Tag Leadership

Leadership That Builds Better Systems, Better Results, and Better Work

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.

A Lean Healthcare Job Interview Process: Thoughts and Reflections

Mark's Note: I asked my firiend Sam Selay to write a blog post on this topic after some private discussions that we had. He agreed and shared this post. I've talked to many others who have run into similar roadblocks and frustrations when trying, with the best of intentions, to bring their Lean skills and experience into healthcare.

Sam was one of the contributing authors to the anthology "Practicing Lean," which is now available through Apple iBooks, in addition to Amazon (Kindle and paperback), and Leanpub (eBook and audiobook). Here is his post:

In June, I was informed by my employer that the company had decided to go in a new direction. They said they would now build lean into their processes and enable process owners to be responsible for all continuous improvement functions. To date, I don’t know many organizations that have been able to successfully embed lean into everyone’s work and sustain it.

Operational Excellence Mixtape: August 17, 2018

Healthcare – Creating Value for Patient Canadian healthcare is still mired in a system of outdated technology (including reliance on faxing and pagers) in a world where consumers expect total transparency and availability of data.  Canadian doctors agree that patients should have…

Operational Excellence Mixtape: August 3, 2018

Thanks as always to Ryan McCormack for this… there’s always so much good reading, listening, and viewing shared here by him! Subscribe to get these directly from Ryan via email. Healthcare – Creating Value for Patient Not surprisingly, healthcare organizations with poor cultures of rigid…

Jess Orr on Lean Leadership, Toyota Lessons, and Saving 200 Jobs

My guest for Episode 311 is Jess Orr, a continuous improvement practitioner at WestRock, a large paper and packaging company, where she helps plants foster a culture of continuous improvement and employee engagement.

\Her experience includes working directly for Toyota Motor Manufacturing Kentucky. She is particularly passionate about sharing best practices across industries, which motivated her to found Yokoten Learning.

In today's episode, we talk about her path from Six Sigma Black Belt to a Lean-thinking engineer at Toyota. How did she progress from solving problems herself to developing others? We'll talk about a blog post that she wrote for this blog earlier this year, Lean and ROI, leadership and culture, and much more. What is it like working outside of Toyota again? I hope you enjoy the discussion.

Podcast #310 – Steve Shortell, The Impact of #Lean on Healthcare Quality

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"

Are Hospitals Not Getting Any Closer to Having “Just Cultures?”

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."

The Three Questions That Reveal Whether Your Organization Respects People

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.

Lessons from Tesla “Schooling” Toyota: Did You Get the Memo?

Tesla CEO Elon Musk has been quoted as saying he will "school Toyota on Lean manufacturing."

OK, let's take inspiration and lessons from the apparent Tesla Way management system. What would happen if hospitals and other organizations tried emulating Tesla instead of Toyota? What are the methods and mindsets? The behaviors and principles? What's the management approach and culture?

The GM Quality Death Spiral, Part 2: Production Pressure and the Memos That Blamed Workers

GM Quality Death Spiral 1996 Part 2

Recently, I blogged about a quality catastrophe that I lived through at GM just over 20 years ago, at the now-closed GM Livonia Engine Plant.

Bluntly, the quality problems were caused by poor management and the side effects of their decisions. Even though they constantly blamed workers, management directly interfered with workers and engineers being able to do the right thing for quality.

Here is Part 2 of that story... the first quality "spill" took place in April 1996. As I wrote about last time, Angry high-horse memos were sent out by management. Workers were told to have pride and to pay closer attention to quality (as if those had been the problems).

Trending now

Historical black-and-white image of nurses and aides performing separate tasks for patients in a crowded hospital ward, illustrating functional or assembly-line nursing.
Assembly-Line Nursing Was Meant to Be Temporary
cartoon of mark graban sitting at laptop vibe coding an email filtering app.
Building an AI Email Filter With ChatGPT: A Kaizen Experiment
Lean management whiteboard with S, Q, D, C columns, where D and C are filled with charts and S and Q are blank
The Danaher Business System Page Talks About Speed. Where Did Safety and Quality Go?
Medical professional in dark scrubs stands in a brightly lit hospital corridor, looking toward the distance.
When “I Have a Pulse” Gets Dismissed: A Toddler Found Alive in a Hospital Morgue