Episode #421: Ryan McCormack on His “Operational Excellence Mixtapes” & More

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We've been on hiatus over the summer here, but I did a live streaming video the other day with my friend Ryan McCormack, who regular readers of this blog will recognize as the creator of the bi-weekly “Operational Excellence Mixtape” emails that he allows me to publish here on the Lean Blog.

He was also my guest for Episode 12 of the “Lean Whiskey” podcast.

In this 30-minute discussion, Ryan and I chat about:

  • Why did you start the “mixtapes”?
  • What are some favorite books and podcasts that you have highlighted recently?
  • What have been the transferrable Lean lessons going into healthcare and now back out into other settings?
  • Best Thing / Worst Thing — What's the best thing about doing OpEx work? The worst thing?

I hope you enjoy the conversation.

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


Watch the Video:



Automated Transcript (Not Guaranteed to be Defect Free)

Announcer (2s):
Welcome to the Lean Blog Podcast. Visit our website www.leanblog.org. Now here's your host Mark Graban.

Mark Graban (13s):
Hi, it's Mark Graban here. I know I had announced a summer hiatus without new episodes, but we'll call today's episode number 421. It is August 4th, 2021. Today. I'm bringing you audio that comes from a live stream video broadcast that I did yesterday with my friend, Ryan McCormack. We did that out on LinkedIn live and the Lean Blog Facebook page and YouTube live. We talked for about 30 minutes. If you are a regular reader of Lean Blog, you'll know that Ryan contributes every other Friday, what he calls his “operational excellence mixtape.”

Mark Graban (55s):
He includes links to articles and books and podcasts and all kinds of great resources. Again, you can find that leanblog.org search for mixtape. So we're talking about that. Why did he start that? What are some of his favorite books and podcasts? We'll talk a little bit about his experiences with lean and operational excellence in healthcare and other settings. If you are a listener of the occasional Leaan Whiskey podcast, Ryan was my guest. We had a conversation in episode 12 of that series. So if you want to find links to all of this, you can go to lean blog.org/421.

Mark Graban (1m 41s):
All right. Hi, welcome to my live stream. I'm Mark Graban, and I am the host of a number of podcasts among other things. I'm the host of a podcast called Lean Blog Interviews. I'm the host of a podcast called My Favorite Mistake. And today I've got a guest here, a friend of mine, Ryan McCormack, we've met how long, how many years ago I should welcome me, but we'll keep this casual. We met maybe 10 years ago.

Ryan McCormack (2m 9s):
I'd say 10 ish. Yeah, maybe,

Mark Graban (2m 12s):
Maybe a touch more. So we, we crossed paths when I was involved with the Lean Enterprise Institute and an organization now called Catalysis at a chance to come visit Ryan's organization. So Ryan, how about if you want to fill in some of the details here about where you live and where you were working at the time and what you're doing now is in terms of some introductions?

Ryan McCormack (2m 38s):
Sure. So my name's Ryan, I live in sunny, Winnipeg, Manitoba, Canada. Mark and I first met when I worked at St Boniface Hospital. They were in a engaged in a fairly significant lean transformation starting in about 2007. And of course our paths crossed or all sorts of learning events and, and gemba visits across North America. Currently I work for Canadian Pacific Railway based out of here in Winnipeg. We're undergoing a lot of transformation as well as we learned to be the best operating railroad in north America.

Mark Graban (3m 22s):
And so your career has kind of taken the path of, I don't know, like three phases, like pre health care, then your time in healthcare, and now you've been doing other things. What was helpful for you or what was that transition like pre health care coming into healthcare with your job at St. Boniface?

Ryan McCormack (3m 39s):
Wow. Yeah. Pre healthcare, you know, the idea of using industrial engineering techniques or improve this type of continuous improvement technique in healthcare was, was still fairly unheard of at the time. So the challenge early on was just convincing people that these methods have merit and can actually be helpful in reducing harm for patients and also improving flow and, and financials. So the early part of that was really just on that demonstration and convincing of course now it's fairly well established that it can be part of an approach to transform health care, improve value, post health care.

Ryan McCormack (4m 26s):
It's been a bit of adjustment to get back to a private industry with a little more results focus, then public health care in Canada had. So I've enjoyed that transition back as well. And I've been able to apply a lot of what I learned in healthcare, which is probably the most complex system you can work in into my roles, post health care. Yeah.

