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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