Popular Posts
A Lean Management System That Doesn’t Depend on the Lean Team — Emily Swaney, OhioHealth What 21,050 Clinicians Told Us About Fear and Futility
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A Lean Management System That Doesn’t Depend on the Lean Team — Emily Swaney, OhioHealth

ByMark Graban September 30, 2026 Comment (0) 884
Emily Swaney, VP of Operational Excellence at OhioHealth, explains how a Lean Promotion Office of 11...
Historical black-and-white image of nurses and aides performing separate tasks for patients in a crowded hospital ward, illustrating functional or assembly-line nursing.

Assembly-Line Nursing Was Meant to Be Temporary

ByMark Graban September 29, 2026 Comment (0)
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The Toyota Andon System in South Africa: Two Buttons Instead of a Cord

ByMark Graban September 27, 2026 Comment (0)
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Ryan McCormack’s Operational Excellence Mixtape: September 25, 2026

ByRyan McCormack September 25, 2026 Comment (0) 3624

Mark Graban

Lean Leadership, Psychological Safety, and Continuous Improvement

Since 2005, LeanBlog.org has shared practical insights from real-world work in healthcare, manufacturing, and beyond.

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Books by Mark Graban on Lean, Leadership, and Learning (4)

Lean Blog Interviews Podcast

emily swaney in a black blazer smiling in a bright hospital corridor with blurred medical equipment and a Lean Blog logo

A Lean Management System That Doesn’t Depend on the Lean Team — Emily Swaney, OhioHealth

ByMark Graban September 30, 2026 884
Emily Swaney, VP of Operational Excellence at OhioHealth, explains how a Lean Promotion Office of 11 people supports a Lean management system for 35,000 associates. The approach relies on developing...
20 year anniversary lean blog interviews podcast

20 Years Of Lean Podcasting, Thanks to Norman Bodek

ByMark Graban July 16, 2026 1209
Twenty years ago, on July 16, 2006, the Lean Blog Podcast began with a conversation with Norman Bodek. Norman was my friend and mentor–and the person who suggested that I start doing audio...
thomas cox and andre demerchant lean

Why Lean Fails to Stick — with Thomas Cox and Andre DeMerchant

ByMark Graban June 24, 2026 1722
Why does Lean fail to stick so often? Thomas Cox and Andre DeMerchant join me on Episode 547 to make the case that the missing precondition is psychological safety, and that it has to exist at the top...
gary peterson

When a Lean Leader Admits He Doesn’t Know What He’s Doing, with Gary Peterson

ByMark Graban June 10, 2026 1728
Gary Peterson spent almost 40 years helping O.C. Tanner build a continuous improvement culture, work that earned the company the Shingo Prize in 1999. He joins me to talk about psychological safety...

More Blog Posts

Pilot in a cockpit viewing a coastline at dusk with glowing instrument panels and the Lean Blog logo in the corner

What The Rehearsal Gets Wrong About Pilots–and Right About Leadership Training

Mark GrabanByMark Graban September 14, 2026
Season 2 of The Rehearsal opens in a cockpit. Two pilots are on final approach. The first officer thinks they're lined up wrong and says so, mildly. The captain brushes it off. The first officer tries...
medical mistakes and re-training

Training as a Countermeasure? The “Fix” You Can Finish by Friday.

Mark GrabanByMark Graban September 10, 2026
Empty hospital wellness room with armchair, succulent, and noise machine — designed but unused

What 21,050 Clinicians Told Us About Fear and Futility

Mark GrabanByMark Graban September 9, 2026 22
Conceptual illustration of automotive engineers being sorted into fixed performance-ranking categories, with the lowest-ranked group highlighted in red against a factory and vehicle-design backdrop.

GM Adopted Forced Ranking in 2024. Ford Dropped It in 2001.

Mark GrabanByMark Graban September 7, 2026
Cassette tape with unspooled magnetic tape forming a winding path on a surface with printed directional arrows

Ryan McCormack’s Operational Excellence Mixtape: September 4, 2026

Ryan McCormackByRyan McCormack September 4, 2026 3624

Webinars

karen martin ask the expert webinar kainexus

Ask Karen Martin Anything on Operational Excellence: A KaiNexus Webinar

March 5, 2026
Karen Martin is one of those people I've been lucky to know and learn from for a long time. She's...
1. Professor with glasses in front of EMS 20th anniversary logo and KaiNexus logo on blue background.