Mark Graban (4m 51s):
And you know, there are opportunities that we've both had to help bring ideas from one industry to another. Then there's the question of bringing ideas across borders. I've been part of groups to come up to Winnipeg there to St. Boniface years ago, you were part of groups to come down to the U S you know, the Canadian healthcare system in the different provinces is of course, very different in a lot of ways from the high level structure of the us health system. But what comes to mind when you think in terms of things that can actually be learned when it comes to healthcare delivery, commonalities or lessons that can be shared?

Ryan McCormack (5m 28s):
Yeah. I mean, that was a common question I would get as well, that works well in public health care. But what about private and truth be told there, having visited so many different locations throughout Canada and the U S I, the problems that the healthcare providers and patients and facilities encountered were all the same. It like the, the who pays side rarely figured in, in the main causes of what was preventing the delivery of the highest quality care was your usual, your usual suspects applied absolutely everywhere. So, and that, that bore out really quickly.

Ryan McCormack (6m 8s):
I thought I personally thought it would be a bigger difference from where the first time we went to Appleton. And I was like, ah, well, yeah, that's the U S so it won't be the same. But once we talked to the first nurse and first doctor about what was frustrating them, I realized the problems are absolutely the same,

Mark Graban (6m 25s):
Those day-to-day challenges when it really gets into the nitty gritty of how care is organized and how care is delivered tends to be very similar. You know, there, there may be slightly different systemic root causes to an issue like emergency room waiting times, you know, in the US it might be people who don't have insurance and don't have access to care. So they go to the emergency room in Canada. There might be other drivers leading people to come to the ER, when it's like, it's, it's questionable, should this be emergency care or not?

Ryan McCormack (6m 58s):
Yeah. And of course, probably the biggest contributor to systemic emergency backlog in Canada is, is downstream, which is the lack of capacity in, in acute medical wards, primarily, which isn't always the case in the US.

Mark Graban (7m 16s):
Yeah. So in speaking of different places, and, and please do add into the chat where you're from. I see people who've been doing that already. We've got people here from South Africa, Chile, Ghana, Iran. So, wow. Really cool. To have a global audience to say hello, to and share a cup of coffee with, well, the one thing I wanted to talk about today, and one thing I've been really appreciative of Ryan for his, something, he puts out every other Friday, he calls it the “operational excellence mix tape.” And if you are ever short on something to read, or you're looking for a new podcast to listen to Ryan does such a good job of curating things that would be interesting, you know, on topics of operational excellence or even things that might be kind of on the periphery of operational excellence when it comes to leadership and psychology and change management.

Mark Graban (8m 9s):
So Ryan puts that out as an email, which you can sign up for, or Ryan's been kind enough to allow me to post all of the mix tape, going back a couple of years on my blog, leanblog.org. So if you do a search for lean blog mixtape, you'll find Ryan's most recent one. And you'll, you'll find the history if you want to go into that. But I wanted to ask you, Ryan, you know, what, what, what was the origin for putting together the mix tape, and maybe an explain for people what it is. We had somebody once who was looking for the music to listen to, and that's not, I mean, that's literally what a mix tape used to be like. Tell, tell us a little bit about this collection you do and how it got started.

Ryan McCormack (8m 52s):
Yeah. So when, when I started in healthcare, part of that whole convincing process that some of these ideas are worth experimenting with included the, you know, predisposition to healthcare professionals to look for the literature first. So I quite often I'd be like, Hey, why don't we try this approach? Or why don't we run an experiment on, on this particular process? And one of the defensiveness, or, or even the questions I would get from providers is what does the literature say? So that was starting to frustrate me a bit. And I thought, well, okay, what does the literature say?

Ryan McCormack (9m 32s):
So what I started to do was procure different articles at the time, mostly from like new England journal of medicine that related to improvement. And then I started sending those out to a mailing list at the hospital. Every couple of weeks, I was like, well, here's what the literature says as a, as a way for us to discuss what it could mean for us at St. Boniface hospital, but also as a way to kind of convince people, Hey, why don't we try this? This is a, this is a legitimate approach. Look at other places are learning. And then from there I had more people from hospitals start asking me, Hey, I heard you send out these links. Could I be included as well?

Ryan McCormack (10m 12s):
And then it just kind of spiraled from there. And it became something I started offering up publicly maybe six years ago. So I do, you know, now people subscribed to it. Obviously you can share it on, on your, your website and it's kind of expanded away from just healthcare. It started off just as healthcare related links. And now I tend to include anything that I think is interesting relative to creating value, driving improvement and coaching and developing self or others.

