Habits, Continuous Improvement, and the Latest at KaiNexus: Greg Jacobson

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My guest for this bonus episode of the Lean Blog Interviews Podcast is Gregory H. Jacobson, M.D., a co-founder and the CEO of KaiNexus.

Greg, also a practicing emergency medicine physician to this day, was previously a guest in Episode 149 and was a part of a physician panel in Episode 361. He also joined me for Episode 31 of the “My Favorite Mistake” Podcast. We also podcast together fairly often via the KaiNexus Continuous Improvement Podcast.

Greg is one of the three keynote speakers at this year's Healthcare Systems Process Improvement Conference that's presented by the Society for Health Systems. I'll also be facilitating an intensive session on Psychological Safety and Continuous Improvement. Come join us in Atlanta next month!!

In this episode, we preview Greg's talk at the conference. Since it's been more than 11 years since Greg has been here, we talk about the progress that KaiNexus has made as a company and as a continuous improvement software platform.

Questions, Notes, and Highlights:

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Episode Summary & Article Based on the Discussion

Exploring Continuous Improvement and Habit Formation in Healthcare Systems

The field of healthcare is not just about medical advancements and curing illnesses; it's also about the ongoing improvement of systems and processes that support patient care. The Society for Health Systems (SHS), under the Institute of Industrial and Systems Engineers (IISE), contributes significantly to this aspect of healthcare through events like the Process Improvement Conference. Additionally, thought leaders in the healthcare sector often emphasize the role of habit formation and its profound impact on operational excellence.

The Role of Conferences in Enhancing Healthcare Systems: A Look at SHS's Process Improvement Conference

Meetings like the Healthcare Systems Process Improvement Conference serve as crucial platforms for professionals to discuss innovative strategies and advancements in healthcare. This annual event brings together hundreds of healthcare professionals who are passionate about efficiency, patient safety, and quality care. The conference is a fertile ground for sharing best practices and discussing the latest research and applications influencing healthcare systems.

Keynote speakers and facilitators at the conference often address critical themes such as the importance of psychological safety, lean management, and the significance of establishing continuous improvement as a cultural norm within healthcare organizations. The event provides an excellent opportunity for professionals from various healthcare backgrounds to learn from each other, build networks, and take away practical solutions that can be applied to their work environments, thereby improving patient outcomes and staff satisfaction.

Habit Formation as a Key to Organizational Success

In recent discussions about habit formation, it has become apparent that the principles are not only applicable on a personal level but are equally essential for organizational change. Habit formation is instrumental in creating the behaviors that foster a culture of continuous improvement within organizations. This realization has led healthcare systems to delve deeply into literature on habit science, referencing works like Charles Duhigg's “The Power of Habit” and James Clear's “Atomic Habits.”

These resources have ignited new approaches to cultivating consistent behaviors that are conducive to improvement at both the individual and organizational scales. Understanding the habit loop–consisting of a cue, a routine, and a reward–and its application has the potential to revolutionize how healthcare institutions operate. The emphasis is on intentional behavior creation through structured and strategic routines that ultimately lead to sustainable improvement and innovation in healthcare systems.

Integrating Continuous Improvement with Daily Operations

The implementation of continuous improvement techniques, such as daily huddles and management systems, is a hallmark in lean healthcare organizations. Establishing these as routine, daily habits is vital for the sustenance and success of lean methodologies within healthcare. However, forming such habits goes beyond simple repetition; it involves creating lasting changes in practice and mindset. As evident through various leaders' experiences, the journey to solidify these practices into daily habits is not always straightforward.

Effective strategies to build and maintain these habits include identifying clear cues and immediate, meaningful rewards. By reinforcing these practices with positive outcomes, healthcare professionals are more likely to integrate them into their daily operations. Consequently, the consistency in following lean practices will drive quality improvement across the board–from patient care efficiency to staff workflow optimization.

In summary, the advancement of healthcare systems relies heavily on initiatives that promote process improvement and the cultivation of good organizational habits. Conferences like the Healthcare Systems Process Improvement Conference provide much-needed insight into the latest trends and methods, while the principles of habit science offer a roadmap for ingraining continuous improvement into the very fabric of healthcare organizations.

Leveraging Technology for Habit Formation in Healthcare

The digital age has ushered in platforms like KaiNexus that catalyze the habit formation process within organizations. KaiNexus, for instance, exemplifies how technology can support continuous improvement and the adoption of new habits within healthcare systems, as well as other industries. These sophisticated platforms extend beyond just tracking improvements but also encapsulate various methodologies central to the continuous improvement process, such as Kaizen, PDSA, and Toyota Kata, among others.

