Healthcare improvement isn’t about working harder—it’s about better systems, better leadership, and a culture that supports learning and speaking up. This archive brings together blog posts, podcasts, and reflections on Lean healthcare, patient safety, quality improvement, leadership, and continuous improvement. Many of these posts draw on real hospital experiences and lessons from Deming, Toyota, and frontline healthcare teams, with a consistent emphasis on respect for people and learning from mistakes.
The target printed on the chart was zero percent. The red line had never been near zero. Not in the nine months posted on the wall, and probably not in any month before them. It sat between 6.43% and 6.98%.…
Back in 2009, I pointed an early iPhone at my TV and recorded a Fox News segment about ThedaCare’s collaborative care model. The footage is grainy. You can see the glare on the screen and hear the room around me.…
TL;DR: The NHS backlog gets narrated one month at a time, and millions in bonus money ride on the moves. A Process Behavior Chart shows most movement is noise — and the trusts that stay on top are running structurally…
TL;DR: Behavioral nudges can produce real gains in patient experience at almost no cost. They can also be used to dress up a process that should have been fixed. The discipline for CI leaders is knowing the difference and getting…
A lunch, a hand gesture, and the question most Lean implementations are answering backwards. The gesture is the whole thing. The late Hajime Oba held his hands out in front of him, palms down, one higher than the other. “All…
TL;DR: Rory Sutherland’s Alchemy is a useful provocation for Lean practitioners. Lean already knows how to test small, low-cost ideas without demanding an airtight ROI in advance. We sometimes forget. A Small Idea, Quietly Killed A few years ago, I…
A food company had a flowchart any auditor would love. Every step mapped. Every step mapped. Every critical control point identified. The HACCP plan (Hazard Analysis and Critical Control Points, the standard food safety framework that identifies where contamination can…
Most hospital quality dashboards are designed to answer one question: Are we OK? Green means yes. Red means no. The trouble is, once the answer is green, nobody asks the more useful question: what did we do, and is it…
There’s a hospital somewhere this quarter presenting a labor efficiency story to its board. A unit that used to have a dedicated charge nurse now has a “Working Charge Nurse” – someone who takes patients and runs the unit. The…
Thanks, as always, to Ryan McCormack for this. He always shares so much good reading, listening, and viewing here! Subscribe to get these directly from Ryan via email. News, articles, books, podcasts, and videos about how to make the workplace…
A Florida surgeon, Thomas Shaknovsky, was indicted on a second-degree manslaughter charge on April 13. The charge followed the death of William Bryan, a 70-year-old Alabama man, during what was supposed to be a laparoscopic splenectomy in August 2024. Instead…
TL;DR: The eight wastes give you a lens for seeing problems — but Lean isn’t a scavenger hunt for waste. The real work is understanding why waste exists and building systems where people feel safe enough to point it out.…