Mark Graban (10m 42s):
Yeah. So if somebody asks them in comments, how to find it again, you can go to lean blog.org, do this link slash question mark S equals mixed tape, or you can just Google lean blog, Ryan mixtape, and you can get it through the blog. Or there are links in all of those posts for how you can sign up to get it directly from Ryan via email. We've got people here also from let's see, Missouri, Nigeria, Florida, Wisconsin, South Carolina. So again, thank you everyone for being here. Yeah. It's not, you know, my, my blog back in 2005, it's funny. I was doing something very similar before I started the blog. I would send articles out to a list of friends.

Mark Graban (11m 23s):
Some of them from work, some of them from grad school. And then, you know, at some point I said, well, let me put it on a blog. I'll let people pull for that information. Sometimes people appreciate having the information pushed out them. So to me, this isn't an academic discussion of which is best push versus people have options. Absolutely. Kind of question, just triggered by something you said when it comes to journal articles. One thing I think is fascinating. I think, especially in healthcare, there's a reliance on looking at the literature when that comes to clinical innovations or clinical decision-making, and you can do these controlled double-blind studies on medications or therapeutic treatments.

Mark Graban (12m 8s):
I think a lot of that makes sense when it comes to management and culture, I think it's a lot more difficult to do those types of studies. You can look for evidence anecdotal and measurable that lean methods work in healthcare, and people will say, well, show me the journal article approves this work when the prevailing existing management system was not chosen based off

Ryan McCormack (12m 31s):
Of absolutely. There's no evidence for what we're currently doing. So why not try even, or take a leap of faith, but that argument doesn't, doesn't compel too many people in healthcare in my experience. Yeah.

Mark Graban (12m 45s):
Yeah. I mean, people do get anchored in the status quo. It must be the status quo for a reason. And I think those of us who do work with lean and other methodologies tend to think, well, everything, everything can be better. We can, we can create improvements to the existing system or invent, create a new, a new system, but back to the mixed tapes. So, you know, again, I encourage people to check those out. Ryan shares links to articles, online books. We always know what he's reading or what he's about to read and, and what he's listening to. Is there a, a recent favorite book or one that you've read that you might want to share a little bit about?

Ryan McCormack (13m 29s):
Sure. I'd say some of my more recent favorites. There was one book by Roger Martin. It's called. I have it right here. When More is Not Better, you can see it right here.

Mark Graban (13m 41s):
Cause he writes a lot about corporate strategy. Is that correct?

Ryan McCormack (13m 45s):
Yeah. So he's, he's a professor at the University of Toronto here in Canada. He writes a lot of a corporate strategy. I found this book particularly interesting. It's a bit of a modern take on some principles that we're all familiar familiar with from damning. I would say some, he walks through some fairly well-publicized examples of where seeking efficiency for its own sake can create a host of problems rather than solve them. It can lead to monopolistic situations. It can lead to sub optimization and short-termism whereas of course, you know, students of improvement often know that long-term thinking is, is essential principle.

Ryan McCormack (14m 32s):
And thinking of the whole system is a, is a lot, not more sustainable than thinking of improving a part. So it was getting guacs here. For example, the Wells Fargo example that many of us are familiar with where even, you know, sub optimizing against immense systemic damage to the customers and to the brand of Wells Fargo that, that continued to endure today. So he offers up some different ways of thinking from, from a business executive point of view, from an academic point of view, any even into political point of views, I'm not really a political guy, but he offers up some ideas of, of how to make long-term improvements and gains for everybody in, in a political sense.

Ryan McCormack (15m 21s):
So that's one book I highly recommend it's quite readable and not too long.

Mark Graban (15m 25s):
Yeah. Just a quick comment on the Wells Fargo case. And this is something I've blogged about where, you know, the CEO decided eight is great and that every customer should have eight accounts like eight different products. You could have a mortgage checking account, a savings account, a car loan because you could have investment vehicles, but that led to, as you described it, a very systemic problem where frontline bank, employees and managers were under pressured, either pressure, you know, pressure customers and the signing up for accounts they didn't need or even doing so on behalf of the customer when it wasn't authorized. And so you talked about the harm to the customers, the harm to Wells Fargo's reputation.

Mark Graban (16m 9s):
It actually also harmed a lot of people's careers because people were individuals were fired for what I would, I would really, I would die on this hill that this was a systemic problem. It was happening all across the bank. And it's a systemic problem. I think, driven by the pressure where there's another book out there called the tyranny of metrics. This might fall in that category and it was driven by organizational policy. And if the bank wanted to say, well, we had thousands of ethical employees, that's a different systemic problem. And I don't believe it was thousands of unethical employees. So some of these people literally can't work in banking or finance again, if they were fired for cause which is a different level it's damaging.