With tools integrated to acknowledge achievements like completing leader standard work or maintaining a streak in consistent daily practice, these platforms engage the dopaminergic system, providing the digital equivalent of a high-five or thumbs-up. This subtle gamification taps into the rewards system of habit loops, reinforcing positive behaviors that contribute towards a culture of sustained organizational growth.

Integration of Habit Science and Continuous Improvement Platforms

  • Feedback and Recognition: Utilizing badges, streaks, and other feedback mechanisms, digital platforms like KaiNexus provide immediate rewards for staff dedication and consistency, driving further engagement and commitment.
  • Personal and Organizational Identity: When leaders promote the identity of being a continuous improvement organization, it solidifies the belief system and influences day-to-day micro-decisions across the workforce.
  • Flexibility and Industry Agnosticism: Platforms have evolved to cater to not only healthcare but also a variety of industries, demonstrating the universality of core continuous improvement principles and their relevance across different sectors.

As organizations grow and scale, the capabilities of platforms like KaiNexus become even more vital. They offer a structured way to collect, process, and manage the plethora of improvement initiatives that emerge from a large employee base, while simultaneously embedding these initiatives into the organization's habitual rhythm.

Creating a Sustainable Ecosystem for Improvement

Developing a sustainable environment that fosters daily management habits is contingent upon a strategy that blends identity, cue, routine, and reward. This strategic blend is not just key for individual practices like yoga but is equally significant in a professional setting. The parallels drawn between personal habit formation and organizational habit development underscore a crucial point: the micro-decisions we make on a daily basis, whether they relate to personal self-improvement or to our professional roles, propel us towards our goals if rooted in a strong sense of identity.

The habit of continuous improvement becomes ingrained in the fabric of an organization's culture when its leaders and employees align their identities with their desired outcomes. A simple statement of self-identification, such as “I am a person that practices daily yoga,” or “We are a continuous improvement organization,” can subliminally guide a multitude of micro-decisions throughout the day.

Key Strategies for Fostering an Improvement Ecosystem:

  • Clear Mission and Identity: Define and communicate the organization's commitment to continuous improvement as part of its core identity.
  • Scheduled Routines: Leaders can use visual management tools, such as leader standard work sheets or shared digital calendars, to establish and maintain routine improvement activities.
  • Accountability and Partnerships: Encourage employees to partner or share their achievements, leveraging peer support and community reinforcement to enhance accountability.

In conclusion, the seamless integration of habit formation into daily operations is not only a strategic approach to personal development, but it's also a cornerstone of organizational success. With platforms like KaiNexus further enabling this integration, healthcare systems and other industries are well-positioned to excel in their continuous improvement endeavors, ultimately elevating the quality of service and operational efficiency in profound ways.

Harnessing the Full Spectrum of Technology, Methodology, and Leadership in Continuous Improvement

While technology like KaiNexus greatly facilitates the process of continuous improvement, it is becoming increasingly clear that it cannot operate in isolation. The coalescence of technology with sound methodology and resilient leadership behaviors forms the foundation for an effective and sustainable continuous improvement culture within any organization.

The Triad of Technology, Methodology, and Leadership:

  • Balancing the Elements: An equilibrium among technology, methodology, and leadership ensures that the system functions optimally, avoiding an overreliance on any single component.
  • Functioning Synergy: When these elements work in concert, the collective system supports a widespread adoption of continuous improvement without imposing undue burdens on any level of leadership.
  • Evolution of Technologies: With advancements in technology, it is paramount that methodologies and leadership strategies evolve concurrently to utilize these tools to their maximum potential.

Organizations that successfully integrate these elements not only simplify the process of improvement but also lower the threshold for the effort required by executives and local leaders to drive change. This synergy creates an infrastructure that standardizes methodologies and galvanizes the continuous improvement (CI) team to foster innovation without the need to build complex systems internally.

The Exponential Potential with Integrated Platforms

Transitioning from rudimentary tools like Excel and SharePoint to sophisticated platforms such as KaiNexus can catalyze an explosion of improvement potential. These platforms allow teams to clearly articulate their impact, demonstrating value and tapping into the intrinsic motivation of frontline workers who may previously have lacked an outlet for participation.

  • Automating Communication: Essential tasks like notifications and reminders can be automated, streamlining the continuous improvement process.
  • Impact Measurement: Both qualitative and quantitative impacts are tabulated, providing executives and teams with insight into not just activity, but the far-reaching effects their improvements are having.

By standardizing how improvements are reported and measured, organizations can ensure that improvements are not only being implemented but also celebrated, motivating team members to continue participating and contributing to company-wide goals.

Lean Principles in Practice: The Real Value

The discussion surrounding the value of lean management underscores the fact that lean, or any continuous improvement principle, has no inherent value in the abstract–it is the consistent application and practice of these principles that create impactful change.