Unlock the Power of Leadership: A Preview of the Electrolux Manufacturing System (EMS) Webinar

December 4, 2025
KaiNexus recently hosted a webinar I was especially looking forward to: “Unlock the Power of...
Breaking Through Cultural Friction: Respect for People and Sustainable Performance

Breaking Through Cultural Friction: Respect for People and Sustainable Performance

June 9, 2025
When organizations struggle to sustain Lean transformation, people often look first at tools...
Driving a Culture of Patient Safety: Lessons for Healthcare and Beyond

Driving a Culture of Patient Safety: Lessons for Healthcare and Beyond

April 28, 2025
Recently, I had the pleasure of moderating a webinar titled “Driving a Culture of Transforming...
Why Lean Fails Without Psychological Safety

Why Lean Fails Without Psychological Safety

April 16, 2025
TL;DR: Lean tools don't fail because people resist change–they fail because people don't feel...
Preview: Driving a Culture of Accountability – Transforming Patient Safety with KaiNexus (Webinar, April 15)

Preview: Driving a Culture of Accountability – Transforming Patient Safety with KaiNexus (Webinar, April 15)

April 8, 2025
One of the most powerful elements of continuous improvement is the ability to learn from each other...
My Upcoming Webinar on Mistake-Proofing Across Industries

My Upcoming Webinar on Mistake-Proofing Across Industries

February 3, 2025
I'm excited to be presenting this webinar on February 12th at 1 pm ET as part of the KaiNexus...
Top 5 Takeaways from my KaiNexus Webinar: Psychological Safety as a Precondition for Continuous Improvement

Top 5 Takeaways from my KaiNexus Webinar: Psychological Safety as a Precondition for Continuous Improvement

January 8, 2025
TL;DR: Psychological safety isn't optional for continuous improvement. This KaiNexus webinar...
Creating Leader Standard Work (LSW) Across a Distributed Business Model — Webinar Preview

Creating Leader Standard Work (LSW) Across a Distributed Business Model — Webinar Preview

November 7, 2024
I'm happy to be hosting and moderating this webinar that will be presented by Brent Loescher, a...
Embedding Change Management into your Continuous Improvement Initiatives – Webinar Preview

Embedding Change Management into your Continuous Improvement Initiatives – Webinar Preview

September 25, 2024
I'm happy to be hosting and moderating this webinar that will be presented by Melissa Sherman, a...
View Our “Ask Us Anything” Event on Psychological Safety and Lean

View Our “Ask Us Anything” Event on Psychological Safety and Lean

August 20, 2024
Psychological safety is often described as “feeling safe to speak up.” In Lean...
From Strategy to Execution: Webinar with Karen Friedenberg

From Strategy to Execution: Webinar with Karen Friedenberg

July 17, 2024
Are you looking to transform your business strategy into actionable results? Join us for our...

Videos

john toussaint collaborative care fox video

ThedaCare’s Collaborative Care, Captured on a 2009 Video

ByMark Graban June 17, 2026 Comment (0) 582
Back in 2009, I pointed an early iPhone at my TV and recorded a Fox News segment about ThedaCare's...
mark graban elisabeth swan linkedin live

Mistakes and Leadership Lessons: Still Learning, Three Years Later

ByMark Graban May 8, 2026 Comment (0) 1000
Three years ago, The Mistakes That Make Us came out. Around the same time, Elisabeth Swan published...
Yellow diamond warning sign on a pole showing a cyclist flying over handlebars after hitting streetcar tracks, along the Ohio River in Cincinnati

Warning: Signs! Mistake-Proofing Is More Effective Than Warnings

ByMark Graban April 20, 2026 Comment (0) 779
At the 2024 KaiNexicon (the KaiNexus user conference), I gave a talk called “Warning: Signs!...

