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.
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…
When productivity metrics are poorly designed, they can punish good people for system failures. Real improvement comes from redesigning the work–not pressuring individuals to work faster. Children’s Hospital of Philadelphia (CHOP) is the oldest children’s hospital in the United States.…
Healthcare – Creating Value for Patients “Imagine walking into a restaurant and being seated. Sometime after your meal, you receive the check and find an additional charge that was not indicated on the menu or previously mentioned by your waiter.…
My guest today is Tim Turner, who joined us previously in 2010 for episode #90. Tim was the lead author for a book called One Team on All Levels: Stories from Toyota Team Members that was about the Toyota plant and its…
Healthcare – Creating Value for Patients If you set a target without providing a clear path on how you want it achieved, and then punish staff when they fail to achieve it, then staff will achieve the target – by any means necessary and…