Translating Lean Principles into Meaningful Improvements:

  • Value Beyond Process: Lean must translate into improvements that benefit employees, customers, and the business at large.
  • Empowerment and Recognition: Continuous improvement shows employees their opinions matter, affirming their significance in the organization's success and fostering a culture of empowerment.
  • Benefitting from Side Effects: Just as running in circles might seem pointless, the side benefits–healthier bodies, improved endorphins–are the true rewards. In lean, the ‘running' is the process, and the health is the marked improvements in efficiency, safety, and satisfaction.

Cultural Acceptance and Adaptability of Continuous Improvement Software

In the past decade, there's been a visible shift in the level of acceptance when it comes to using software platforms for managing continuous improvement. The question has moved on from whether to use technology to how to integrate technology without overhauling existing successful processes.

  • Configurability Over Conformity: It is crucial that technology be adaptable and capable of mirroring an organization's unique continuous improvement processes, without forcing changes to these proven methodologies.
  • Technology as an Enabler: Technology should bolster and facilitate a company's existing process, never dictating how they must approach their improvement journey.

As companies grow, the need for a flexible, customizable technology platform becomes more apparent. KaiNexus and similar systems exemplify how technology can be tailored to support an organization's unique approach to continuous improvement. This ensures that even as internal processes evolve, the platform remains a supportive tool, serving the people and the process rather than the other way around.

Culture-First Approach in Technology Companies

As the conversation concludes, the importance of fostering a culture-first approach, even within a technology-centric organization like KaiNexus, is highlighted. Culture and values form the bedrock for decision-making and talent acquisition. By hiring individuals who reflect the organization's values, leadership ensures that as the company expands, the foundations of success and identity are preserved and strengthened.

  • Defining and Refining Values and Traits: Companies must reflect on their journey, identifying what has worked and establishing a values-based framework for decision-making.
  • Hiring with Culture in Mind: It is essential for organizations to seek out talent that personifies their core values and traits, ensuring a cultural fit that predicts success within the company.
  • Flexibility in a Values Framework: While values and traits serve as guiding lights, discussions and debates around these are fundamental in maintaining a dynamic and responsive culture.

In technology companies focused on continuous improvement, nurturing a culture that allows for a learning-from-mistakes mentality is foundational. A cultural acceptance that errors are an inevitable step in the continuous improvement process is essential in fostering an environment where everyone, from the CI team to front-line workers, feels that their contributions are valuable and that their efforts toward improvement are recognized and make a difference.

Continuous Improvement as a Way of Life

The journey of continuous improvement is perpetual, with evolving technology, methodologies, and leadership approaches that traverse well beyond the confines of business. Every aspect–from lean principles to culture-first strategies–serves to emphasize that continuous improvement is not just an aspect of one's professional life but a way of life that can enrich all facets of an individual's personal and professional existence.

Embracing Mistakes in the Journey of Continuous Improvement

The Importance of Mistakes in Learning and Growth

One of the most profound insights in the realm of continuous improvement is the understanding that making mistakes is an integral part of the learning journey. It is not the error itself that defines us, but rather the lessons we glean and the actions we take following a mistake that truly shape our paths.

  • Encouragement to Share: By encouraging the sharing of mistakes, we open the door to collective learning and reduce the stigma associated with errors.
  • Valuing the Learning Process: Organizations must cultivate an environment where mistakes are seen as growth opportunities and where continuous improvement is a demonstration of commitment to betterment.

In this manner, each mistake becomes a stepping stone toward greater understanding and efficiency. Consequently, the continuous improvement process turns into an educational narrative that reassures everyone involved that their experiences contribute to the overall progress of the organization.

Learning from Others: The Collective Benefit

Collecting and disseminating stories of past errors and the resultant improvements offers a valuable reservoir of knowledge. This collective intelligence serves as a tool for preempting future issues and accelerating the learning curve for everyone.

  • Storytelling as a Learning Tool: Through sharing stories, citizens within an organization can avoid repeating past mistakes and instead build upon previous learnings.
  • Creating a Repository of Experiences: A structured approach to documenting errors and the lessons learned creates valuable resources for ongoing reference.

Utilizing platforms like KaiNexus can help in cataloging these narratives and making them accessible organization-wide, thereby enriching the knowledge base and fostering a continuous learning environment.

Inspirational Leadership: Leading by Example

Leaders who are open about their own mistakes model the behavior they seek to nurture within their teams. By highlighting their errors and emphasizing their own learning process, they send a powerful message that it is safe and encouraged for others to do the same.

  • Leaders as Role Models: Leaders who are transparent about their failures provide strong role models for embracing mistakes as part of the growth process.
  • Fostering a Safe Environment: When leaders share their missteps, they help to create a culture where employees feel secure in expressing their vulnerabilities and taking calculated risks.