Ryan McCormack (16m 55s):
Yeah. And, and, and the basic thesis of, of when more is not better is if we we've gotten pretty good over a hundred years of treating business as a mechanical machine that we can optimize by pulling levers, but that doesn't always lend itself to sustainable improvement in the more complex environments we have today. Now that said, that was an argument in healthcare. I used to get a lot as to why not to apply these principles. It would be like, well, we're a complex adaptive system. Therefore these methods don't work, but of course thinking systemically, respecting individuals and learning through experimentation are completely consistent with these ideas of how to create noise and change within a complex adaptive framework as well.

Mark Graban (17m 44s):
There was a second book you were about to mention, is that right?

Ryan McCormack (17m 46s):
Yeah. I could go, I could mention a hundred, but here's another, I liked that I brought with me, it's called How Innovation Works by Matt Ridley. Innovation is, is the flavor. These days I find many big organizations are engaging in innovation labs, pursuing innovation as, as the new methodology to help propel them and, and help transform. There's some great historical walks through innovation over history, whether it's the steam engine to the computer. And Matt really does a great job of sharing, which what the underlying principles are that are common with innovations throughout human history.

Ryan McCormack (18m 34s):
And there are things, again, very familiar to lean thinkers, things like collaboration, most innovation over history was actually done by what he refers to in the book as unlettered people. So this is another reason to engage widely in your organizations to drive improvement. People need to be free to experiment and learn from trial and error. That's essential ingredient to innovation throughout human history, as well as gradual incremental ism. That's part of the challenge. Why big organizations engaging in innovation strategies may struggle with that? Short-termism you want that big step change. You want to go all in on that one change, but history shows us that sustainable innovation and breakthrough innovations come from long-term gradual incremental ism.

Ryan McCormack (19m 22s):
Hmm.

Mark Graban (19m 23s):
Can you turn, does the book touch on the idea? Can you turn innovation into a process?

Ryan McCormack (19m 30s):
Yeah, it, it does, but the, you know, the spoiler alert, the process is the scientific method. So it wasn't, it wasn't a great insight to me personally, reading the book, but that's essentially what one can arrive through there. Interesting to that over history, innovation tends to be a competition. And quite often the, the, the degree to which simultaneous innovation for the same breakthrough or the same problem happens over history is remarkable, but that just goes to show more reason to be transparent and more reason to collaborate across the globe.

Ryan McCormack (20m 11s):
And today there's very few barriers in doing that.

Mark Graban (20m 14s):
I mean, say, or when they say unlettered, do you mean people without college degrees and the letters of their names that we see in healthcare at least.

Ryan McCormack (20m 22s):
Yeah. You know, read the book and, and you find out many, many of the innovations that made human life better came from people just tinkering. It was regular people trying things out, tinkering. Yeah.

Mark Graban (20m 38s):
And like you were saying that, that points to the need to engage everyone in the organization and continuous improvement and tap into everybody's creativity.

Ryan McCormack (20m 48s):
Don't make innovation, a department that has a license monopoly on ideas and your organization engage widely engaged, deeply and engage frequently in unleashing freedom for people to test out their ideas without fear of failure and with the support to move forward. Yeah.

Mark Graban (21m 10s):
There was a comment in the chat here from Tom who works in healthcare, Tom Bouthillet, and he says there isn't much evidence for many of our medical treatments either. I know a couple of years ago I heard Dr. Brent James, who was pretty legendary in the healthcare quality improvement circles. And at the time maybe a decade ago, he said maybe one-third of medicine is driven by like really well-known evidence-based best practices. Like it's typically the most common kind of illnesses. You said a lot of things in children's medicine, but then a lot of healthcare. And I've, I faced this as a patient a couple of times over the last 15 years, getting wildly different opinions from two different physicians or two different surgeons about what the right path forward was.

Mark Graban (21m 55s):
And, and, and they're in, in their own mind, they were each correct. I'm sure.

Ryan McCormack (21m 59s):
Yeah. And that's, that's another book I'm, I've been reading too is Noise by Daniel Kahneman. It's, it's a good reminder of this topic about variation, which is obviously near and dear to lean thinkers as well. But it, it just reinforces the point you just made is variation is way more rampant than we think. And you know what? Humans are lousy at judgment. And the bad news is machines that we're building now are only slightly better. Unfortunately, the, the book for those of you, who've read Daniel Kahneman's thinking fast and slow, which was one of the better books I've ever read. I had high expectations.

