Popular Posts
Creating a Continuous Improvement System in Accounting: Nick Katko on PDCA, Culture, and Psychological Safety Signals & Levers: Elisabeth Hendrickson and Joel Tosi on Change Theater, Open Loops, and Systems Thinking for Software Teams How Toyota Turned Around Its Kentucky Plant: Darril Wilburn on Leadership
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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

Gerald Harris on Lean Lessons from Auto Manufacturing and Healthcare

Gerald Harris on Lean Lessons from Auto Manufacturing and Healthcare

ByMark Graban October 4, 2022 1943
Gerald Harris spent 25 years leading lean transformations in automotive manufacturing before shifting into healthcare consulting, and his origin story starts with a Toyota supplier in crisis that went...
Damon Baker on Lean, Private Equity, and the Ownership Works Initiative

Damon Baker on Lean, Private Equity, and the Ownership Works Initiative

ByMark Graban September 28, 2022 2548
Scroll down for how to subscribe, transcript, and more My guest for Episode #458 of the Lean Blog Interviews Podcast is Damon Baker. He was recently my guest in Episode #454. He is the founder and CEO...
Why Sam Morgan Loves Lean (and Kata) and How He Helps Others Be Confident Learners

Why Sam Morgan Loves Lean (and Kata) and How He Helps Others Be Confident Learners

ByMark Graban September 21, 2022 2166
Scroll down for how to subscribe, transcript, and more Joining me for Episode #457 of the Lean Blog Interviews Podcast is Sam Morgan. Sam is a self-proclaimed “confident learner” and...
Jake Stiles on Lean Executives, the Recruiting Landscape, and a Coming “Compensation Correction”

Jake Stiles on Lean Executives, the Recruiting Landscape, and a Coming “Compensation Correction”

ByMark Graban September 14, 2022 2100
Scroll down for how to subscribe, transcript, and more Joining me for Episode #456 of the Lean Blog Interviews Podcast is Jake Stiles, CEO of Stiles Associates. For nearly three decades, Jake has...

More Blog Posts

A bright hospital emergency room waiting area where the space is decorated with red and silver balloons and colorful lighting. Four patients are seated in blue chairs, with one reading a pamphlet. A large TV screen behind the reception counter reads "CELEBRATING WAIT TIME REDUCTIONS! Our Shortest Wait Ever!" accompanied by a bar graph and colorful confetti. Various posters on the walls list the "TRIAGE PROCESS & EXPECTATIONS" and celebrate achievements like "NEW RECORD: TRIAGE IN < 10 MINUTES" and "45% AVERAGE WAIT REDUCTION."

The ER Wait Time Metric That Can Hide Deteriorating Patient Experience

Mark GrabanByMark Graban March 31, 2026 1158
If your emergency department metric improved this quarter and you felt good about it, the problem might not be your emergency department. It might be your metric. Most hospital leaders have been in...
Robot lectures at overflowing whiteboard while a bored human sits with crossed arms and cold coffee, unnoticed.

“Help Me” Doesn’t Mean “Do It for Me” — What ChatGPT Gets Wrong About Coaching

Mark GrabanByMark Graban March 30, 2026 983
meeting where employees are afraid to speak up

Why Employees Don’t Speak Up: Everyday Responses That Create Silence

Mark GrabanByMark Graban March 27, 2026 1552

Toyota vs. Tesla: What Manufacturing Mindsets Reveal About Quality and Culture

Mark GrabanByMark Graban March 26, 2026 12522
catch ball and chuck rock lean strategy deployment

Strategy Deployment: Are You Playing Catch Ball or Chucking Rocks?

Mark GrabanByMark Graban March 26, 2026 939

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

Video: What is Kaizen?

Video: What is Kaizen?

ByMark Graban July 30, 2014 Comment (0) 1654
I made this short three-minute video for KaiNexus where I try to succinctly answer the question...
Weird Al’s Hilarious “Mission Statement” Song & Video Mocks Corporate Buzzwords

Weird Al’s Hilarious “Mission Statement” Song & Video Mocks Corporate Buzzwords

ByMark Graban July 25, 2014 Comments (10) 2285
“Weird Al” Yanokvic skewers corporate buzzwords in this new song and music video. He...
What Does Lean Flow Look Like in Healthcare? Check Out These Two Videos

What Does Lean Flow Look Like in Healthcare? Check Out These Two Videos

ByMark Graban July 1, 2014 Comments (4) 1422
It's easy for people to think that Lean is about cost-cutting. That would be wrong, but many people...