This approach inspires a community within the workplace that actively exchanges insights and continually builds on collective wisdom, pushing the boundaries of innovation and efficiency.

Continuous Learning and Improvement Conferences

Conferences and events, such as the healthcare systems process Improvement conference, bring together thought leaders and practitioners in the field of continuous improvement. They offer a venue for sharing experiences, networking, and staying abreast of the latest advancements and methodologies.

  • Networking Opportunities: Conferences allow professionals to connect with peers from diverse backgrounds, sharing insights and forging partnerships.
  • Learning from the Best: Presentations and case studies at conferences provide exposure to best practices and successful strategies from various industries.

Anticipation for such events grows as they present unique opportunities for personal and professional development within the continuous improvement community. These gatherings are crucial in sustaining and reviving the commitment to a culture where improvement is indeed a way of life.


Automated Transcript (Not Guaranteed to be Defect Free)

Mark Graban:
Hi, welcome to the podcast. I'm Mark Graban. We are joined today by Greg Jacobson. He is the co founder and CEO of KaiNexus. He was previously a guest, and we were both dumbfounded by this before we started recording twelve years ago in episode 149.

Mark Graban:
He was also part of a team that was here for episode 361, ask docs anything during the COVID era. Greg is also still a practicing emergency room physician. You may have heard Greg and I talking more recently in episode 31 of the My Favorite Mistake podcast. And Greg and I regularly talk about continuous improvement in different episodes of our KaiNexus continuous improvement podcast. So Greg, welcome back here.

Greg Jacobson:
I'm doing great. Thanks so much for bringing back. I cannot believe that not only has it been twelve years that I've been on the podcast, but it means that our relationship goes back that long. So it's a pretty remarkable time to get to know you and work with you. And thanks for bringing me back.

Greg Jacobson:
Well, sure.

Mark Graban:
And I feel the same. And yeah, I mean, quick recap and we're going to talk about two main things here today. One is the upcoming conference produced by the Society for Health Systems, the healthcare systems Process Improvement conference, February 13 to 15th in Atlanta. We'll come back and talk about that more, and we're going to do a little bit of an update about KaiNexus. But the long story short of it is Greg and I met in February of 2011, and I became part of the team at KaiNexus in June of that year.

Mark Graban:
And my role has evolved and changed as the company has grown. But I like to say it's a part time role, full time belief in the company. So, Greg, we're still here. The company's growing, and we'll come back and talk about that. But congratulations, and thank you for all of that progress.

Greg Jacobson:
Well, thank you for the call out on that. And I love when you say part time role, full time belief. So that's lovely to hear.

Mark Graban:
Yeah. So again, about the conference, and we're talking about this because Greg, I'm really excited about this. Greg is one of the three keynote speakers this year. Again, that's a healthcare systems process improvement conference. There's a link in the show notes.

Mark Graban:
We're going to give a preview of Greg's talk today. This is a conference I attend almost every year, and I have going back to probably 2006. It's part of the Institute of Industrial and Systems Engineers. So that is my home professional organization, and the Society for Health Systems is part of that. I am going to be leading, facilitating what they call an intensive session.

Mark Graban:
So I believe it's a 90 minutes session, interactive session. A lot of conversation and discussion in the room about psychological safety and continuous improvement. But Greg, I'm excited you're going to be us. You know, give us a little bit of a preview of the topic and what you're going to be sharing in your keynote.

Greg Jacobson:
Yeah. So I have been really fascinated with habit and habit science now for. I mean, we've been probably talking about it for seven, eight mean, really, with Du Higg's power of habit was my primer, my introduction to the idea that habit formation is not something that happens by accident, or it's not something that necessarily has to happen by accident. It's something that happens by accident a lot of the time when people aren't intentional about either removing bad habits or adding good habits. And it's been a really meaningful part of my professional career, my personal development.

Greg Jacobson:
And I think the success of mean we teach these concepts in personal productivity. And then as time went on, James clear came out with his book Atomic Habits, and it became apparent to me that, wait a minute, this habit literature and habit formation does not need to just be thought of on the personal level. Every book talks about it being on an organizational level, but it's usually a small, minor part. Maybe it's a chapter, maybe it's a part of a chapter. And so we here at KaiNexus have just gotten really passionate about how can we use habit science to create the behaviors that we're looking for that will foster a culture of continuous improvement?

Greg Jacobson:
And so we added Fogg's book tiny habits, and really synthesized that information to be consumable to someone in a 45 minutes hour format. We've done talks and stretched it out and added a lot more content, but I'm looking forward to presenting about that and hopefully just getting the juices flowing for people to realize that behavior creation can be intentional. It reminds me that when I say behavior creation being intentional, is that we've also added a book into kind of the KaiNexus lexicon called critical influence. The primary or the first author on that is Grenny, and I highly recommend it. Prior editions of that book were called influencer, and I think they changed it.