Ryan McCormack (22m 40s):
I found noise to be good, but ironically, I found it to be a bit noisy as well,

Mark Graban (22m 48s):
Delving in meaning like delving into the topics that kind of distracted from the main,

Ryan McCormack (22m 52s):
Yeah. I would move around a lot. It had a, a lot of different discussion on how to calculate error throughout the book. I felt that it could have been delivered more clearly and in about half the number of pages,

Mark Graban (23m 10s):
That's true with a lot of books. And I hope I'm not guilty of that with any of mine. So Ryan loves sharing books, and then he's also a podcast listener. Is there a podcast episode or a podcast series that comes to mind recently for

3 (23m 24s):
You? Something you enjoyed? Sure.

Ryan McCormack (23m 29s):
I'm, I'm a big fan of the knowledge project by Shane Parrish, who has a website called Farnam Street, which is quite popular. He brings on a lot of heavy hitting thinkers that share ideas. Recently. I, the last one I recall us until we had Danny Meyer. Who's the founder of Shake Shack on the lessons he shared on, on customer service are universal and were just inspiring. I find Shane Parrish is his writings and his, his podcast really challenge traditional ways of thinking those of you who follow the mixtape.

Ryan McCormack (24m 9s):
No, I'm also a big fan of Coaching for Leaders with Dave Stachowiak, they're good too, because they're shorter, like 20, 20 to 30 minutes, he brings on great coaches. I can relate to almost every episode. It's at one part of my career and it's, listable in like my commute. So that's, that's enjoyable of course, Lean Blog Podcast, classic that I continue to listen to, Mark. I just noticed the other day that you, you publish just a brief list of, of those who've been guests on your podcasts that are no longer with us. And of course, one of my personal mentors, Dr.

Ryan McCormack (24m 49s):
Michel Tetrault, you mentioned, and reshared his audio clips. So I want to thank you for that.

Mark Graban (24m 56s):
Yeah. I, I, you obviously got to work with on much more closely than I did. I probably had, you know, four or five different, you know, encounters with him visiting St. Boniface Hospital. I will never forget how he was part of a group that went and visited an airbag manufacturer in Utah called Autoliv. And so here he was crossing borders, crossing industries, looking for lessons about improving safety and lean management and yeah, well, we all miss him a lot. I know he was very, you know, very, very principled to me, a very principled and earnest and inspiring leader.

Mark Graban (25m 38s):
The little bit I got to talk with him,

Ryan McCormack (25m 41s):
Absolutely. Another podcast I'd like to recommend. And everybody that I listened to recently was the work life with Adam Grant recently had a podcast centered on speaking up at work. And it's, I think he did a great job of dissecting the very prevalent and popular concept around psychological safety. He shared some interviews with some folks from Boeing as like what contributed to the 737 Max tragedies. He brings on some military guests as well to talk about how to cultivate psychological safety and remind us that it's not about being nice to everybody.

Ryan McCormack (26m 24s):
That's a common thing I get when I bring up this subject is psychological safety is not just being nice and placating people at all. And I think Admiral McRaven on this particular podcast does a great job of reminding us how to achieve psychological safety with, without it becoming an exercise in softness. Yeah.

Mark Graban (26m 48s):
And in that episode, Amy Edmondson from Harvard was I think one of the experts that w was she, I haven't listened to it. So I saw, I think I saw the, the notes. Did he, he had interviews interspersed with different people in that episode. I should go and listen to it.

Ryan McCormack (27m 5s):
Yeah. Amy Edmondson was on it again. Another grade book, the fearless organization I recommend without the reservation to anyone on the line right now is about psychological safety. And what are the factors that contribute to creating a culture where people aren't afraid to speak up at work? And the stakes are really high we're, that's what we're talking about in healthcare. People can die. We saw in the air aircraft industry, people can die. So the stakes are very high as is a very important topic and a lot can be learned from, from these podcasts and books. Yeah.

Mark Graban (27m 41s):
And I was really fortunate to have a chance to interview professor Amy Edmondson in my lean blog interviews, a podcast series talking about her book and psychological safety. So maybe the last thing before we wrap up in the interviews recently have come up with this question of all right. Tell me the best thing in the worst thing about blank. What's the best thing about doing operational excellence work like you do regardless of the industry.