Mark Graban on YouTube

A patient was supposed to undergo surgery for a right-sided inguinal hernia. But the incision was made on the left side. Dr. David Mayer, then a senior anesthesia resident, recalls how the operating room team moved quickly into the procedure while everyone focused on their own responsibilities. About two minutes after the incision, the attending surgeon entered the room, looked at the patient, and asked: “I thought this was a right-sided inguinal hernia?” That was the moment the team realized what had happened. In this clip from *My Favorite Mistake*, Dr. Mayer describes the wrong-site surgery that became a defining experience in his career—and helped shape his commitment to patient safety, transparency, and learning from medical errors. The larger lesson isn’t simply “be more careful.” It’s to understand how systems, communication, time pressure, teamwork, and culture can allow an error to reach a patient. Full episode: **The Surgical Mistake That Changed a Doctor’s Life: Dr. David Mayer on Honesty and Patient Safety** #PatientSafety #MedicalErrors #Healthcare #Leadership #SurgicalSafety #MyFavoriteMistake
Wrong-Site Surgery: The Mistake Discovered Mid-Procedure
How did Toyota’s Georgetown, Kentucky plant go from needing to build almost 90% of its capacity just to break even, to a much healthier 60%? Former Toyota team member Darril Wilburn, co-author with Hiro Yoshiki of Courage, Humility, Kaizen: The Three Disciplines of Toyota Leadership, tells the inside story. We talk about the andon cord myth, “healthy paranoia,” why Toyota never talked about being number one, sending managers back through jishuken, why every VP’s first A3 was sent back by design, and why doing TPS was never the point. Full episode page, links, show notes, and transcript: https://leanblog.org/551 What you’ll learn: 🔵 What really happens when someone pulls the andon cord 🔵 Why psychological safety at Toyota includes being challenged 🔵 How “healthy paranoia” keeps an organization from getting complacent 🔵 How TMMK cut its break-even point from nearly 90% to 60% 🔵 Why Hiro Yoshiki rejected blame and focused on equipping people to succeed 🔵 How Toyota turned its masters’ know-how into teachable curriculum 🔵 Why humility had to be built into how executives were developed Chapters: 00:00 Introducing Darril Wilburn and Courage, Humility, Kaizen 01:47 How Darril met Hiro Yoshiki 05:52 The andon cord myth 07:59 How andon escalation actually works 11:35 Building psychological safety before line-off 13:23 Respect for humanity includes challenge 15:56 Healthy paranoia 18:36 Why Toyota didn’t talk about being number one 20:03 Toyota’s careful entry into the U.S. 22:36 Rapid expansion and a 90% break-even point 24:47 The turnaround: from 90% to 60% 25:39 No blame 27:00 Pulling wisdom out of the masters 30:36 Why expertise had to be dragged out 33:52 Breaking the cycle of rescue teams 35:11 Jishuken and the humility to relearn 37:04 Straight talk instead of spin 40:35 Hiro, not heroes 42:52 Formal and informal communication 46:08 Can you help someone become more humble? 47:42 Every VP sent back on the first A3 51:07 “Doing TPS was never the point” 52:32 Toyota is a business 53:48 Stop counting kaizens when you’re losing money 54:36 Closing Subscribe to Lean Blog Interviews for more conversations on Lean, leadership, continuous improvement, and psychological safety: http://leancast.org/ #Toyota #LeanManagement #ToyotaWay #Kaizen #Leadership #ContinuousImprovement #PsychologicalSafety
Toyota’s Kentucky Turnaround: Courage, Humility, Kaizen | Darril Wilburn
Wrong-site surgery didn’t disappear once healthcare introduced timeouts, checklists, and surgical-site marking. In this clip, Dr. David Mayer explains why those safeguards matter—but also why they aren’t enough on their own. Healthcare began improving these systems because clinicians started talking openly about errors that had previously remained hidden. Without transparency, organizations lose the opportunity to understand how mistakes happen and prevent them from happening again. That’s the larger patient-safety lesson: checklists and mistake-proofing matter, but learning also requires a culture where people can speak openly about errors, near misses, and system failures. This clip is from my My Favorite Mistake conversation with Dr. David Mayer about wrong-site surgery, medical error, transparency, and patient safety. #PatientSafety #MedicalErrors #SurgicalSafety #Healthcare #PsychologicalSafety #MyFavoriteMistake
Why Wrong-Site Surgery Still Happens — Even With Checklists
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