Greg Jacobson:
Yeah, they've changed it in the third edition because influencer and social media means something a little bit different than what he's talking about, but just really intentional leadership of changing behaviors. And so I'm really excited. This has really resonated with people in general. It applies way beyond KaiNexus software and I think it's incredibly applicable to what we're trying to accomplish in healthcare of spreading continuous improvement.

Mark Graban:
Yeah. And I'll put a link, by the way, or links to those three webinars that Greg did with Morgan Wright, one of our colleagues from KaiNexus, for that really super deep dive into all of this. I know you're going to share a lot of this in the keynote, and it's out there in the webinars for people who can't come and attend the conference. We hope people will, because there's a lot to learn, a lot of great activities and learning there. But let me throw a question at you, Greg, and tell me if this is, in your view, kind of a myth like we hear a lot.

Mark Graban:
I think even going back to Benjamin Franklin, some variation of a phrase, like it takes 21 days to build a habit. But I know from learning from what you've taught, this is a leading question, but it seems like it takes more than just doing something for 21 days straight. Right?

Greg Jacobson:
Yeah, I think that, I love little axioms like that because there's probably some bit of wisdom, and I think the bit of wisdom that I would take is that habits aren't going to be just doing something one time and that they're going to simply change your behavior. So I think habits are on a spectrum, and I think people can gain strength of a habit and then weakness of a habit. And I think there's a lot of things that could influence whether or not you keep up with a habit. But I don't know if there's a certain duration of time that I would say, oh, if you do this for x number of days, then you're certainly going to do it for the rest of your life because you can just simply change your identity, you can change your desires, you can change your environment, and there's only 24 hours in a day, so it might be a prioritization issue as well. So there is a lot to think about when you're thinking about habit formation.

Greg Jacobson:
And I think, though I'll say it's a lot simpler than one would imagine.

Mark Graban:
Yeah. And I think there's a lot of application of these lessons about building and sustaining habits that could apply in the realm of lean. You look what organizations are doing. The phrase daily comes in a lot like lean. Daily management, daily huddles.

Mark Graban:
I had somebody ask me once, how often should we do our daily huddles? I'm like, well, you could do them daily.

Greg Jacobson:
Or it reminds me of going to the cruise ship information desk and saying, what is the altitude that we're at? Probably sea level.

Mark Graban:
Yeah, but to make something a daily habit can be difficult, whether it's in the realm of lean. I always come back to a personal example, because something I'm going to do later today is 30 minutes of yoga and stretching, and that's beneficial. And I know I want to do it, I need to do it. And ideally, that would be a daily practice. I've had months, and my yoga app tracks it at least once, maybe twice.

Mark Graban:
I did all 30 or 31 days of a given month. But I think that maybe proves that the axiom is somewhat true. It wasn't automatic. I mean, it was encouraging and reinforcing to do yoga for 30 days in a row, but it's still pretty good habit beyond that. But I try to build in cues.

Mark Graban:
Right? That's one of the keys to building and sustaining a habit that you talk about.

Greg Jacobson:
So you're touching on what neither of them invented these concepts, but I think they made these concepts a little bit more tangible for the non academicians. The habit loop, now, duhiggs is a three step habit loop and clears is a four step habit loop. I personally am a simple minded person, so I like fewer steps. And the habit loop is really the idea that you're going to first have a cue that's going to trigger a routine, and then it's really important that that routine have some type of reward that is meaningful to you. And I say meaningful probably in an emotional, but also in really a biologic sense, that it tickles, that it triggers, that it engages the dopaminergic system.

Greg Jacobson:
And that will help when the next time you see that queue, you'll again do that routine. Let's talk about a daily management situation where you're trying to do a daily huddle. What is the queue for that? Some of the best cues are location and time. So it might be when we're at this place at 09:00 we are going to do this routine where we're going to talk through these three, five, seven topics.

Greg Jacobson:
But make sure you're building a reward there for that group to make sure that the next time, the next day, hopefully that comes along, you do that. So for your yoga example, I would make sure it's definitely on the calendar. I would make sure you have a plan, like at 10:00 I am going to do this. And that you've set your environment up to be successful. You've got your yoga clothes, you've got your yoga mat, or whatever the things are that you do.

Mark Graban:
You can't see it. The yoga mat is behind me, actually, right here.

Greg Jacobson:
I would also venture to say that maybe don't start with 30 minutes, maybe start with five minutes of yoga and build from there.

Mark Graban:
I did start shorter, and now I've built up to 30. And part of that reward is my lower back feels so much better. So there's positive physical reward, and I'm trying to build in more positive mental reward and think about yoga as something I get to do as opposed to something I have to do.

