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

Ken Segel on Lean Healthcare, Safety, and Building a Comprehensive Operating System

Ken Segel on Lean Healthcare, Safety, and Building a Comprehensive Operating System

ByMark Graban July 9, 2025 3128
In Episode #530 of the Lean Blog Interviews Podcast, I'm joined by Ken Segel of Value Capture to discuss what it really takes to build a comprehensive Lean healthcare operating system, starting with...
YouTube Video Covers - 2025-06-11T102502.958

Designing a Culture of Respect: Lessons from the Respect for People Roadmap

ByMark Graban June 25, 2025 3818
Many Lean transformations stall not because of poor execution, but because respect for people is treated as an attitude rather than a system. In this conversation, Scott Gauvin explains how the...
mark reich lean toyota podcast

Hoshin Kanri and Managing on Purpose: Lessons from Former Toyota Leader Mark Reich

ByMark Graban June 11, 2025 5444
Former Toyota leader Mark Reich explains why Hoshin Kanri is not a top-down planning exercise, but a leadership system for aligning strategy, developing people, and managing on purpose through...
mark graban lean accelerator japan david fitzpatrick

Inside the Lean Healthcare Accelerator: Lessons from Japan with Dave Fitzpatrick

ByMark Graban May 13, 2025 4726
Learning Lean from Japan isn't about copying tools or culture–it's about seeing what's possible when organizations commit to respect for people, continuous improvement, and long-term thinking...

More Blog Posts

Illustration of “success theater”: a glowing metrics board full of green charts and positive indicators sits on a stage framed by red velvet curtains, while behind one curtain, hidden red charts and messy notes reveal operational problems out of view.

Larry Culp on Success Theater, Embracing Red, and the GE Turnaround

Mark GrabanByMark Graban August 18, 2026 267
GE was in bad enough shape in 2018 that investor Nelson Peltz says he was sure the company would end up in Chapter 11. Inside GE, meanwhile, business reviews were full of good news. Both things were...
Factory equipment cabinet stenciled with two identical labels reading LEAN and TPS

Toyota Doesn’t Call It Lean? Its Own Websites Say Otherwise

Mark GrabanByMark Graban August 17, 2026 222
Conceptual illustration of one hospital reporting a safety incident, with the warning transformed into shared learning that spreads through connected pathways to multiple hospitals, each shown with safety shields and improvement symbols.

What If Every Hospital Learned From Every Other Hospital’s Safety Incidents?

Mark GrabanByMark Graban August 14, 2026 235
A single open door stands alone in a wide, empty slate-blue space, with warm light spilling through the doorway and casting a long beam across the floor.

An Insulin Error Killed a Hospital Patient. How Does Every Other Hospital Learn From It?

Mark GrabanByMark Graban August 13, 2026 324
A vintage “Suggestion Plan” booklet sits between a dark, top-down factory culture and a bright, collaborative improvement team, illustrating how the same formal system can produce very different results.

Toyota Copied Ford’s Suggestion System–and Got Far Better Results

Mark GrabanByMark Graban August 12, 2026 578

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

The image shows Jamie Bonini from Toyota with a quote overlayed on the image. The quote reads: "We define TPS as an organizational culture of highly engaged people solving problems or innovating to drive performance."

Toward a Lean Hospital: Culture, Engagement, and Continuous Improvement

ByMark Graban October 23, 2023 Comment (0) 2864
This video explores what it really means to build a Lean hospital culture, drawing on lessons from...

Different Types of Mistakes – Those That Are Preventable & Those That Help Us Innovate

ByMark Graban August 31, 2023 Comment (0) 1984
tl;dr: In this post, Mark categorizes mistakes into two main types: those that are preventable and...
First Printed Proof Copy of The Mistakes That Make Us (Video)

First Printed Proof Copy of The Mistakes That Make Us (Video)

ByMark Graban June 14, 2023 Comments (3) 1302
In June 2023, I held the first printed proof of The Mistakes That Make Us: Cultivating a Culture of...

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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