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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.

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Books by Mark Graban on Lean, Leadership, and Learning (4)

Lean Blog Interviews Podcast

Podcast #210 – Lean in Washington State Government: Darrell Damron and Hollie Jensen

Podcast #210 – Lean in Washington State Government: Darrell Damron and Hollie Jensen

ByMark Graban October 1, 2014 1478
Listen My guests today are Darrell Damron and Hollie Jensen and we're talking about Lean in Washington state government. Darrell and Hollie are both state employees, serving in the role of Enterprise...
Podcast #209 – George Friesen on Lean, Kaizen, and Idea Boards – Experiences at the NUMMI Plant

Podcast #209 – George Friesen on Lean, Kaizen, and Idea Boards – Experiences at the NUMMI Plant

ByMark Graban September 18, 2014 1545
Listen My guest for episode #209 is George Friesen, Business Practice Leader for Lean Transformations in the Workforce Solutions Group at St. Louis Community College. In this episode, we talk about...
Podcast #208 – Michael Bremer on How to Do a Gemba Walk in Lean Management

Podcast #208 – Michael Bremer on How to Do a Gemba Walk in Lean Management

ByMark Graban September 9, 2014 2439
Joining me for episode #208 is Michael Bremer, author of the recently released book How to Do a Gemba Walk. Michael is president of The Cumberland Group, a business improvement consulting firm...
Emily’s Story, Part 2: Forgiveness, Emily’s Law, and the Case for System Change in Healthcare

Emily’s Story, Part 2: Forgiveness, Emily’s Law, and the Case for System Change in Healthcare

ByMark Graban August 28, 2014 3274
Chris Jerry, founder of the Emily Jerry Foundation, continues his conversation on why patient safety demands system change — not blame — and why he chose to publicly forgive the pharmacist...

More Blog Posts

From Strategy to Execution: Webinar with Karen Friedenberg

From Strategy to Execution: Webinar with Karen Friedenberg

Mark GrabanByMark Graban July 17, 2024 1679
Are you looking to transform your business strategy into actionable results? Join us for our recorded webinar, “Leveraging a Strategy to Execution Framework: A Journey of Transformation,”...
MLB runs per game trend line on baseball stadium background.

Stop Comparing MLB Stats Year to Year: A Better Way to See Real Trends

Mark GrabanByMark Graban July 15, 2024 8198

Lean Whiskey #47: Decriminalizing Medical Errors, Mouse Jiggling, and New (to us) Bourbons

Mark GrabanByMark Graban July 12, 2024 4768

Ryan McCormack’s Operational Excellence Mixtape: July 12, 2024

Ryan McCormackByRyan McCormack July 12, 2024 5514

What People Know But Won’t Say: The Hidden Cost of Low Psychological Safety

Mark GrabanByMark Graban July 11, 2024 2672

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

Lean Blog Homework – CNBC CEO Videos

ByMark Graban January 9, 2007 Comment (0) 771
I can't get the videos to play on my PC. CNBC did interviews today with the Big 3 big wigs, a big...

30 Rock’s Jack Donaghy Declares Jack Welch Greater Than the Pharaohs

ByMark Graban December 2, 2006 Comments (8) 2713
We know Dilbert makes fun of Six Sigma, but the new NBC show “30 Rock” does a great job...
“Assembly Line Medicine”? What Lean Healthcare Really Means

“Assembly Line Medicine”? What Lean Healthcare Really Means

ByMark Graban November 28, 2006 Comments (7) 1674
I give many lean overview presentations to healthcare audiences. While I mostly talk about the...

Mark Graban on YouTube

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
Eric Dingler paused a weekly numbers meeting with his wife for six weeks. It became a year, and a cash-flow gap grew into debt he kept to himself. Eric, author of Hire to Grow, was running two businesses remotely while his family traveled full time through 20 countries. Without the weekly check-in, losing a client led to a short draw on a line of credit, then another, then one that never got repaid. Embarrassed, he held off telling his wife until he could also show her a way out. Meanwhile he launched a string of new offers that confused clients and his email list. He explains what was driving that silence, what changed after he told her, and how the same pattern shows up when owners hold on to work they should be handing off. What you'll learn: 🔵 Why pausing a routine accountability meeting can remove the check that catches both bad ideas and bad numbers 🔵 How a small line-of-credit draw snowballed when no one else was looking at the numbers 🔵 Eric's "significance, acceptance, and security" explanation for why people hide mistakes, even from someone who has never given them a reason to fear the reaction 🔵 Why testing ideas with bullets before cannonballs broke down once he started launching out of panic 🔵 The difference between training a team and developing one, and how that let Eric go 10 days in the Amazon without checking in 🔵 The 10/10/80 approach to using the hours a first hire frees up 🔵 Why Eric has committed that no one on his team will lose their job to AI 🔵 The first step for an owner who suspects they're the bottleneck: an honest time audit Chapters (approximate): 00:00 Meet Eric Dingler 02:05 The paused weekly meeting 06:05 Panic launches vs. small tests 10:34 Significance, acceptance, and security 14:38 Training vs. developing your team 19:35 Hiring before you feel ready 23:25 AI and a people-first team 34:48 Healthcare as a digital nomad 38:36 First step: an honest time audit Eric Dingler is a business coach and the owner of In Transit Studios, a digital marketing agency. He helps small business owners build teams that can run without them in the day-to-day. Hire to Grow: Make Your Next Hire Pay for Themself in 30 Days: https://link.amazon/B0cccpPQF (affiliate link) Website: https://ericdingler.com LinkedIn: https://www.linkedin.com/in/ericdingler/ Episode page, show notes, and full transcript: https://markgraban.com/mistake368 Subscribe to My Favorite Mistake for more conversations with leaders about the mistakes that changed how they work. #MyFavoriteMistake #Leadership #SmallBusiness #Hiring #Delegation #PsychologicalSafety #DigitalNomad
The Accountability Meeting He Stopped Having | Eric Dingler
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