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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

Adam Ward on Lean Design in Healthcare and Lessons from Honda to Hospitals

Adam Ward on Lean Design in Healthcare and Lessons from Honda to Hospitals

ByMark Graban May 21, 2019 1991
My guest for Episode #342 of the podcast is Adam Ward, the author of Lean Design in Healthcare: A Journey to Improve Quality and Process of Care. Adam is an innovation process expert and independent...
Podcast #341 – Dr. Rob Hackett on the Theatre Cap Challenge & Change in Healthcare

Podcast #341 – Dr. Rob Hackett on the Theatre Cap Challenge & Change in Healthcare

ByMark Graban May 15, 2019 2459
My guest for Episode #341 of the podcast is Dr. Rob Hackett, an anaesthesiologist in Sydney, Australia. Rob has become known around the world for his role in what's now called the “Theatre Cap...
Joy Furnival on Lean in the NHS: Lessons from Manufacturing to Healthcare

Joy Furnival on Lean in the NHS: Lessons from Manufacturing to Healthcare

ByMark Graban April 23, 2019 1775
Joining me for Episode #340 of the podcast is Dr. Joy Furnival CEng MIET, an experienced senior NHS manager, improvement leader, and chartered engineer. I first crossed paths with Joy at a Lean...
Charlie Protzman on the BASICS of Lean and Applying Lessons from Manufacturing to Healthcare

Charlie Protzman on the BASICS of Lean and Applying Lessons from Manufacturing to Healthcare

ByMark Graban April 10, 2019 2183
Joining me for Episode #339 of the podcast is Charles Protzman, author of a great number of Lean healthcare books. Today, we are talking about a book that he wrote for a broader audience, The BASICS...

More Blog Posts

Two Years of Learning from Mistakes — Celebrate with the Book for Just $10.99

Two Years of Learning from Mistakes — Celebrate with the Book for Just $10.99

Mark GrabanByMark Graban July 6, 2025 849
It's hard to believe it's been two years since my Shingo Award-winning book, The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation, was published. What started as a...

Medical Mistakes and Patient Safety: Asking “Why?” Instead of “Who?”

Mark GrabanByMark Graban July 3, 2025 1509

When Was the Last Time a Leader Around You Admitted They Were Wrong? [Poll]

Mark GrabanByMark Graban July 1, 2025 910

From Cost Cutting to Real Continuous Improvement: A Lesson from My GM Days

Mark GrabanByMark Graban July 1, 2025 1897

LeanBlog.org 2025 Mid-Year Top 10: Most-Read Articles on Lean, Leadership, and Improvement

Mark GrabanByMark Graban June 30, 2025 3442

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

PDSA Video from IHI

ByMark Graban May 21, 2011 Comments (3) 4045
It's alphabet soup Saturday, as this IHI PDSA video comes from a PhD, Robert Lloyd. A great basic...
Checklists Promoted and Debated on “Grey’s Anatomy”

Checklists Promoted and Debated on “Grey’s Anatomy”

ByMark Graban May 17, 2011 Comments (13) 2014
It's my second post about the TV show Grey's Anatomy, the first being “McDreamy” Fights...
New DVD – “Thinking Lean at ThedaCare: Strategy Deployment”

New DVD – “Thinking Lean at ThedaCare: Strategy Deployment”

ByMark Graban May 6, 2011 Comments (4) 1052
Sorry for what might seem like a very promotional post, but I'm happy to share some details with you...

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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