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.
Such confusion out there…
"Do you want to learn about #Kaizen (continuous improvement?"
"Yes, I want to learn about Kaizen Events."— Mark Graban (@MarkGraban) March 27, 2017
.@Rushconsulting Thanks. Nothing wrong with events. I just cringe when people think "events" are the only way to do Kaizen.
— Mark Graban (@MarkGraban) March 27, 2017
"A statistical chart detects the existence…" from "Out of the Crisis (MIT Press)" https://t.co/rDxi5SfHxf pic.twitter.com/kXvYm1chRp
— Mark Graban (@MarkGraban) March 26, 2017
The ? and ? are there for the benefit of the color blind? ? pic.twitter.com/snB5dRf3ug
— Mark Graban (@MarkGraban) March 28, 2017
"…when attempting to interpret patent
nonsense, it is always best to use arbitrary guidelines." ~ Donald J. Wheeler— Dwight Marcellus (@DwightMarcellus) September 23, 2014
There are three ways to meet a goal:
1. Improve the system, 2. Distort the system or 3 distort the data (Donald J.Wheeler)— Tomas S. Feliu (@t_sanfe) June 11, 2014
Understanding Variation – the Key to Managing Chaos by Donald J. Wheeler is a great book http://t.co/a9ljSa4X10
— The Deming Institute (@DemingInstitute) November 12, 2013
Managing With Red/Green Charts is Like Driving By Looking at the Rear-View Mirror – #Lean Blog https://t.co/2FGyQVuCce
— Mark Graban (@MarkGraban) March 27, 2017
"Daily huddles" can be a good #lean management practice. But overreacting to each daily metric is going to be counterproductive.
— Mark Graban (@MarkGraban) March 29, 2017
It's very common for people to look at control chart & say "range between limits is too big." That's voice of the process, like it or not.
— Mark Graban (@MarkGraban) March 29, 2017
.@kayakendall hospitals, in attempt to "manage lean" are creating the problems we were trying to solve with lean at GM in the 90s
— Mark Graban (@MarkGraban) March 29, 2017
"Our metric is better than target"
"But the target's arbitrary"
"So?"
"How do you know you are improving?"
"We are better than target" ?
— Mark Graban (@MarkGraban) March 28, 2017
"Be careful with arbitrary targets."
"But these goals are driven by corporate hoshin kanri strategy."
"Those aren't arbitrary?"
— Mark Graban (@MarkGraban) March 29, 2017
"Explain why sales were below average last month!"
"It's just noise in the data."
"Well I don't want to see any months below average!"
?
— Mark Graban (@MarkGraban) March 28, 2017
We need to be careful that "#lean daily management" doesn't turn into old-fashioned MBO with targets and red/green. That's not innovative.
— Mark Graban (@MarkGraban) March 29, 2017
“Our findings do not imply that the Joint Commission should visit hospitals more often.” https://t.co/uXh1f1NwaA
— Mark Graban (@MarkGraban) March 27, 2017
They didn't test this? “the fabric and the tightness of the jerseys that make them uncomfortable for the players.” https://t.co/64WWdmscvS
— Mark Graban (@MarkGraban) March 28, 2017
Bad leaders + #Lean = bad leaders with new tools. How can we help transform leaders into being better leaders? I think that's the challenge.
— Mark Graban (@MarkGraban) March 28, 2017
Paperback or Kindle… Practicing #Lean: Learning How to Learn How to Get Better… Better https://t.co/SG8ncQSWMH benefits @batzpatientsafe
— Mark Graban (@MarkGraban) March 28, 2017
“the outbreak calls into question the safety of the newly modified scopes” ?https://t.co/YXC9Qs1sGA
— Mark Graban (@MarkGraban) March 28, 2017
In our @KaiNexus webinar, @KRCLean4Service talks about #Lean, service, and creativity Get recording via this link https://t.co/hS8AIycyrL pic.twitter.com/nzLsqelvRH
— Mark Graban (@MarkGraban) March 28, 2017
I agree with @KRCLean4Service that all people can be creative. @nbodek teaches this too with #Kaizen. #Lean @KaiNexus
— Mark Graban (@MarkGraban) March 28, 2017
Thanks @MarkGraban and @KaiNexus for the opportunity to talk about Coaching for Creativity and Service Excellence today! https://t.co/2LRHod4o2Q
— Karyn Ross (@KRCLean4Service) March 28, 2017
Webinar Recording now online: How to Coach for Creativity and Service Excellence by @KRCLean4Service via @KaiNexus https://t.co/Ulx5CTaT2j
— Mark Graban (@MarkGraban) March 28, 2017
#Kaizen is for everybody, as they say. Here's a small improvement I made during a workshop recently. @hckaizen pic.twitter.com/l5tFTzwNzy
— Mark Graban (@MarkGraban) March 28, 2017
#Lean Thinking Questions for a Provider Delay Board by @jmiller_kaizen https://t.co/TGeY9IsqAU
— Mark Graban (@MarkGraban) March 28, 2017
Asking why 5 times is helpful after properly framing a problem; brainstorming possible causes… then do that drill down. #LeanStartup #lean https://t.co/orBpZMxK96
— Mark Graban (@MarkGraban) March 29, 2017
What do better metrics look like? Why is this important? @MarkGraban teaches us how at #HCsummit17 https://t.co/rnfEq8hbXW pic.twitter.com/ASwcCYBATp
— Catalysis (@HCValue) March 29, 2017
“If your org wastes efforts focused on the differences between numbers and goals that is a sign of failure.” https://t.co/fyuD5VwAmJ
— Mark Graban (@MarkGraban) March 29, 2017
Good post – The Top Ten Worst Things You Could Do on a Gemba Walk via @KaiNexus https://t.co/KcCJfzZCGh
— Mark Graban (@MarkGraban) March 29, 2017
If you can't improve the system, distort the system and the data… https://t.co/reyBVjvVE0
— Mark Graban (@MarkGraban) March 30, 2017
podcast: the Current State of #Lean in #Healthcare with @markgraban & Joe Swartzhttps://t.co/xXFtaPdELj @GembaAcademy
— Jon Miller (@jmiller_kaizen) March 30, 2017
We do better by using plain language, I think. #lean pic.twitter.com/QrFrPc7KWw
— Mark Graban (@MarkGraban) March 30, 2017
"The pathologist asked us what we thought… and then ignored us. But at least he asked. And he was nice about it." ?
