Leadership isn’t about titles, charisma, or quick decisions—it’s about creating systems where people can do their best work and continuously improve. This archive brings together blog posts, podcasts, and reflections on leadership through a Lean lens, drawing on ideas from Deming, Toyota, healthcare, and real-world management practice. The common theme: leaders shape culture, influence behavior, and own the systems that produce results—for better or worse.
Process behavior charts offer a way to move beyond emojis, colors, and single data points by showing whether a metric is actually changing or merely fluctuating. This post explores why many common visual scorecards unintentionally drive overreaction — and how…
Joining me today for episode #357 is Michael Conroy, M.D., the Chief Medical Officer of Sutter Medical Group in northern California. Mike was previously the Medical Director of the Lean Promotion Office for the Palo Alto Medical Foundation and he…
TL;DR: In healthcare huddles, how leaders ask about patient safety can either invite honest discussion or make speaking up feel risky. Open-ended, system-focused questions–combined with consistent follow-through–are essential for building psychological safety and preventing harm. I think that working to…
TL;DR: Two Japanese hospitals improved patient safety by combining Toyota-style problem-solving with psychological safety. By making it safe for staff to report problems and near misses, leaders uncovered more issues, learned faster, and reduced harm–turning safety into part of daily…
tl;dr: When doctors and nurses are afraid to speak up about safety risks, problems stay hidden and patients are harmed. Real cases from the UK show how fear, retaliation, and leadership behavior undermine patient safety, while true improvement requires psychological…
Healthcare – Creating Value for Patients Sometimes you just need to get a team together and improve. Here’s a good example of use of A3 thinking to improve opioid prescribing in outpatient rheumatology. Reducing harm requires the conditions to speak up, raise…
The other day, I stumbled across an old article that I remember, as it was published in the Wall Street Journal in 2004. The WSJ normally has a paywall, but this article is old enough that it’s free to the…
Joining me for episode #354 of the podcast is Kim Hollon, the CEO and President of Signature Healthcare, based in Brockton, Massachusetts. I first met Kim about a decade ago and, as we discover during the podcast discussion, one of…
Healthcare – Creating Value for Patients It’s been 20 years since To Err is Human, the seminal report from the Institute of Medicine, was released, estimating, to many people’s surprise, that almost 100,000 deaths per year in hospitals could be prevented. …
Kim Hollon is CEO and President at Signature Healthcare. I don’t know him well, but I’ve heard a lot of great things about him and his leadership from a friend who used to do Lean work at Signature. I did…
Healthcare – Creating Value for Patients Does Lean “work” in hospitals in the US? Sort of, according to the Journal of Healthcare Management. There is evidence that Lean improves efficiency and financial performance, but little evidence to support improvements in patient…
My guest for Episode #353 of the podcast is somebody whose work I’ve appreciated for a long time — Quint Studer. I was first introduced to his book Hardwiring Excellence back in 2005 and I’ve been following his work (and…
