Podcast #296 – Dr. Zeev N. Kain on Lean and Clinical Variation


Joining me for Episode #296 of the podcast is Zeev N. Kain, MD. MBA, FAAP. He is a physician and a Chancellor's Professor at the University of California, Irvine.

He has many additional roles and titles, including:

Per his bio, Dr. Kain is “recognized as an international expert in the clinical management of perioperative fear and anxiety, and management of children undergoing invasive medical procedures. His research addresses major dilemmas encountered in the management of affected children.”

He's also an advocate for Lean and Six Sigma and the connections to reducing “clinical variation” in healthcare. So, that's what we're talking about today. I enjoyed chatting with him and I hope you enjoy the discussion too.

Streaming Player (Run Time 50:28)

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For a link to use for this episode, refer people to www.leanblog.org/296.

For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS, through Android apps, or via Apple Podcasts.  You can also subscribe and listen via Stitcher.

  • How and when did you get introduced to Lean?
  • Why did you take interest in the approach?
  • How do you see Lean connecting with the challenge of clinical variation?
  • Is Lean controversial in this realm?
  • How was “Lean and Six Sigma” combined and taught at Yale-New Haven?
  • What role did GE play?
  • What reaction do you get from physicians when you introduce them to Lean and Six Sigma?
  • The BMJ article he references on the number of patients who die each year due to medical error
  • How many errors are caused by “execution errors” instead of a lack of knowledge?
  • In the scientific process, is there “intentional variation?”

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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.


  1. Good insight that Lean adopters rarely address change management.

    Considering Toyota purposefully addresses change (isn’t that how John Shook got his first job at Toyota?) and its importance to success, I wonder why the topic is generally ignored.

    • Good question. My impression is many organizations are still stuck in the mindset that telling people what to do is the best strategy or the only strategy.

      It’s amazing sometimes how little effort goes into engaging employees… but then leaders complain that employees aren’t engaged (as if it’s the fault of the employees).

      I’ve been teaching a change management workshop with a learning simulation for a couple of years now. I think it’s incredibly important…


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