— Mark Graban (@MarkGraban) March 30, 2017
"I have lots of ideas, but my manager always says no… can't spend any money." ?
— Mark Graban (@MarkGraban) March 30, 2017
Representing @KaiNexus at the 10th Annual Children's Health Conference today and tomorrow! @childrenstheone pic.twitter.com/c6oiQ2rt0z
— Mark Graban (@MarkGraban) March 30, 2017
Posted in a lab I coached on #lean 10 years ago. Instead of blaming employees, leaders work together with them to understand & support. pic.twitter.com/DMcdmvZ4eg
— Mark Graban (@MarkGraban) March 30, 2017
There's no shortage of employee ideas being implemented, documented, & celebrated in that hospital lab. #lean pic.twitter.com/P5lc84HStc
— Mark Graban (@MarkGraban) March 30, 2017
Toyota bringing 'kaizen' to Japan's farms- Nikkei Asian Review https://t.co/dpaSS01BAF
— Chet Marchwinski (@leanthinking) March 30, 2017
"My boss always shoots down my ideas. But sometimes I can make micro changes that she never knows about." People want to improve!! ? #lean
— Mark Graban (@MarkGraban) March 30, 2017
OH "The lab won't offer that test because it affects their budget. But test would shorten length of stay and reduce total hospital cost." ?
— Mark Graban (@MarkGraban) March 30, 2017
OH: "Hospital makes us do an in-service on #Lean. But we don't really get to do anything with what we learn, so…"
— Mark Graban (@MarkGraban) March 30, 2017
Unlike a Toyota plant where it's obvious if a door is missing, the skipped steps (due to lack of time) are pretty invisible in healthcare.
— Mark Graban (@MarkGraban) March 30, 2017
The silly & inaccurate trichitomy of the day on #Lean #SixSigma & #TOC pic.twitter.com/JmHmwusJS3
— Mark Graban (@MarkGraban) March 30, 2017
Awful example of public reporting leading people to distort the system/data rather than doing what's right for pts https://t.co/UMx0Q4PXaA https://t.co/xsZWTkJ0cI
— Mark Graban (@MarkGraban) March 31, 2017
So an MD doesn't want to take "the ding" on mortality measure, so they don't send patient to the cath lab… outrageous system failure https://t.co/0HW1ndBEJk
— Mark Graban (@MarkGraban) March 31, 2017
“risk-averse behaviors related to these quality initiatives may actually negatively affect patient outcomes” https://t.co/vEgTrCxF7W #Deming
— Mark Graban (@MarkGraban) March 31, 2017
#Lean – A hospital lab I introduced #Kaizen to in 2007 is still at it! It's all about culture & engaging staff. Ex of technical improvement: pic.twitter.com/ZPjKlwIOYT
— Mark Graban (@MarkGraban) March 31, 2017
VP of hospital quality: ""Keep me safe" is a patient and family goal, but they don't know to say that. They should." #patientsafety
— Mark Graban (@MarkGraban) March 31, 2017
Unlike for breast cancer, "I've never seen a race or fundraiser to help reduce medical errors in hospitals." says MD / VP of Quality
— Mark Graban (@MarkGraban) March 31, 2017
Dr. Morse: "You can actually improve quality, reduce LOS of stay, reduce cost, and get paid less" due to reimbursement model. ?
— Mark Graban (@MarkGraban) March 31, 2017
Heard in a presentation: "Patients aren't pancakes." Another one to add to the "Patients aren't cars" list of unlike things. #Lean
— Mark Graban (@MarkGraban) March 31, 2017
Having "targets" doesn't magically reduce waiting times. Look at all of the gaming of the system & "fiddling with the figures" that occurred https://t.co/rJrNWsJAgi
— Mark Graban (@MarkGraban) March 31, 2017
Thinking that a target leads to magical improvement is "management negligence." You have to improve the system, not just set targets. https://t.co/t6k8YZz8di
— Mark Graban (@MarkGraban) March 31, 2017
“Before you decide your employees are a bunch of complainers with no solutions, take honest look at your operations” https://t.co/jVGviJtCUi
— Mark Graban (@MarkGraban) March 31, 2017
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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.