Monthly Archives: August 2017

Podcast #286 – Dean Gruner, MD on ThedaCare’s #Lean Journey

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My guest for Episode #286 is Dean Gruner, MD, the recently retired CEO of ThedaCare, a health system in Wisconsin that has long been considered a worldwide leader in the practice of Lean in healthcare. See this article about his retirement, where he says "I've gotten more than I've given." Dean was previously my guest in Episodes 119 and 144 and I'm thrilled that he took time out of his retirement to talk with me about his lessons learned as he looks back on how ThedaCare's Lean journey has evolved, including some things he would consider to be missteps and challenges that they used as a springboard to get even better. I will also be releasing a separate episode where Dean talks about their experiences with Accountable Care Organizations (our topic from #144) and other "big picture" healthcare issues of the day. I'm including a full transcript along with a three-page PDF summary, as I've been doing recently.

“Practicing Lean” Audiobook is Released! And a New Essay on This Theme

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Don't forget - you can enter for a chance to win a paperback version of the book through midnight tonight. I'm excited to announce that...

How NOT to Improve Patient Flow: Laws, Targets, Blame, and Threats

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Let's start by stating the obvious: it sucks to wait 24 hours or more on a stretcher in an emergency department hallway waiting for a real hospital bed. It's sad and frustrating to have a couple of blog readers from Canada send me this story from Quebec: Quebec wants 24-hour cap for patients waiting on stretchers in ERs Barrette says there would be consequences for hospital staff, doctors who don't comply I think there's agreement that waiting 24 hours, 12 hours, or four hours for a bed after an admission is a problem. That's a problem worth working on.

Aim for “Effectiveness” in Your Gemba Walks, Not “Efficiency”

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Hear Mark read the post (subscribe to the podcast): This is an elaboration on something I originally posted on LinkedIn. I saw somebody touting an approach that...

Variation in Definitions of #Lean (The Good, the Bad, and the Different)

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One challenge with teaching Lean is that there isn't aways a consistent definition that's used by everybody. Some of the definitions are really bad....

Great White Paper: “No More Projects” (or “More Than Projects”)

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I really enjoyed and appreciated this new white paper that was written by Dr. Lisa Yerian and Nate Hurle from The Cleveland Clinic: "No More...

[Updated] Monday’s Solar Eclipse: Supply Chain Challenges and Eye Safety Considerations

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Any rare event creates a number of challenges when it comes to manufacturing and supply chains. We're seeing a pretty historic "spike" in demand for products like the inexpensive glasses that allow one to safety view the eclipse (our friends in the totality zone can look at the totally-eclipsed sun safely, but that's the only time). You could call it "supply chain challenges" or a "lack of planning on my part," but I cannot find eclipse glasses anywhere. There are MANY articles online about this widespread problem -- it's been impossible to buy "eclipse glasses" anywhere. Why is this? What could have been done?

Webinar Archive: “Teaming with Patients to Improve Safety”

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I'm excited to be playing host for a KaiNexus webinar on August 30 on a topic that's very important to me (and to many) -- patient safety. As I mentioned yesterday on LinkedIn, estimates suggest that medical error is the third leading cause of death in the United States, with approximately 250,000 deaths a year... and that's four times as many deaths as caused by the opioid crisis. Don't get me wrong, opioid abuse and what happens to patients who end up addicted is horrible. But the newly-named "national emergency" of opioid abuse gets far more attention than what I would call "the international patient safety emergency" that has been around for a long time. I try bringing attention to the serious, yet solvable, problem of patient harm caused by preventable medical error. That's why I'm happy that we'll have three presenters on the 30th on this topic: "Teaming with Patients to Improve Safety" Click here to register - the webinar is free.

Highlights of “Boss Level Podcast” – Gen. Stan McChrystal and the Book “Team of...

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I've read most of retired General Stanley McChrystal's excellent book Team of Teams: New Rules of Engagement for a Complex World (I start a lot...

My Webinar Recording: Standardize What Makes Sense…

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Today at 3 PM, I'm doing a webinar at the invitation of the BC Patient Safety & Quality Council, as part of their "Quality Café" series. Thanks for the invitation! It's open to the public and it's titled: "Standardize What Makes Sense... Then Engage Everybody in Improving What You Standardized" I hope you can join us...

Why Lean Manufacturing… is Less Fun Than Google Autocomplete?

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There's a fun game you can play online in your browser... and it's free. Start typing a phrase into the Google search box (or into...

Does Being Giddy With Knowledge About Wine or Lean Cause Problems?

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I enjoy "gemba visits" (of sorts) to wineries and vacations often focus on this walking, tasting, and learning. I usually read the wine column that's...