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.
If your emergency department metric improved this quarter and you felt good about it, the problem might not be your emergency department. It might be your metric. Most hospital leaders have been in this meeting. The percentage of patients seen…
There are things about Lean you cannot learn from a book, a conference, or a consultant. I say that as someone who writes the books and gives the talks. You learn them by standing in a place where the work…
I asked the Lean Hospitals Coach to role-play as a manager bringing me a problem. Then it evaluated my coaching in real time. Within three exchanges, it caught a habit I teach others to avoid. The Problem I Was Given…
Dr. Eric Dickson spent the early part of his leadership career telling people what to do. It nearly cost him everything. What he built after that failure — over 23 years and eventually across a $5 billion health system —…
I had a long conversation last week with one of the first subscribers to the Lean Hospitals Coach. She’s a senior continuous improvement coach at a community hospital, working mostly with nurse managers and directors. She told me up front:…
A new report from the HHS Office of Inspector General (OIG), released in July 2025, found that hospitals failed to capture 49 percent of patient harm events among hospitalized Medicare patients. The report is titled “Hospitals Did Not Capture Half…
AI tools are showing up everywhere in healthcare — for clinical decision support, operational analytics, and now for learning and coaching around improvement methodologies. If you’re a healthcare leader exploring AI, you’ve probably already been pitched a few. Most evaluation…
Here’s something I’ve learned over many years of consulting: giving people advice they haven’t asked for is a reliable way to get ignored, no matter how correct the advice is. This is also, unfortunately, exactly what every AI tool does.…
TL;DR: Three stories from a single day highlight a familiar pattern in healthcare technology: a pharmacy text message with the wrong hours that nobody has fixed, medical imaging that has to be mailed on a physical CD in 2026, and…
TL;DR: I asked ChatGPT how to use Lean to reduce hospital headcount. It gave me a detailed plan to do exactly that. My custom Lean AI refused and explained why. Generic AI will confidently help you damage your culture. I…
This week’s Operational Excellence Mixtape tackles the challenge of sustaining improvement amidst turbulence and change fatigue. We explore why values must act as your “North Star” when markets shift, methods for building quality systems that fight entropy (with examples from…
TL;DR: NUMMI proved in the 1980s what healthcare is still learning today: you can’t punish your way to safety. Real improvement comes from mutual trust, system thinking, and leaders who respond to problems with curiosity–not blame. When we talk about…
