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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

Interview with Keith Ingels on Developing Your People and Making Lean /TPS Your Own

Interview with Keith Ingels on Developing Your People and Making Lean /TPS Your Own

ByMark Graban September 6, 2023 2869
Scroll down for how to subscribe, transcript, and more My guest for Episode #484 of the Lean Blog Interviews Podcast is Keith Ingels, who previously joined us in Episode 390. He's the RLM Manager of...
A Discussion with Amanda Zimmerman and Dominic Stokes on “Squishy Lean”

A Discussion with Amanda Zimmerman and Dominic Stokes on “Squishy Lean”

ByMark Graban August 23, 2023 2478
Scroll down for how to subscribe, transcript, and more My guests for Episode #483 of the Lean Blog Interviews Podcast are Amanda Zimmerman and Dominic Stokes, two Lean Six Sigma professionals who...
Interview with “Kata Girl Geek” Gemma Jones on Lean, Improvement, and Mental Health

Interview with “Kata Girl Geek” Gemma Jones on Lean, Improvement, and Mental Health

ByMark Graban August 9, 2023 2456
Scroll down for how to subscribe, transcript, and more My guest for Episode #482 of the Lean Blog Interviews Podcast is Gemma Jones. Gemma is an Improvement Coach, Trainer, and Visual Facilitator...
George Saiz on “We Started With Respect” and His Career Focused on Improvement

George Saiz on “We Started With Respect” and His Career Focused on Improvement

ByMark Graban July 26, 2023 2494
Scroll down for how to subscribe, transcript, and more My guest for Episode #481 of the Lean Blog Interviews Podcast is George Saiz. As a coach, writer, and speaker, George Saiz actively promotes...

More Blog Posts

scott burgmeyer lean think

Why Most People Don’t Think — and What to Do About It, with Scott Burgmeyer

Mark GrabanByMark Graban April 29, 2026 1837
Scott Burgmeyer, founder and CEO of Become More Group, has spent more than 30 years watching smart people make avoidable decisions — not because they lack intelligence, but because they stopped...
A close-up of a metal name badge or nameplate on a dark blue work shirt. The badge reads "PROCESS COACH" in crisp embossed letters. The shirt and badge look new. Behind the figure, slightly out of focus, is an industrial factory environment with fluorescent overhead lighting and assembly line equipment. The composition emphasizes the contrast between the pristine, almost promotional quality of the title on the badge and the harsh, utilitarian reality of the environment. Photorealistic, documentary style, muted industrial color palette with deep blues and steel grays. The mood is quietly ironic - the title and the setting don't match.

Calling a Supervisor a “Process Coach” Doesn’t Mean the Job Really Changes

Mark GrabanByMark Graban April 28, 2026 1469
deming red bead game simulator

A Free Red Bead Game Simulator: Try Dr. Deming’s Experiment Online

Mark GrabanByMark Graban April 26, 2026 850
A yellow andon cord hangs in an empty automotive assembly plant, with one section slightly frayed and worn. Soft overhead industrial light illuminates the cord against a muted backdrop of grays and concrete tones.

Did Ford’s Andon Cord Problem Ever Get Fixed? Help Me Find Out.

Mark GrabanByMark Graban April 23, 2026 1135
A yellow andon cord stretches horizontally across the upper part of an empty factory interior, slightly slack and attached to a dark overhead beam. Below it, a large expanse of smooth concrete floor and muted gray walls creates generous open space, while a softly blurred production line runs along the right side. Natural overhead light and subdued editorial color grading give the scene a calm, documentary feel.

New Book Announcement: Psychological Safety for Lean Leaders — Vote on the Title

Mark GrabanByMark Graban April 22, 2026 590

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

See How a British Psychiatrist is Using LEGO Videos to Explain Lean Healthcare

See How a British Psychiatrist is Using LEGO Videos to Explain Lean Healthcare

ByMark Graban July 21, 2015 Comment (0) 1468
A collection of creative videos was recently brought to my attention and I'd like to share them...
What’s a Kanban System? This Video From Saskatchewan Provides a Great Overview

What’s a Kanban System? This Video From Saskatchewan Provides a Great Overview

ByMark Graban June 8, 2015 Comments (11) 1958
Today, I'm sharing a 10-minute video that was shared by the Five Hills Health Region within the...
Safety Huddles in Healthcare: How Daily Huddles Improve Patient Safety

Safety Huddles in Healthcare: How Daily Huddles Improve Patient Safety

ByMark Graban May 13, 2015 Comments (5) 2391
Following up on yesterday's post on seemingly successful experiments with ACOs, here's another...

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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