Mark Graban on YouTube

Emily Swaney, VP of Operational Excellence at OhioHealth, explains how a Lean Promotion Office of 11 people supports a Lean management system for 35,000 associates - by developing about 1,500 leaders as problem-solving coaches instead of leading projects. Episode #548 of Lean Blog Interviews. Full transcript and show notes: https://www.leanblog.org/548 We discuss: - Why the Lean team doesn't lead projects, and how process owners take over after kaizen events - Coaching leaders to stop being heroes and to advance problem-solving at the gemba - The patient safety exception to slow coaching - Second coaches, including managers who coach hospital presidents on their coaching - Five-tier safety huddles, good catches, and a roughly twofold increase in reported concerns - Closing the loop on escalations during daily protected gemba time - How frontline teams choose their own KPIs, connected to the balanced scorecard - What's next: an associate idea platform and extending the system into corporate functions Chapters: 0:00 Introduction 1:08 Emily's path into Lean and healthcare 3:29 Why Lean over Six Sigma in healthcare 6:05 Using marketing to sell the management system 8:47 An 11-person Lean team for 35,000 associates 12:21 Why the Lean team doesn't lead projects 15:08 Coaching leaders to stop being heroes 18:29 The patient safety exception 19:01 Psychological safety and tiered safety huddles 22:59 Good catches and looking for patterns 27:30 Closing the loop through protected gemba time 30:45 Structure and accountability for gemba walks 33:44 Coaching the coaches 35:53 Connecting frontline KPIs to the balanced scorecard 42:17 Executive buy-in and results 45:01 What's next: idea platform and corporate functions 47:58 Emily's expanded role Guest: Emily Swaney - https://www.linkedin.com/in/emilyswaney/ Host: Mark Graban - https://www.markgraban.com/ Subscribe to the podcast: https://www.leanblog.org/podcasts/podcasts-how-to-subscribe/ Part of the Lean Communicators network: https://leancommunicators.com/ #Lean #LeanHealthcare #OhioHealth #ContinuousImprovement #TieredHuddles #Gemba #PsychologicalSafety #LeanManagement
How 11 People Support a Lean Management System for 35,000 | Emily Swaney, OhioHealth
Toyota has been replacing its famous andon cord with buttons. I visited Toyota's plant in Durban, South Africa, to see how the andon system works there and why they made the switch. Toyota started the change at a plant in Toyota City in 2013. The Durban plant switched about a year ago, and they gave me two reasons. First, there are now two buttons. Yellow calls for help, and red stops the line right away for something like a safety issue. Second, with 90 to 100 andon activations a day in one area, reaching overhead that often was becoming an ergonomics risk. The hardware changed, but the response didn't. When a team member pressed the button, the team leader was there within seconds. Read more on LeanBlog.org: The Toyota Andon System in South Africa: Two Buttons Instead of a Cord https://www.leanblog.org/2026/09/toyota-andon-system-south-africa/ Why Toyota Is Eliminating the Andon Cord (2014) https://www.leanblog.org/2014/08/toyota-eliminating-andon-cord/ Follow for a new Lean short every week. #Andon #Toyota #ToyotaProductionSystem #Lean #LeanManufacturing #ContinuousImprovement #Kaizen #Leadership #PsychologicalSafety #Manufacturing #Shorts
Why Toyota Is Replacing the Andon Cord with Buttons
Strategy deployment -- hoshin kanri -- is supposed to work like a game of catch. Goals flow down from leadership, ideas and feedback flow back up from the people doing the work, and both sides adjust. The ball goes back and forth. A lot of organizations are playing dodgeball instead. The ball only goes one direction, it's thrown hard, and the people on the receiving end are just trying not to get hit. The cost isn't the meeting time you save by skipping the conversation. It's the year you lose executing against metrics that don't match the work. In this short, I share what happened when a hospital cascaded a patient falls target to a labor and delivery unit whose patients don't fall -- and the dashboard that would have looked perfect while the real risks went unmeasured. More on Lean leadership, psychological safety, and continuous improvement at LeanBlog.org. #StrategyDeployment #HoshinKanri #Lean #LeanLeadership #ContinuousImprovement #Leadership #CatchBall #OperationalExcellence #Kaizen #ProcessImprovement
Catch Ball or Dodgeball? How Goals Really Flow in Lean Management
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