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.
Why healthcare organizations need fewer heroes–and better systems–according to former ThedaCare leader Kim Barnas. In memoriam: Kim Barnas (1956-2026)I always valued my interactions with Kim and deeply admired what she accomplished–and how she treated people along the way. She stood…
Regular readers of the blog will know that one of my favorite topics is “Gaming the Numbers” (or “Gaming the System“). As Brian Joiner so brilliantly wrote, as shared by the late, great Peter Scholtes , there are three things people…
I am an unabashed fan of the ThedaCare Center for Healthcare Value, as you’re probably aware. For full disclosure, I was previously an employee of the Lean Enterprise Institute, a key partner of the Center. They have a lot of…
Sorry to get all Katie Couric on you, but I’m going to have a colonoscopy on Friday. I turned 40 last October and I have some family history that leads my doctor to get one done now rather than at…
It’s often said that Lean is about “doing more with less.” Historically, and practically speaking, it’s true. But, it’s a phrase that we should be careful about for a number of reasons. Looking back at the origins of the term…
Thanks to Dodge Communications for interviewing me for their blog: “Improving healthcare–there’s no instant pudding.” I was, of course, citing the late great Dr. W. Edwards Deming and his “There is no instant pudding” admonition. Hospitals and health systems are…
As a former GM employee and a GM customer, I’m really fascinated by the reaction of the public, the media, and Congress to the recalls and scandal over ignition switch problems in some GM small cars from recent years. The…
In 2009, I wrote about a nurses’ union in New Brunswick that supported Lean because they realized this methodology could help reduce waiting times and improve working conditions. It’s win Yet, as part of the recent politicized Lean healthcare brew-ha-ha in…
The price paid for most management consulting work is based on either a daily rate or some variation of a flat-rate fee based on what is being delivered. Enterprise software pricing is also often fixed. In both cases, the client…
What Henry Ford wrote about hospitals in 1922 sounds surprisingly modern. He argued for reducing nurses’ wasted motion, designing around patients, standardizing rooms, challenging professional hierarchy, and treating every process as experimental. More than a century later, many of those…
TL;DR: Lean thinking teaches us not to blame individuals for mistakes that are caused by broken systems. In healthcare, this mindset aligns closely with Just Culture and patient safety principles: human error is inevitable, fear makes performance worse, and real…
Since the healthcare improvement work I do is apolitical and non-partisan, I’m generally not one to butt into the political affairs of Canada or other countries. But, when I hear complaints about Lean or when it’s being called a “scam”…