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.
Today's post is some material that I wrote for my book Measures of Success but cut due to length. I've modified the material a bit to hopefully be fine as a standalone post.
There's a somewhat humorous, if not scary, story from a book (This is Going to Hurt) written by a former "junior doctor" in the British National Health Services (NHS) -- the equivalent of a "resident" in the American medical education system.
Joining me again for Episode 310 is Stephen M. Shortell Ph.D., MPH, MBA. He is Blue Cross of California Distinguished Professorship, HPM and is a Professor of Organizational Behavior at the University of California, Berkeley School of Public Health.
He was previously a guest on Episode 267 talking about the establishment of the Center for Lean Engagement and Research (CLEAR) at the University of California, Berkeley, where he is the director.
In this episode, we talk about some initial research that they released in a paper that was published in The Joint Commision Journal on Quality and Patient Safety:
"Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results From a National Survey"
It's great to see Lean healthcare featured in one of the world's leading news and business publications. The Economist recently published this article:
"Hospitals are learning from industry how to cut medical errors"
Hi — I’m still not blogging much these days, as I try to focus on finishing my book Measures of Success. You can still buy the current “in-progress” book, which is about 85% complete. I’m still editing and tweaking the book,…
Recently, I stumbled across some video of me and Dr. Greg Jacobson giving a talk at a health system. I think it's from 2013. So, I'm sharing this as a "Throwback Thursday."
KaiNexus software has changed and evolved a lot in five years as the company has grown. Kaizen, or continuous improvement, principles and practices are timeless.
Today, I'm giving a talk at the International Society for Blood Transfusion (ISBT) conference in Toronto. I was invited by the company Quotient to participate in a panel presentation and discussion with some laboratory professionals from the U.S. and the U.K.
The others are presenting examples of how they have improved flow, productivity, and quality in blood collection and hospital blood bank settings. Lean often gets portrayed as just being about efficiency or flow, when Toyota's definition of the Toyota Production System talks about how flow and quality go hand in hand.
I was specifically asked to give a short talk titled, "What Do Cars Have to Do With Healthcare? How to Adopt and Adapt Lessons From Manufacturing."
Today is one of those days where I think, "Forget what I have to say, read this...."
This being a LinkedIn post written by James Hereford, the CEO of Fairview Health Services in Minnesota.
"How huddles help us lead"
I think the "us" says a lot, instead of a headline about "How huddles help ME lead."
For a long time, I've been an advocate for the parallels between Lean and an approach called "Just Culture." See previous blog posts on this topic. Here's a good overview of Just Culture, which says, in part:
"A just culture recognizes that individual practitioners should not be held accountable for system failings over which they have no control. A just culture also recognizes that many individual or active errors represent predictable interactions between human operators and the system in which they work.
However, in contrast to a culture that touts no blame as its governing principle, a just culture does not tolerate conscious disregard of clear risks to patients or gross misconduct, such as falsifying a record, performing professional duties while intoxicated, etc."
I'll be teaching my "Better Metrics" workshop (aka "Measures of Success," ala my book) twice in June:
Cambridge Investments - Open for Public Registration (Fairfield, Iowa) -- June 5
Lean Healthcare Transformation Summit (Chicago) -- June 13
After facilitating the Red Bead Experiment in the workshop, one other way I've found to simulate variation is an online simulation that's available, of all places, on the BBC website:
"Can chance make you a killer?"
Last week, I wrote Part 1 of this piece about TQM and "Small Kaizen" at a Japanese Hospital pharmacy.
The hospital was happy that employees were participating in their "Small Kaizen" process, but there was a month in which they saw the number of submitted Kaizens drop, from about 138 to 58 or so.
As I write about in Measures of Success, two data points usually don't make a trend.
I'm overdue in writing more about my last trip to Japan a few months back.
Today, I'll like to share some highlights from one organization we visited, Seki Chuo Hospital, which is located outside of Nagoya. I have visited this hospital in 2012 and 2014 and it's interesting to see how their approach to Total Quality Management (TQM), Lean, and Kaizen has progressed and evolved. I mentioned them in a 2014 post about "quality circles."
I'm often reminded of three challenging questions that are asked by Paul O'Neill, former CEO of Alcoa and former US Treasury Secretary.
I've mentioned the questions before, in this blog post about Eric Ries and an employee's bill of rights. See more blog posts and my podcast with Mr. O'Neill.
Sadly, I'm reminded of the questions when I'm around people who cannot answer "yes" to them in healthcare workplaces. This is a widespread problem.
