Operational Excellence Mixtape: October 25, 2019


Healthcare – Creating Value for Patients

If you set a target without providing a clear path on how you want it achieved, and then punish staff when they fail to achieve it, then staff will achieve the target – by any means necessary and at all costs.  To be sure, reducing falls for elderly patients in a hospital is a noble target, but to do so by simply preventing patient mobilization will result in harm, as described in this Washington Post article.

You won't transform by doing a few projects. UCSF credits its 5 year Lean transformation journey that engages staff daily in problem solving for making sure its patient initiatives aren't seen as flavor of the month.

Lengthy hospital stays are anathema to health outcomes.  Many hospitals have focused on length of stay reduction over the last 20 years and getting buy-in from care staff is a formidable challenge.  Mayo Clinic describes how they were able to get buy-in for reducing length of stay. 

Another example of the power of engaging patients in innovation

Home care is the next frontier in healthcare innovation.

Operational Excellence

Lean has been around a long time and it can be surprising to find out how few organizations are actually advanced at it.  Truly many organizations are looking for the next new thing instead of getting really good at their core operations.  Get better every day, starting now.  It's time for lean manufacturing.

Let's agree that there are indeed “bad ideas”, even during brainstorming.  Jon Miller argues that when brainstorming cause and effect, identifying “bad ideas” may helps us to learn, and calling out bad ideas may help make analysis more efficient

Innovation cycles and hack-athons are now commonplace in large organizations – but most don't produce significant products and fewer produce cultural change.  Steve Blank explains “Why Companies Do ‘Innovation Theater' Instead of Actual Innovation”. 

As automation continues to remove rote, repetitive tasks, it is becoming increasingly important to continue to develop and reward staff's capabilities to think and improve.  Bruce Hamilton celebrates the thinker-doer and the importance of the ‘small' idea,

The 7 basic quality tools are often underrated, probably because they are deemed unsophisticated.  My experience suggests that these tools are sufficient to establish and diagnose most operational problems. 

Leading & Enabling Excellence

Here's why leaders should ask rather than tell.

How bad is the state of management?  A study by Oracle and Future Workplace found that 64% of respondents would trust a robot over their manager.

Have your Kotter/Prosci based change models delivered results?  An interesting interview with Paul Gibbons, author of  IMPACT: 21st Century Change Management, Behavioral Science, Digital Transformation, and the Future of Work suggests it's time to update our thinking about change management for the 21st century.

Coaching – Developing Self & Others

October 16 is National Boss's Day .  But what if your boss talked to you the way you talked to yourself?  For most of us, we are our own worst boss.

So your CEO wants to implement a coaching culture, and is asking you to lead it.  Dr. Jeannette Winters provides advice on how to create a coaching culture.

Being overburdened once in a while is tolerable.  Being overwhelmed constantly is bad for your mental health.  Here's how to deal with constantly feeling overwhelmed.

Books, Podcasts, Videos

I recommend watching American Factory on Netflix.  It is a compelling examination of culture clashes in organizations, and is worth it just to see children in China sing and dance to songs expounding the virtues of lean manufacturing (not kidding).  

I enjoy books on the history of industrialization and the future of work.  I am enjoying reading the surprisingly optimistic account of human progress through industrialization and innovation in More from Less: The Surprising Story of How we Learned to Prosper With Fewer Resources – and What Happens Next by Andrew McAfee.

Scientific thinking is a cornerstone of operational excellence.  Neil DeGrasse Tyson is interviewed about how to encourage scientific thinking and skepticism on the Tim Ferriss Show

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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. I enjoy books on the history of industrialization and the future of work. I am enjoying reading the surprisingly optimistic account of human progress through industrialization and innovation in More from Less: The Surprising Story of How we Learned to Prosper With Fewer Resources – and What Happens Next by Andrew McAfee.

    • I love the example of Russian whaling in the 1940’s. “hit the plan at all costs”! I see this behavior in modern tech implementations. Overall, the case for optimism outlined in this book are strong. Many pundits overlook the fact that the growing economies in the East didn’t have the same starting points as Western industrialization.

      • I didn’t know that Soviet whaling story:


        “The Soviet whalers, Berzin wrote, had been sent forth to kill whales for little reason other than to say they had killed them. They were motivated by an obligation to satisfy obscure line items in the five-year plans that drove the Soviet economy, which had been set with little regard for the Soviet Union’s actual demand for whale products. “Whalers knew that no matter what, the plan must be met!” Berzin wrote. The Sovetskaya Rossiya seemed to contain in microcosm everything Berzin believed to be wrong about the Soviet system: its irrationality, its brutality, its inclination toward crime.”


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