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All posts from Mark Graban’s LeanBlog.org, including podcasts, announcements, articles, and more.

“ER wait times down, but only slightly” or ER wait times are virtually the same?

This article was sent by a friend and blog reader from Winnipeg the other day:

"ER wait times down, but only slightly"
Oh good, the waiting times are down. But what does "only slightly" mean? Have ER wait times gone down in a meaningful way? Or are they just comparing two data points? Is this "down" a matter a signal or is it just noise in the system?

These are the types of questions that can be answered by methods in my new book Measures of Success: React Less, Lead Better, Improve More.

Are Reshoring Trends Real? Using Process Behavior Charts Instead of Headlines

Bar graph with upward trending arrow inside an industrial space, highlighting business growth and Lean principles.

I started my career in manufacturing, so that's just one reason I'm interested in the topics of offshoring (sending manufacturing work overseas) and what's now called "reshoring," or bringing jobs and factories back to the U.S.

Somebody at A.T. Kearney sent me a link to their recent report on reshoring, with the headline:

Reshoring in Reverse Again
US manufacturers are not exactly coming back in droves. In fact, the 2018 Reshoring Index shows that imports from traditional offshoring countries are at a record high.

When you learn to look at data and workplace metrics through the "Process Behavior Chart" methodology, you learn to be skeptical of text descriptions like "a record high." Does "a record high" mean that the data point is statistically meaningful? Not always.

Why Unchanging Metrics Can Be a Warning Sign

1. Nurse in green scrubs drawing blood from a patient's arm with a syringe.

Today's post is some material that I wrote for my book Measures of Success but cut due to length. I've modified the material a bit to hopefully be fine as a standalone post.

There's a somewhat humorous, if not scary, story from a book (This is Going to Hurt) written by a former "junior doctor" in the British National Health Services (NHS) -- the equivalent of a "resident" in the American medical education system.

Podcast #310 – Steve Shortell, The Impact of #Lean on Healthcare Quality

Joining me again for Episode 310 is Stephen M. Shortell Ph.D., MPH, MBA. He is Blue Cross of California Distinguished Professorship, HPM and is a Professor of Organizational Behavior at the University of California, Berkeley School of Public Health. 

He was previously a guest on Episode 267 talking about the establishment of the Center for Lean Engagement and Research (CLEAR) at the University of California, Berkeley, where he is the director. 

In this episode, we talk about some initial research that they released in a paper that was published in The Joint Commision Journal on Quality and Patient Safety:

"Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results From a National Survey"

It’s Exciting to See an “Idea Board” at Buffalo Trace Distillery

Thanks to posting about the trip on LinkedIn, I learned that Mike Bukowski is now working for Sazerac, the parent company of Buffalo Trace, in a process improvement role. Last year, Mike attended the site visit and class that Joe Swartz and I hosted at Franciscan St. Francis Health.

Mike has embraced might call "lessons from Toyota," as taught to healthcare people, and is now training and coaching people who make some very fine bourbon, including Aaron Krentz, Processing Supervisor (at right).

Podcast #309 – David Meier, A Toyota Guy on Making Bourbon with a Continuous Improvement Flavor

Back on the podcast for the sixth time is my friend David Meier, a Lean / TPS consultant who is a former Toyota leader at their plant in Georgetown, Kentucky. As we mentioned in our April episode (#304), he's gotten into what's, perhaps, the most Kentucky of industries... distilling bourbon (and more) at Glenn's Creek Distillery.

In this episode, there's a lot of bourbon talk, with some Lean concepts thrown in. If you share our interest in Lean and whiskey, then this might be your most favorite episode ever. Of course, if you don't have any interest in bourbon, you might well skip this one.

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