#TBT: Kaizen Upon Kaizen in Meeting Scheduling (and a New Kaizen of Mine)

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One really strong, common theme at Franciscan St. Francis Health, and we heard about this during our recent site visit, is “Kaizen upon Kaizen…”

Kaizen is an incremental approach to problem solving and continuous improvement. We don't need to put pressure on ourselves to make things perfect… we can focus on “a little better, every day.”

“Kaizen upon kaizen” was a theme in this recent post (a video) that I shared, and there was an example from Healthcare Kaizen that I added.

Here is another example from our book:


“In another case, Natalie Novak, director of medical records at Franciscan, engaged her entire department in a vision of a medical records department that is fully electronic. This would be a major change, so Natalie's leadership style was not one where she came up with a master improvement plan and then dictated all of the required changes for her staff to carry out. Instead, she set a vision, explained why that vision was important, and worked together with her employees to draw out their ideas to make that vision a reality.

Excerpt from the Shingo Award-winning book Healthcare Kaizen by Mark Graban and Joe Swartz

Over the last several years, her staff implemented Kaizen upon Kaizen in the effort to go electronic. For example, one Kaizen was to convert all memos to an online format, and now staff can search any memo they have received, which is helpful because the Franciscan email system automatically deletes memos after three months. Another was to convert all labor productivity calculation work- sheets to an electronic format. Another was to perform all of their quality reviews online. A big Kaizen was to scan auditing information into an online searchable database, which dramatically cut the time required to prepare for Medicare Recovery Audit Contractor (RAC) audits.

Collectively, the small Kaizens have added together to make a big difference. Because of the Kaizen work, the medical records department was able to take on an increase in volume without adding the three additional employees that they estimate would have been required without implementing Kaizen. This makes the hospital more cost competitive in an era when costs are rising and reimbursements are dropping.”


I recently stumbled across an example of “kaizen upon kaizen” in my own work… in particular the way I schedule meetings with people.

My first kaizen from 2014 involved sharing visibility into my calendar and availability:

My Personal Kaizen on Scheduling Meetings – Fewer Emails and Less Time

Later, I added the ability for two-way communication to my calendar, reducing lag times and eliminating instances of double booking in the old process:

Personal Kaizen: How I Reduced Effort & Time in Scheduling Phone Calls and Meetings

I recently made another Kaizen improvement in that scheduling process on my calendar page.

Somebody told me that their organization's IT systems blocked my calendar plugin, so she contacted me manually through the contact form.

I realized that might happen to others, so I modified the page to add the message (and a link):

If your organization blocks the calendar app below, please use this form to propose a time to talk.

Every day a little better… never perfect, just better. Sometimes, there are large leaps (adding a new technology)… sometimes there are just small improvements (adding text to a page).

I set up the page as markgraban.com/cal but then I realized that somebody might remember it or enter it as markgraban.com/calendar, so I set it up to forward to the calendar page instead of returning a 404 error. Kaizen!

What did you improve today? Feel free to share an example in a comment, below. If you want a “before/after” template, you can find one here (direct PPT link). You can use the “Share a Kaizen” link on our book's website, if you like, to upload your story and/or file and I can post it below for you as a comment.


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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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