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Podcast #285 – Karen Martin (@KarenMartinOpex): “Is Lean Dead?”

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Joining me for Episode #285 is my friend and colleague, Karen Martin. She was previously a guest on Episode #151 where we discussed her book The Outstanding Organization and #190 we discussed her book Value Stream Mapping book. We'll be doing another podcast later this year about her next book, which is titled Clarity First: How Wise Leaders and Organizations Achieve Outstanding Performance.

Karen reached out with a provocative question that's easy to discuss, but hard to answer: “Is Lean Dead?” The reason she asked is that she's heard murmuring and read articles that ask “is it time for something new?” or if we're somehow in a “post-Lean” world.

I hope you enjoy the discussion where we explore this question and topic. We'd love to hear your thoughts about this if you'd like to leave a comment here on the post.

You can reach Karen through her website and you can also find her on Twitter and LinkedIn.


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Topics and Questions

  • Is Lean Dead? Are there more people saying Lean is ineffective and we need to try something new?
  • “What's beyond Lean?” is something people have asked
  • Are the reports of the death of Lean exaggerated?
  • Do people try something and conclude it doesn't work?
  • Is it about the methodology or the approach they took?
  • What are the short-term and the long-term results that are seen and should be expected?
  • Who decides what's “right” or “wrong” when it comes to Lean and the approach organizations take?
  • An example of a “Lean Sigma” curriculum that doesn't include much Lean
  • What books do you recommend for people who are learning about Lean?
  • Is it hard for outsiders to see the totality of the Lean / TPS approach?
  • Blog posts on “Motivational Interviewing

PDF Episode Summary

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Video of Karen Martin

 

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Mark Graban is an internationally-recognized consultant, author, and speaker who has worked in healthcare, manufacturing, and startups. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent book is an anthology titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus. His next book, to be released in 2018, is Measures of Success.

9 Comments
  1. Tom Gormley says

    Intriguing, and scary. I haven’t actually listened yet, but I’m both looking forward to this discussion to hear Karen’s thoughts and Mark’s, because I do sometimes wonder the same question, but at the same time I’m afraid. Probably irrationally afraid that leaders in my health system will read or hear about it, with the result that it increases their already anxious thoughts about whether it’s the right approach for us, how much to invest / commit to lean, etc., even as we’ve barely started on our journey.

    1. Mark Graban says

      Hi Tom – Not meaning to scare anybody. Long story short, I think the answer to Karen’s question is “no.” Lean has “died” in some organizations, which is really sad to see.

      There’s a related question that we hear sometimes: “Is Lean a fad?” My answer to that (being serious, not flippant) is that Lean is a fad only to those who are susceptible to fads.

      Is Lean dead? Only where it has died (or been killed). What can we do to help prevent that and help people be more successful?

  2. Tom Gormley says

    OK, I’m glad and relieved the podcast concludes “lean is not dead”, mostly just hampered by a range of organizational impediments – I agree. Like you I don’t think it’s a problem with the method (lean doesn’t work), it’s the execution? I think patience for the long term nature of culture change is a major factor, especially when exec leaders are changed out part way along.

    Are adoption curves a useful tool for evaluating lean’s diffusion across organizations? I would call the organization I started with in 2010 an early adopter, and the next two early majority. Today I know of organizations that fit the description of late majority in how they’re thinking about lean. The “innovators” like Virginia Mason and ThedaCare provided amazing results and stories, leading to early adopters. But there probably haven’t been enough successes among the early adopters, leading to a feeling of stagnation and wondering if lean is dead.

    Do we need the next thing after lean? Clearly, the need has not subsided — no one is saying we’ve resolved our immense challenges in safety, reliability, consistency in patient experience, cost, or outcomes. Is there another method to replace lean? The only thing I hear with some frequency is “innovation”, instead of improvement, but I don’t think innovation will solve our improvement needs. When we have such convincing, persuasive examples as VM and ThedaCare and others, it boggles my mind why we don’t have more. One answer which resonates with my experience is the need for a CXO who truly takes charge and leads the lean transformation (a la Kaplan, Toussaint, Koenigsaker, etc..).

    This reminds me of a time many years ago in a prior career when I wrote a piece as an industry analyst titled, “The Demise of CRM” about the lack of successes among companies pursuing transformational customer relationship management, for mostly the same reasons we’re talking about the death of lean. In retrospect, I was frustrated and impatient as a thought leader that so few organizations took a holistic approach and instead viewed it mainly as a technology quick-fix solution. So, perhaps we as practitioners and you as thought leaders need to exercise patience as well. Keep up the good work!

    1. Mark Graban says

      Yes, the need has not subsided, especially in healthcare.

      Too many are quick to say, “We tried Lean and it didn’t work here.” Maybe they’ll come back and try again, but better and more effectively?

      Not everybody in manufacturing got it right the first time. There was the first wave where people thought Lean was just “just in time” or some other “Japanese manufacturing practices.” Then, there was realization that it was a broader set of tools and principles. Some failed there.

      But, then the next wave realized it was more about culture and management systems…

      Some got it right the first time, kept practicing, kept improving… and that helped those in the “Lean failed” camp realize that there was a different or better approach.

      I hope the ThedaCare and Virginia Mason examples survive the retirement of Dean Gruner and the future retirement of Gary Kaplan. If not, will that be bad for the “Lean healthcare movement” or will people not care if they’re finding success and improvement on their own?

  3. Andrew Bishop says

    Mark,
    A thought-provoking conversation, as always. Great to hear Karen Martin again.

    My view: lean isn’t dead, it’s just so darn challenging that most don’t stay the course or really embrace the practice. Not that it is so technically challenging. The important question is, challenging to what? I’d say it challenges many of our mental models and assumptions about business, organizational behavior, values even. It almost seems that many people and businesses finding clinging to their worldview is more important (certainly more comfortable) than gaining access to the extraordinary success available to them if they would just let go (and of course, commit to practice!)

    And BTW, on the subject of quarterly business results focus in non-profits: a driver to keep in mind that I’ve only recently come to appreciate is bond ratings. It’s not the same as stock price/earnings-driven behavior in a public for-profit, but it is real and affects the ability of the organization to serve the community. Not an excuse for “short-term thinking”, but one reason that even non-profits (especially capital intensive ones like hospitals) need to keep an eye on operating margins.

    Thanks for the podcast!

    1. Mark Graban says

      Thanks for the comment, Andrew. Good point about the bond ratings.

      ThedaCare, for example, has an A1 bond rating from Moody’s.

      Their report reads, in part:

      “The outlook incorporates our expectation that ThedaCare will restore margins to levels consistent with prior years, demonstrating a run rate of quarterly improvement; the inability to do so will place pressure on the outlook.”

  4. Karen Martin says

    Good point, Andrew. It’s very likely that bond ratings should be a top-level KPIs for non-profit hospitals. I haven’t suggested this is in the past, but may do so going forward. Thank you for bringing light to that.

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