Greg Jacobson:
Right.

Mark Graban:
And trying to enjoy and being present and what have you. But for some reason, the other day, someone popped into my head. I was done with the yoga. I kind of, in my head, said, good job. Oh, that was another kind of reward.

Mark Graban:
I'm like, I'd like to make that a habit, too, of that reinforcement. I'm not perfect at yoga, but it's good that I did it. I tried.

Greg Jacobson:
Yeah. And I think that you're articulating an example that was even discussed in the book, that if there's not an obvious reward, you can literally create your own reward, which is what you did. You could also text your wife, hey, just want to let you know I just finished my. And she's going to give you a thumbs up or a heart, or go, nice job. Maybe you have an accountability partner that you're doing that.

Greg Jacobson:
Hey, just finished my yoga session. So those are all things that if you create these things and you have been a little bit thoughtful in how you're going to do it, all simple things. This is not complex quadratic equations or this is not rocket science, as they say. These are simple things. Doesn't mean they're easy to do, necessarily.

Greg Jacobson:
But if you're aware and you're mindful and you're intentional about it, your success rate is going to be much higher. And I know we're just doing a little bit of a primer. We'll dive in all these things more in the keynote and in the webinars that we mentioned. But having the identity of, oh, I'm a daily yoga practitioner, that's a very different statement than, oh, I'm trying to do yoga every day and start a habit of that.

Mark Graban:
And there's some growth mindset language there. Right. I'm somebody who practices yoga, as opposed to saying, I'm good at yoga, which that would be more the fixed mindset. Right. I am a person who practices yoga.

Greg Jacobson:
Right. And so when you self identify as that, then all of a sudden all your micro decisions are made for you. In the case of yoga, there's probably only two micro decisions for the day is do I have a plan for when I'm going to do it that day? And then when that plan comes up, am I going to do it or not? Right.

Greg Jacobson:
And so if you self identify as I'm a person that practices yoga or I'm a person that practices daily yoga, when that time comes up, what is the decision that someone that identifies as that, well, obviously you're going to get down and do your yoga. Which applies also to an organization, right. If a CEO, if she says to the organization, we are a continuous improvement organization that does daily management, that collects ideas from the frontline staff, that has a strategy deployment discipline, that's just what we do versus, oh, well, we're trying to do an idea program.

Mark Graban:
Yeah. And those cues, maybe as a final thought on this, could include leaders have on their tablet or they printed out their leader standard work sheet for the week. It could be their calendar, that queue that helps prompt the action of what habit they're building and working on.

Greg Jacobson:
Yeah. And what's interesting is let's continue to pick on the executive there for that leader standard work. I was talking to the coo of a very large electronics company and I just wanted to set that. And so we have concepts minkind access of badges and habits. And the first thing that came out of his mouth was a product enhancement, a piece of feedback on the product that related to him losing a streak in KaiNexus, related to a badge.

Greg Jacobson:
That was the first thing that came out of his mouth. So do not underestimate the impact of congratulating people when, oh, you've done your leader standard work every day for the last week or every week for the last month. Those are things that need to be built in and built in intentionally to create that reward and to call those out and make sure your system has a way to measure that so you know who needs help and who to congratulate. And those are all going to be part of the kind of the intentional and the system design that you're going to build to ensure that your organization is creating the right habits.

Mark Graban:
Yeah. So let's segue to talk about KaiNexus, the company and the software platform. There are a lot of people out there who have a daily habit of logging in to KaiNexus and using the system. I know KaiNexus is much more well known than twelve years ago with the growth and the spread of the company, but let's not assume people know what KaiNexus does and what the platform is for. So you probably get asked all the time, what's your elevator pitch?

Greg Jacobson:
KaiNexus is a continuous improvement software platform where we're used by organizations that believe everybody should have the opportunity to participate in improvement every day. And so we are working with large organizations that are doing some form of bottom up idea collection, issue collection, and not only just collecting it, but processing it all the way to causing improvement at an organization. Helping organizations do their lean focused project management work, whether it's domaic or PDSA or a three s, organizations that are doing strategy deployment, hostion work that has maybe cascading goals or needs to be some alignment. And then the final kind of group of use cases relate to process based work, whether that's leader standard work or rounding or some kind of incident collection and evaluation. And we have grown a lot from 2012.

Greg Jacobson:
If you listen to this, in 2012 it would have probably just been a Kaisen suggestion system. I think that's what we really started at and have just evolved and really found that we add the most value and people get the most value from us in really scaled enterprise large organizations. So if you're a team of 100 people or less, we could add value. It's just typically not the direction you're going to go. You're going to use something kind of off the shelf that needs a little configuration.

Greg Jacobson:
But if you're into the hundreds, thousands, tens of thousands of people, then we really shine.

