Cleveland Clinic's daily tiered huddles are not just short meetings–they're a Lean management system that connects front-line realities to executive decision-making in real time. By combining visual management, clear escalation rules, and psychological safety, these huddles help teams solve problems locally when possible, escalate risks quickly when needed, and learn from performance every day. The result is greater alignment, healthier accountability, faster problem-solving, and leaders who truly understand what's happening across the organization.
Our guest today for Episode 348 is Cinnamon Dixon, Director Of Continuous Improvement at Cleveland Clinic. I interviewed her for the KaiNexus Continuous Improvement Podcast series, and I'm cross-posting that interview here to give it more exposure.
Our KaiNexus team members who were at the Lean Healthcare Transformation Summit in June were really impressed with Cinnamon's presentation on their “tiered huddle” process that's part of their Lean methodology. So, we asked her to do the podcast.
You can get a full transcript via the KaiNexus blog.
I recently had a chance to visit Cleveland Clinic. I spent the morning observing their tiered huddles, so I'll be writing a blog post about that soon. Thanks to Cinnamon and Cleveland Clinic for being so willing to share!
For a link to this episode, refer people to www.leanblog.org/348.
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What We Discussed
Getting to Know Cinnamon Dixon
- Cinnamon, please introduce yourself and share a bit about your professional background.
- When and how were you first introduced to continuous improvement? Was it under the banner of Lean, or another methodology?
Cleveland Clinic's Improvement System
- Can you give us a high-level overview of the Cleveland Clinic Improvement Model (CCIM)?
- What role does visual management play within CCIM?
Understanding Tiered Huddles in Practice
- What are “tiered huddles,” and how do they work at Cleveland Clinic?
- Let's start at the front line:
- What topics are typically discussed in front-line huddles?
- What actions or responses are expected to come out of those meetings?
- How do issues and information flow upward through the different leadership tiers?
Escalation, Ownership, and Problem Solving
- What kinds of issues are handled locally, and which ones get escalated?
- How do you decide the appropriate level for escalation without overloading leadership?
Implementation and Learning Over Time
- How were tiered huddles initially rolled out across the organization?
- What have you learned along the way, and what adjustments have you made based on experience?
Advice for Other Organizations
- What advice would you offer healthcare organizations that are considering daily tiered huddles or are early in their journey?
- What are the most common pitfalls or misunderstandings you see when others try to adopt this practice?
Why Tiered Huddles Matter More Than the Mechanics
What stands out most about Cleveland Clinic's tiered huddles isn't the mechanics, the templates, or even the escalation structure–it's the way daily management reinforces learning, respect for people, and shared responsibility. When people have a reliable way to surface problems, ask for help, and see issues addressed quickly, accountability becomes something that's enabled, not imposed.
Tiered huddles work when they're more than meetings–when they're a daily habit that connects purpose, data, and people across the organization. Done well, they strengthen psychological safety, improve communication flow, and help leaders stay grounded in what's really happening at the front lines.
As healthcare organizations continue to face uncertainty, staffing pressures, and increasing complexity, systems like this matter more than ever. Cleveland Clinic's experience is a reminder that sustainable improvement doesn't come from heroics or dashboards alone–it comes from creating simple, consistent ways for people to learn and improve together every day.
If you're exploring tiered huddles or other Lean daily management practices, the real question isn't whether you can copy the structure–it's whether you're building the culture that allows those structures to work.
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If you’re working to build a culture where people feel safe to speak up, solve problems, and improve every day, I’d be glad to help. Let’s talk about how to strengthen Psychological Safety and Continuous Improvement in your organization.