Ryan McCormack (28m 13s):
For me personally, the best thing is, is teaching and developing others with these principles. I was fortunate to have strong mentors throughout my career, and I, whenever I'm able to give back in any job or any situation, if I look back on my proudest accomplishments, it's, it's those I was able to help along their journey. I'd say the worst thing is, I mean, it's kind of the flip side of one of the better things. One of the better things also is that, you know, you get to work on all sorts of interesting problems, so you're never bored, but I gotta tell you once in a while, it'd be nice to be bored and just do some, you know, Ida, Ida director that I used to work for, who would say, you know, what if sometimes you just need to dig a ditch.

Ryan McCormack (29m 8s):
And I think what he meant was sometimes you need to get into a routine in order to liberate some of your thinking to come up with your most novel ideas. And that sounds weird, but sometimes it'd be nice to get into more of a routine. And I find an operational excellence. You have to adapt and move on to problems very quickly. So that's, that's one of the, I shouldn't say it's a worst thing, but it's, it's one downside. Yeah.

Mark Graban (29m 31s):
And invite people in the chat. Maybe if you do work in this field of operational excellence or lean or lean six Sigma, however you frame it. If you want to share something, that's the best thing or a worst thing about doing that type of work, it would be interesting to see best thing. Worst thing about living in Winnipeg, I'm throwing this out.

Ryan McCormack (29m 52s):
That's the thing about living in Winnipeg, the sense of community Winnipeg's well known for it's a small town feel in a big city, I'd say that's the best thing. And if you're in Winnipeg, you're halfway to everywhere right. In the middle of the country, pretty much. Right. But that's also the worst thing is you're halfway to everywhere. So to get anywhere, you have to travel as well. I know people hate the winters here. Like that's a big sticking point of Winter-peg. Everyone thinks that's hilarious, but I am I've, I've lived in Canada, my whole life. I love the winter that that doesn't bother me, but it does. Yeah. W we're you know, being isolated, sometimes Winnipeg's a bit behind the trends as well.

Ryan McCormack (30m 37s):
And sometimes perhaps when it picks uppers from a bit of an inferiority complex as a result.

Mark Graban (30m 47s):
Yeah. And you've got, you've got your hockey team back, which I'm sure helps in terms of civic pride.

Ryan McCormack (30m 53s):
Absolutely, go Jets

Mark Graban (30m 58s):
Final thing here. And again, I want it, you know, I want to give exposure and a plug to a project of Ryan's every other Friday, he publishes what he calls his operational excellence mix tape. It's an email that he sends out. It's also available on my blog, leanblog.org. So if you search again, lean blog for mixtape, you can read those. You can subscribe through the blog and you can subscribe if you want to get them directly from Ryan via email every two weeks. So kind of final thing here. Best thing about putting together the operational excellence, mixed tapes to you.

Ryan McCormack (31m 34s):
I, well, it forces me to stay current. It, it keeps me motivated to keep learning and reading and listening and learning from others and to be able to share that as well. So that's the best thing.

Mark Graban (31m 46s):
Is there a worst thing? It might not be horrible, but what, what, what's the worst thing?

Ryan McCormack (31m 50s):
Well, and again, this isn't a worst thing, but since I've been publishing the mix tape, it's been about nine years, total, the amount of paywall has increased every year over year. So the amount of free and shareable material has gone down a lot.

Mark Graban (32m 8s):
All right. Well, there we go. I think this ends up being a flexible question. Best thing. Worst thing. I mean, worst doesn't mean horrible. It just means, I guess all things considered. So like, you know, the worst pizza is delicious still. Well, Ryan, thank you a lot for doing the discussion here today. Thank you to everybody for joining us. And I know the conversation will continue in the chat with those who have been watching this as a recording. So I want to thank everyone for tuning in joining us around the world. Ryan McCormack. It's it's been good to talk to you. I'm glad we could share it today through the live stream.

Ryan McCormack (32m 45s):
Thanks. Pleasure. As always for those listening. Yeah. Subscribe to the mix tape or hit me up on LinkedIn too, and let's chat improvement. All right. Well,

Mark Graban (32m 56s):
Thanks for listening. Thanks again to Ryan. If you want to find links to his mix tapes and everything he shares again, you can find links to this by going to leanblog.org/421.

Announcer (33m 9s):
Thanks for listening. This has been the lean blog podcast for Lee news and commentary updated daily. Is it www.cleanblog.org? If you have any questions or comments about this podcast, email mark@leanpodcastatgmail.com.


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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

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