Mark Graban:
Yeah. And since 2012, like you said, greg, it's become a much broader platform of various modes of improvement. Not just, and neither of us are being dismissive, if I were saying not just employee suggestions, because that is so key and critical, but people are managing Kaizen events, a three s, Toyota Kato work all kinds of lean or six Sigma or whatever they're calling it, methodology strategy deployment. It's really become a very robust management system.

Greg Jacobson:
Yeah. And I think that some of the biggest changes are one, in 2012, we were just healthcare, and we had people continue to reach out to us like, why are you all only talking about healthcare? These are manufacturing automotive improvement principles. And so we made the decision to do a mini pivot and make our product industry agnostic. And as people kept reaching out to us and saying, oh, but we want to do a three s or, oh, but we want to do our x matrix, or, but we want to do a PDSA format.

Greg Jacobson:
And so we are very keen on being process agnostic, discipline agnostic, as long as you're in the continuous improvement realm. And so now we have more non healthcare customers and healthcare customers. And we do lots more with regard to that. And it's been fun adding in all the habit, science has been slowly infiltrating KaiNexus and really trying to allow behavior change to happen a lot easier and be facilitated by technology.

Mark Graban:
There are certain key principles that I think are still really rock solid within KaiNexus. One is the idea, kind of elaborate on what you've touched on is that technology is not a silver bullet, right. That you need technology, methodology and leadership behaviors and some of the words around that change over time. But that's been really consistent and I think reinforced over time.

Greg Jacobson:
Yeah, no, this is not a black box technology. This is not something you can just plug into the corner like an air filter, let's say, and it'll just clean the air. This is something that is going to decrease the threshold for the amount of effort an executive leader, senior leader, or local leader needs to expend in doing it. It creates an infrastructure to do the methodology in a standard way that kind of everyone agrees on. And then, of course, it allows a CI team not to have to go build something internally.

Greg Jacobson:
And so what we've seen is that when people were doing it on Excel and Sharepoint, and then they move over to KaiNexus, there's kind of this explosion of improvement potential that gets actualized. And so they're really able to articulate the impact and articulate the value, and they're really able to tap into the intrinsic motivation of the front line that exists. Sometimes they didn't feel like they had an outlet or a way to participate in an improvement. So it's been very rewarding. It's become my life's work, and I think we're one having fun.

Greg Jacobson:
But more importantly, we're helping people's lives and organizations to meet their business goals better.

Mark Graban:
Yeah, and there's a couple of elements of the KaiNexus platform. I'm sure people aren't assuming that it somehow automates improvement, because it doesn't. But it can automate some communications, some notifications and reminders and things like that. But then the other thing that's been so exciting to see over time is the tabulation of impact, both qualitative and quantitative. People can see that executives love seeing the reports on not just the activity, but the impact, and then collectively, across all customers.

Mark Graban:
I know we published this on the website, but Greg sends out, he calls it his favorite email of the month. It's my favorite email to receive with those numbers, the financial impact number, self reported and validated. By our different customers is over.

Greg Jacobson:
It's in the six to 7 billion, hundreds of millions of saved hours, hundreds of thousands of safety improvements and quality improvements and satisfaction improvements. So it just reminds us why we get out of bed in the morning and continue to work on this. It's fun to see that we've talked about this before, Mark. There's nothing inherently valuable in lean, right? There's no action in there.

Greg Jacobson:
The value of lean in the principles. In the principles of lean, exactly. The value comes from practicing it and either creating an impact for the business, for the people that work at the business, for the customers that get benefit from the business. It's from the individuals, from a self value standpoint, that when you walk into work saying, do I matter, do my opinions matter? When I go home and I know that I was valued at work, I'm going to treat the people better at home and be more present.

Greg Jacobson:
It's the side effect of doing right. There's no probably inherent value in running right. You run into circle, you end up right back where you started. But the benefit is that you're healthier and you get the endorphins and those are the side effects. And so that's kind of what I mean.

Greg Jacobson:
And that's why I think that email makes the most sense because it's probably the closest thing we have to all the individual stories of someone, a driver or a nurse or a doctor or a line person saying, oh yeah, man, this used to frustrate me, or we used to get an injury every month related to this, or now I can spend my time doing something far more valuable than this kind of repetitive task. So those are the real benefits and the value of lean and continuous improvement.

Mark Graban:
Yeah. And I think one other thing that's changed over twelve years, the last ten years, is the level of acceptance of using a platform, of using software to manage continuous improvement. Going back to 2011, 2012, a lot of people were still being, I'll say this and I'll try to be constructive or fact based, that a lot of people really just shot down technology of like, oh, my sensei taught me to do everything manually and pencil and paper, and that's a whole different long discussion. But you've already touched on this, Greg. People are already using technology and then the question is homegrown, cobbled together, easily breakable, not so scalable or a platform like KaiNexus.

