Dr. John Kenagy on Adaptive Design Kata: An Improvement and a Leadership Kata (Lean Healthcare)

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My guest for Episode #417 of the Lean Blog Interviews Podcast is John W. Kenagy, MD, MPA, ScD, FACS, of his firm Kenagy & Associates based in Washington state.

John is the author of the book Designed to Adapt: Leading Healthcare in Challenging Times.

Dr. John Kenagy knows healthcare as a physician, executive, academic researcher and advisor.  In addition to his clinical experience as a vascular surgeon, he has been Chief of Surgery, Chief of Staff and Regional Vice President for Business Development in a not-for-profit healthcare system.  But, his most meaningful experience was becoming a patient, as we'll hear about today.

Searching for new answers, he became a Visiting Scholar at Harvard Business School.  His research included developing disruptive innovation healthcare strategy with Harvard Professor Clayton Christensen and translating to healthcare the drivers of success in resilient, highly adaptive companies like Toyota, Intel and Apple.

Dr. Kenagy is hosting a webinar in the KaiNexus Continuous Improvement webinar series on June 15th. Please join us for that by registering here.


Topics, questions, and links related to today's episode include:

  • What's your Lean / Toyota Production System “origin story”?
  • What he learned after falling out of a tree in 1982
  • What he learned from Clayton Christensen, Kent Bowen & Steve Spear at HBS
  • “Toyota enables people to succeed & makes learning part of that success”
  • 4 Rules in Use – the essence of TPS
  • Spear: Decoding the DNA of the Toyota Production System
  • The rules applied in HC? What did you learn?
  • Learned also from Amy Edmondson at HBS
  • Learned from Toyota's Mr. Oba
  • “Education can get in the way of learning”
  • Learned at a smaller TMMK supplier, not at Georgetown, only 120 employees
  • What is “adaptive design”? Origins of that phrase?
  • Why avoid the word “Lean”?
  • Being adaptive in dealing with pandemic challenges — what are the characteristics of their success? 
  • Leadership Kata — 5 principles
    • 1) Clear, meaningful objective (hearts & minds)
    • 2) always start small, simple, safe, and fast
    • 3) use relevant (timely, role specific, actionable) info and simple rules, rapid feedback on effects on your action
    • 4) improvements made by teams involving people doing the work
    • 5) replicate and scale, success trust and optimism … never stop 
  • What do you mean by “virtuoso leadership”?

The podcast is sponsored by Stiles Associates, now in their 30th year of business. They are the go-to Lean recruiting firm serving the manufacturing, private equity, and healthcare industries. Learn more.

This podcast is part of the #LeanCommunicators network

You can listen to the audio or watch the video, below. I hope you enjoy it like I did.



Video of the Episode:


Automated Transcript (Not Guaranteed to be Defect Free)


Thanks for listening or watching!

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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.

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