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.
Process behavior charts can be used for more than tracking performance over time. In this post, I apply PBCs to compare knee surgeons’ complication rates–and show why many apparent differences are just noise, not meaningful signals. This post is a…
TL;DR:Process behavior charts help leaders compare hospitals (or any organizations) without overreacting to rankings or small differences. By separating signal from noise, they show when performance differences are meaningful — and when they are simply the predictable result of a…
Healthcare – Creating Value for Patients Healthcare is the world’s largest cottage industry, as evidenced by the enormous variation in practice. Healthcare practitioners may finally be ready to acknowledge that reducing variation is important to improving patient safety and outcomes according…
Actually being a patient in the emergency department is a learning experience, to say the least. I've done that twice in the past twelve months (two cases of really bad stomach flu with high fever). I don't recommend this if you can avoid it.
What I do recommend is an interactive learning experience called "Friday Night at the ER."
More about that in today's post...
Jeff Hunter and I have taught related workshops before, him on the first day (teaching about strategy and Lean), and me on the second (teaching about Measures of Success).
We are working to deliver our first COMBINED workshop that integrates topics of strategy and metrics. We're thinking of doing this in Orlando in March 2019. Please see this page for more information, to sign up to be notified when registration opens, and to give input on what dates would work best for you.
Healthcare – Creating Value for Patients Hospitals have been collecting patient complaint data for decades, but leveraging the data for improvement has remained elusive. Some new publications show how using a big data approach for patient complaint data can help identify…
I'm happy to be hosting, via KaiNexus, another free webinar. Click the link below to register:
How One Community Hospital is Creating a Culture of Continuous Improvement
November 28 from 1:00 - 2:00 pm ET
Presented by Mike McGowan, Director of Process Excellence at Marietta Memorial Hospital
This post also includes thoughts from the KaiNexus community about challenges and barriers to improvement and innovation.
Guest Post by Joe Swartz: At Franciscan Health, we were struggling to create a system-wide standard for our improvement boards. Although we had deployed them to over 50 departments across our 14 hospitals, it has been a struggle to agree on what the boards should look like. Five of our hospitals used rows for each key metric while nine of our hospitals used columns for each key metric. However, now our leadership was asking us to become more standardized across our system.
Healthcare – Creating Value for Patients The benefits of Electronic healthcare records are a polarizing topic with healthcare providers. Standardization and electronic workflows have their upsides, but many are developed to optimize billing and payments, and are not designed with…
Today's podcast is a departure from the usual interview format. As I blogged about last week, the Lean community has lost a young, thoughtful, inquisitive, and reflective member -- Samuel Selay.
I regret not having Sam on the podcast to talk about our learning and reflections. He was a guest of Ron Pereira's on the Gemba Academy podcast in 2016, talking about Lean in the Department of Defense.
Today, I'm doing a reading of a blog post that Sam wrote for this site back in August. I'm also sharing the audiobook version of his chapter from the book Practicing Lean (which is read by our audiobook narrator). It's not his voice, but it's his words and thoughts.
As the Marines say (Sam was an active duty Marine for 13 years), Semper Fi.
There is a GoFundMe page that was set up by Sam's sister-in-law to provide financial support to the family — his wife and four children under 18. I've donated and I hope you might consider doing the same.
Healthcare – Creating Value for Patient A lot can be done to optimize flow in hospitals without investing in additional staff and infrastructure by using an operations research approach. Here’s an example from Ottawa. Patient interviews can be uncomfortable, and it…
The other day, I saw a post on Twitter that included a few photos related to what's often called Lean Daily Management practices in a hospital.
The spirit of my post is not meant to come across as "they're doing it wrong" but more in the spirit of "they're doing a lot of great things, but it would be better if..."
If Lean Daily Management is supposed to be, at its core, about identifying opportunities for improvement, I'd hope they wouldn't be offended by my recommendations, but I also don't want to link to the Twitter post or call them out by name. I will pass along private feedback through a channel I have. But, I'm writing a post because what I see here is VERY common in different organizations (not just healthcare).
