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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

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...
Leading Lean for Profitable Growth: CEO Bill Canady on Using Lean and the 80/20 Principle

Leading Lean for Profitable Growth: CEO Bill Canady on Using Lean and the 80/20 Principle

ByMark Graban April 9, 2025 5606
What happens when a CEO treats Lean as a growth system instead of a cost-cutting program? In this episode, Bill Canady shares how he combines Lean, daily management, and the 80/20 principle to drive...
From Noise to Knowledge: Embracing Data-Driven Leadership – Christopher R. Chapman

From Noise to Knowledge: Embracing Data-Driven Leadership – Christopher R. Chapman

ByMark Graban March 18, 2025 4726
Scroll down for how to subscribe, transcript, and more My guest for Episode #525 of the Lean Blog Interviews Podcast is Christopher R. Chapman. He's an experienced agile coach and consultant with a...
John Willis on Deming’s Journey to Profound Knowledge in IT and DevOps

John Willis on Deming’s Journey to Profound Knowledge in IT and DevOps

ByMark Graban March 12, 2025 8610
Scroll down for how to subscribe, transcript, and more My guest for Episode #524 of the Lean Blog Interviews Podcast is John Willis, an accomplished IT management expert with over 45 years of...

More Blog Posts

Lean Blog Cover (24)

Hyundai’s Humanoid Robots, GM Layoffs, Jim Farley’s Ford Quality Turnaround, and Toyota Kaizen for Coffee Farmers

Mark GrabanByMark Graban July 31, 2026 8641
Formerly known as “Lean Whiskey” Listen: In Season 2, Episode 9, Mark Graban and Jamie Flinchbaugh recap the World Cup, declare a “dealer's choice” coffee round, and wade into...
Corkboard covered in pinned papers and red yarn, every strand converging on one small index card at the center

Do 90% of Lean Transformations Really Fail? I Went Looking for the Number

Mark GrabanByMark Graban July 30, 2026 697
Composite blog cover image showing four factory workers of different ages in safety gear standing in an industrial workplace, above two side-by-side charts comparing workplace fatality counts and rates by age; the left chart suggests higher total deaths in middle age groups, while the right chart shows fatality rates rising sharply for older workers.

Workplace Deaths by Age: Why Counts and Rates Tell Different Stories

Mark GrabanByMark Graban July 29, 2026 398
Lean Blog Cover (4)

A Locked Complaint Box in Greece: Learning From Customer Complaints, or Just Bureaucracy?

Mark GrabanByMark Graban July 28, 2026 387
Lean Blog Cover (21)

If This Were Assembly Line Medicine, You Could Stop the Line

Mark GrabanByMark Graban July 27, 2026 377

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
I'm excited to share the first printed proof copy of The Mistakes That Make Us, my new (upcoming)...

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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