Operational Excellence Mixtape: January 18, 2019


Healthcare – Creating Value for Patients

Too often, patient involvement in design and research is tokenist or “tick-box”, and requires burdensome processes for participation.  To truly design around the patient, research needs to be person-centered.

Large healthcare systems continue to consolidate and integrate, but few pull off little more than achieving size and shaking off some loose parts.  Actual improvements access, quality, experience and costs at scale requires a focus on standardization, regionalization, virtualization, and engagement. 

As patients continue gain more access to their own health records (at last), deficiencies in charting are being exposed, as in this delightfully frank confession of by a physician assistant on the habits of ‘copying and pasting' from clinical notes without verifying (“fake news” in health records!). 

Backpacks are just as safe as parachutes when jumping out of planes – according to a published paper.  Cardiologist Robert Yeh demonstrates the pitfalls of shortcuts in medical research and glossing over the details of published experiments when drawing conclusions

Canadian hospitals and patients continue to pay for the decisions made to cut beds in the early and mid 2000's based on a pervasive policy that hospitals running at less than 100% occupancy are ‘underutilized' leading to a generational era of chronic capacity issues.  This report on Northeastern Ontario capacity problems is representative of many national jurisdictions. Every January, Canadian healthcare repeats a pattern of overflowing ERs supposedly due to “flu” season with no advanced systemic capacity planning, even though it is completely predictable.

Operational Excellence

Everyone wants an innovative culture.  Innovation is fun – divergent thinking, running experiments, ‘failing fast'.  But the truth is that innovative cultures are hard to sustain and requires high standards, discipline, and candor.

OpEx practitioners know that defining the problem is the half-way point to solving it.  This research shows us the importance of defining a problem as our brains are designed to keep “moving the goalposts”.

Here's a great collection of 13 of the best lean & continuous improvement articles of 2018 from IndustryWeek.

Transforming across a large system (hospital-based no less) is one of the greatest challenges for OpEx leaders.  Point improvements are relatively easy to make, but value-stream transformation is a whole other challenge.  This article mirrors my experience as a transformational leader in a hospital system almost exactly.

Solving chronic problems doesn't get adrenaline flowing nor the recognition of the fighting a ‘five alarm' problem.  The incomparable Seth Godin on chronic problems, and the need for systems thinking to solve.

Brainstorming can be done without ideal conditions.  Here are some tips on how to pull off an effective idea generating session.

Leading & Enabling Excellence

Students of the Shingo Model know that if you want to help create a culture of excellence, don't simply write down lists of values, but rather describe exactly what the expected behaviour looks like, and what it doesn't look like. This helped Patty McCord create the foundation for Netflix's enviable company culture

You think your meetings are great.  The people attending them think they stink.  Leaders generally assume that their meetings are going well, usually without seeking feedback.  Here's why others think your meetings stink and what to do about it.

Working long hours doesn't pay off.  Here's yet another article on why we should continue to address the myth of the heroic workaholic.

Most managers think they work great under pressure.  Their staff disagree.  Pressure can bring out the worst in a manager, and staff will remember and over-attribute negative interactions by their manager in times of pressure.

Coaching – Developing Self & Others

When developing habit, it's best to start small.  It's easier to take a small step, and the benefits of compounding allow small habits to make a big difference over time.

Is listening to a book the same as reading it?  Audiobooks and written books are different but neither is better overall. 

Books, Podcasts, Videos

We are always rushing and being busy.  The Art of Waiting: Reclaiming the Pleasures of Durational Being in an Instant Culture of Ceaseless Doing promises to be a good read.  I will read it when I find the time ;)

Sometimes we “help too hard” and miss out on opportunities to develop other through coaching.  Corrinne Armour discusses How to Get People to Stop Coming Back With the Same Problems in Coaching for Leaders podcast #387.

Decisions and judgment create increasingly leveraged results, leading the legendary investor Naval Ravikant and philosopher / MD Kapil Gupta to challenge traditional views on “hard work” and its role in the present and future of work.  

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Ryan McCormack
Ryan is an operational excellence professional with over 18 years experience practicing continuous improvement in healthcare, insurance, food manufacturing, and aerospace. He is an avid student of the application of Lean principles in work and life to create measurably better value.


  1. Ryan thanks for including my interview on the ‘Coaching for leaders’ podcast “How to Get People to Stop Coming Back With the Same Problems in Coaching for Leaders podcast #387” in your Mixtape. Glad you found it useful enough to want to share it with others.
    Corrinne Armour


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