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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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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.

Books Keynote Speaking Coaching / Advisory Podcasts
Books by Mark Graban on Lean, Leadership, and Learning (4)

Lean Blog Interviews Podcast

Coaching for Continuous Improvement: Lean Leadership Lessons from Sports with Hugh Alley

Coaching for Continuous Improvement: Lean Leadership Lessons from Sports with Hugh Alley

ByMark Graban September 5, 2024 4599
Scroll down for how to subscribe, transcript, and more My guest for Episode #514 of the Lean Blog Interviews Podcast is Hugh Alley, an author and consultant. He divides his time between coaching...
Insights from ‘Leading Excellence’: Brad Jevons and Stephen Dargan on Adaptive Leadership

Insights from ‘Leading Excellence’: Brad Jevons and Stephen Dargan on Adaptive Leadership

ByMark Graban August 21, 2024 4791
Scroll down for how to subscribe, transcript, and more My guests for Episode #512 of the Lean Blog Interviews Podcast are two of three co-authors of the upcoming book “Leading Excellence: 5 Hats...
Flow Engineering in Action: Insights from Authors Steve Pereira and Andrew Davis

Flow Engineering in Action: Insights from Authors Steve Pereira and Andrew Davis

ByMark Graban August 7, 2024 5555
Scroll down for how to subscribe, transcript, and more My guests for Episode #512 of the Lean Blog Interviews Podcast are Steve Pereira and Andrew Davis, authors of the new book Flow Engineering: From...
Failing Forward: An Interview with Sam Yankelevitch on Lean, Communication, and Innovation

Failing Forward: An Interview with Sam Yankelevitch on Lean, Communication, and Innovation

ByMark Graban July 24, 2024 3839
Scroll down for how to subscribe, transcript, and more My guest for Episode #511 of the Lean Blog Interviews Podcast is Sam Yankelevitch, a distinguished global operations executive who has dedicated...

More Blog Posts

kainexus logging mistakes and failures

Eiji Toyoda on Mistakes: Give Your All, Then Write It Down

Mark GrabanByMark Graban July 1, 2026 878
I was reading The Birth of Lean, the Lean Enterprise Institute's collection of interviews with the people who built the Toyota Production System, and one answer from Eiji Toyoda is worth quoting in...
cartoon illustration of a team member pulling an andon cord

No, One Toyota Worker Can’t Stop the Whole Factory

Mark GrabanByMark Graban June 29, 2026 1535
mixtape leanblog june 2026

Ryan McCormack’s Operational Excellence Mixtape: June 26, 2026

Ryan McCormackByRyan McCormack June 26, 2026 4232
thomas cox and andre demerchant lean

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

Mark GrabanByMark Graban June 24, 2026 1722
Lean Blog Post Cover Image - 2026-05-04T072020.396

What Toyota’s 1992 Booklet Means by Kaizen and Job Ownership

Mark GrabanByMark Graban June 22, 2026 898

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

Videos by Skip Steward That Explain Routine Variation and Rules for Finding “Signals”

ByMark Graban November 7, 2018 Comment (0) 894
You might remember the podcasts that I did with my friend Skip Steward, the Chief Improvement...
The One Where I’m Interviewed About Lean in Healthcare (and Also Talk Metrics)

The One Where I’m Interviewed About Lean in Healthcare (and Also Talk Metrics)

ByMark Graban August 17, 2018 Comment (1) 952
Somebody pointed Dominic Rubino to me as somebody who could be a guest on his podcast. His podcast...
My Article for the LEI “Lean Post”: React Less and Improve More…

My Article for the LEI “Lean Post”: React Less and Improve More…

ByMark Graban August 14, 2018 Comment (1) 1190
It's been a while since I've contributed something to the Lean Enterprise Institute's online...

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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