I’ve seen a number of people post on LinkedIn about the passing of the legendary “Mr. Oba” of Toyota (sometimes spelled “Mr. Ohba”) — Hajime Oba passed away on September 4th, in Connecticut. I’ve heard many stories from people who…
It's time for another new, revised edition of my book! The 4th edition is the fastest new edition yet, since the world is changing quickly and increasingly uncertain. Hospitals need to react now! Do something! Cut costs! Reduce costs! Slash costs!
A number of you emailed me about this report in the Detroit News. I grew up in Detroit and my first job was as a carrier for the News. Loved ones have received care from the Detroit Medical Center system……
I’m really excited to have Steve Bera as my guest for episode #256 of the podcast. I read about him as he was featured prominently in a chapter of the 1994 Pulitzer-Prize winning book Comeback: The Fall & Rise of…
Today’s post is an addendum from Saturday’s post on the apparent death of a health system Lean program: “Why Would a New Healthcare CEO Kill a Lean Program?“ If you read that post, there’s an interesting comment from a Presence…
I wrote a new piece for LinkedIn that I hope would be of interest to you even if you’re in healthcare. Why? It’s a story about what an organization does when you don’t have enough (or any) direct work for your front-line staff to do. Toyota would continue paying employees and would put them to...
If you follow the auto industry, you might have seen headlines this week about how Toyota is being forced to shut down production in its Japanese factories next week (see one article, via Bloomberg). If you’re a devotee of the Toyota Production…
TL;DR: A re-aired episode of This American Life on NUMMI highlights enduring lessons about leadership, learning, and Lean. While critics like Labor Notes frame Lean as “management by stress,” my experience inside GM–and later in healthcare–points to management systems, not…
Editor’s note (2026): This post remains highly relevant as organizations increasingly rely on algorithmic scheduling, utilization targets, and AI-driven workforce planning. TL;DR: Zeynep Ton’s Good Jobs Strategy shows that cutting labor costs creates a vicious cycle of poor performance. In…
My friend Ryan, who works at a hospital in Canada, sent me a few pictures of an Industrial Engineering textbook that he used almost 20 years ago. He wrote: “I was cleaning up my upstairs when I came across a…
Lean provides a philosophy and a management model that should be nothing but good for staff and patients. The idea of “respect for people” might sound nice in principle, but what does it mean in a practical sense...
Happy June, everybody! Summer is here. We’ve actually had a delightfully long spring here in San Antonio, which means the temperature hasn’t really been above 90 yet, which counts as cool (and comfortable for us). I’m headed off to Los…