Greg Jacobson:
Right.

Mark Graban:
It's really more of like, which technology wouldn't lead in question, but what would you say on all of that?

Greg Jacobson:
Yeah, and I think a lot of it has to do with, I think, technology and the aughts. And in the early teens, were they forced you to change your improvement process because of the way the technology was built. And so it's an area that we're really cognizant of to make sure that it's configurable to meet our customers processes. So the first step isn't, oh, well, here's our default way. We do idea collection, and we have a couple of different configuration tweaks.

Greg Jacobson:
But the first step is like, how do you do it? Let's draw a process map and see how does that work at company a, B, and c, and then figuring out, okay, so this is your ideal state. Everyone agrees this is the ideal state. Well, let's configure the technology to do that. And then when it changes, because the organization changes in a month, a year, then you can configure the technology to support that.

Greg Jacobson:
So I think the technology needs to be a slave to the process and to the people. It shouldn't be the other way around.

Mark Graban:
Yeah. There may be a final question before we wrap up. Greg, one thing I appreciate about your leadership and other senior leaders at KaiNexus is the focus on people and culture.

Greg Jacobson:
Right.

Mark Graban:
It's a technology company, but I know we agree it is driven by people, and we have great people at KaiNexus and a culture where we aim to let those people shine and thrive. And we had a chance to explore this through the inclusion of stories from KaiNexus that I put into my book, the mistakes that make us around a culture of participation and improvement and psychological safety. What are your thoughts, in a nutshell, about the culture at KaiNexus and being intentional about that.

Greg Jacobson:
So great question, and I'm not going to answer it with going through what our values and traits are, but I'll answer it with when we realized we needed to figure out what they were, and it was probably about five years ago, we had crossed maybe the 20 person mark or 15 person mark somewhere in the point that it started to become where the co founder, Matt and I, and Jeff and Adam and Maggie, who were the first executive leaders, weren't interacting with everybody every day. And so it became apparent that we needed to figure out what has made us successful to this point, because as we're going to get bigger, people are going to need a framework to make decisions, to figure out how they should behave, to figure out when people are doing the right behaviors. And so we sat down only then. So five, six years into our journey to figure that out. We didn't do that at the beginning.

Greg Jacobson:
And so I think that's important to be self reflective and figure out what are the things that we do that have created the most success in our organization, and then really manage and make decisions around those and constantly bring those back up and say, oh, well, let's make this a decision because it exemplifies this value or this trait, and we hire for that. Just before this call or before recording this podcast, I was on a call where we were interviewing, and we hire, and we're looking for these things in people because we know if these people exemplify these things, they're going to be successful at KaiNexus. And so I think that's really important to, as leaders are thinking about what is their role in their organization, it's important to, one, make sure that they've established those things, but then it's important for them to continue to articulate and repeat those, and then to make decisions based on them and explain why at least they believe, and then have debates and conversations about the way everyone believes, but in the context of those values and traits, because that's really what defines a culture. Seth Godin says the best when he says, people like us do things like you. I'm glad you brought that up.

Greg Jacobson:
Thank you for that space.

Mark Graban:
Yeah. And I will put links in the show notes. There is a fantastic video that Greg and Jeff Roussell, our chief revenue officer, put together about these values and traits at KaiNexus. I'll link to that. The audio is going to be available soon in the KaiNexus podcast feed, actually.

Mark Graban:
And then I'll also link on the KaiNexus blog. I did put together an excerpt from the book, some of these stories about the KaiNexus culture. And maybe last question real quick, before we both have to go, your thoughts on the importance of an environment and a culture where we can learn from mistakes?

Greg Jacobson:
Yeah, I think that learning from mistakes is at the root of continuous improvement. It's the realization that there could be a better way in us kind of opening our minds and realizing that we are not defined by our last mistake. We're actually defined by what we did with learning from our last mistake. And so I just think the work you're doing in collecting those stories and putting the mistakes that make us is such a valuable contribution. So thank you, Mark, for doing that work.

Greg Jacobson:
But that's kind of the way I look at it, and I make mistakes every day and love to highlight them, not because I love making mistakes, but because I love learning from mistakes, and I want other people to learn from my mistakes as well.

Mark Graban:
That's a perfect note to end things on. So again, we've been joined today. Greg Jacobson, co founder and CEO at KaiNexus. Come join me and Greg at the healthcare systems process Improvement conference, February 13 to 15th. Well, near here, Atlanta.

Mark Graban:
So looking forward to that and hope a lot of people will be able to join us. Greg, thanks so much. And let's make sure it's not another twelve years before we do another episode.

Greg Jacobson:
That sounds great, Mark, thanks so much for having me.


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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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