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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

Tim Hobbs: AME Keynote Speaker and Passionate Problem Solver

Tim Hobbs: AME Keynote Speaker and Passionate Problem Solver

ByMark Graban June 4, 2024 3177
Scroll down for how to subscribe, transcript, and more My guest for Episode #506 of the Lean Blog Interviews Podcast is Tim Hobbs, the founder and president of Hobbs Technical Consulting. He is an...
Art Byrne on Lean from the CEO’s Perspective and The Lean Turnaround Answer Book

Art Byrne on Lean from the CEO’s Perspective and The Lean Turnaround Answer Book

ByMark Graban May 22, 2024 6931
Art Byrne returns to the podcast to share CEO-level lessons from decades of Lean transformations and his new book, The Lean Turnaround Answer Book. The conversation covers Lean strategy, cost...
Japan Study Trips: A Voyage of Leadership Discovery with Katie Anderson

Japan Study Trips: A Voyage of Leadership Discovery with Katie Anderson

ByMark Graban May 8, 2024 3659
Scroll down for how to subscribe, transcript, and more My guest for Episode #504 of the Lean Blog Interviews Podcast is Katie Anderson, author of the book Learning to Lead, Leading to Learn. In this...
Lean Coaching for Lean Coaches: Sam Morgan Helps Mark Graban

Lean Coaching for Lean Coaches: Sam Morgan Helps Mark Graban

ByMark Graban April 24, 2024 3331
Scroll down for how to subscribe, transcript, and more My guest for Episode #503 of the Lean Blog Interviews Podcast is Sam Morgan of Illuminate Coaching + Consulting. He was previously a guest in...

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Lean Blog Cover (2)

Ryan McCormack’s Operational Excellence Mixtape: June 12, 2026

Ryan McCormackByRyan McCormack June 12, 2026 4138
Thanks, as always, to Ryan McCormack for this. He always shares so much good reading, listening, and viewing here! Subscribe to get these directly from Ryan via email. News, articles, books, podcasts...
Minimalist line chart over a subtle medical center background, with nearly identical data points clustered just above and below a bold horizontal threshold line. Points above the line glow green and points below glow red, suggesting an arbitrary cutoff separating similar results.

A Prize for Variation? What the NHS Backlog Leaderboard Actually Rewards

Mark GrabanByMark Graban June 10, 2026 580
gary peterson

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

Mark GrabanByMark Graban June 10, 2026 1728
Lean Blog Post Cover Image - 2026-05-13T210609.301

When Behavioral Nudges Help Patients, and When They Cover for a Broken Process

Mark GrabanByMark Graban June 9, 2026 413
Lean Blog Post Cover Image - 2026-06-07T155035.883

AI Didn’t Invent Lean Slop. It Learned It From Us.

Mark GrabanByMark Graban June 7, 2026 834

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

Distinguishing Signal from Noise in Metrics

Distinguishing Signal from Noise in Metrics

ByMark Graban April 2, 2018 Comment (0) 1446
A talk given by Mark Graban at Lean Startup Week 2017. Visit this blog post to learn more:...
Friday Fun: “Bronze Orientation” Video

Friday Fun: “Bronze Orientation” Video

ByMark Graban March 9, 2018 Comment (0) 2611
I sometimes try to share some light or funny on Fridays to get into the weekend with a laugh. I...
A Look Back at “The Good Jobs Strategy” – For Retail and Beyond

A Look Back at “The Good Jobs Strategy” – For Retail and Beyond

ByMark Graban September 28, 2017 Comments (3) 2028
Today, I'm looking back at at podcast from two years ago, sharing this written summary that...

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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