
— Mark Graban (@MarkGraban) April 6, 2017
A "lack of qualified staff" or owner / management problems??? https://t.co/cCi8SPlUeA
— Mark Graban (@MarkGraban) April 6, 2017
Podcast preview: "Clearly, it is human nature to assign blame and it’s completely ineffective,” @tbouthillet said. Episode out next week.
— Mark Graban (@MarkGraban) April 6, 2017
Podcast preview: "You can get compliance with a whip, but you can’t get quality.” – @tbouthillet
ou— Mark Graban (@MarkGraban) April 6, 2017
That's a super harsh "to be fair," since a new release playing in just one theater one time is bad news already. pic.twitter.com/l5NdcRy83g
— Mark Graban (@MarkGraban) April 7, 2017
Airline announces "We don't have any food or snacks on this flight. But if there's anything you need, let us know." Except food.
— Mark Graban (@MarkGraban) April 7, 2017
Such a beautifully formatted patient email message from my doctor's EMR system. The link isn't even clickable. pic.twitter.com/dXYu2DWgN1
— Mark Graban (@MarkGraban) April 7, 2017
Thanks to @emilyjerry for having me on the show to talk #Lean Methods in Healthcare & #PatientSafety https://t.co/hj9AQBjC9B
— Mark Graban (@MarkGraban) April 7, 2017
#lean isn't about being dogmatic about inventory or inspection. Do what makes sense. Improve. Toyota has inspection. pic.twitter.com/nRrfmGeoXc
— Mark Graban (@MarkGraban) April 7, 2017
Reacting to any below average data point usually wastes a lot of time. Common cause variation != "process erosion" pic.twitter.com/7wb9q0T8Xf
— Mark Graban (@MarkGraban) April 7, 2017
“After… #Lean redesigns, healthcare facilities saw a 5 percent increase in monthly productivity per physician.” https://t.co/WtR8edSoTZ
— Mark Graban (@MarkGraban) April 7, 2017
Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.