Quality doesn’t come from inspection, pressure, or choosing between speed and accuracy. It comes from well-designed systems, capable processes, and leaders who focus on learning instead of blame. This archive brings together blog posts, podcasts, and reflections on quality through a Lean and Deming lens—covering psychological safety, metrics, variation, leadership behavior, healthcare quality, and why sustainable improvement depends on fixing systems rather than managing people harder.
TL;DR: An andon cord is not primarily a line-stopping device. At Toyota, it’s a signaling system that allows workers to call for help immediately. Most problems are resolved before production stops. Its deeper purpose is to protect quality and create…
In a car assembly plant, they do a pretty good job of ensuring that no assembly line worker has to do 70 seconds worth of work in a 60 second job cycle. It’s basic Industrial Engineering and, well, it’s relatively…
Yesterday’s PBS News Hour had a piece on the use of Lean and the Toyota Production System at Seattle’s Virginia Mason Medical Center:
Karen Wolk Feinstein, president and CEO of the Pittsburgh Regional Health Initiative, channeled the Saturday Night Live Weekend Update segment “Really!?!” in this recent op-ed titled: “Don’t put this on patients: Sick people are supposed to monitor medical errors? Really??“…
TL;DR: Many “Lean Six Sigma” programs misrepresent Lean as a set of tools layered onto Six Sigma. Lean is not a toolbox–it’s a management system and culture rooted in flow, quality, and respect for people. When Lean is reduced to…
The list of stuff I’ve read and wanted to blog about has grown… that inventory becomes a post like this. Here are links to some varied articles I’ve read recently that might be of interest on a number of Lean…
Listen A returning guest for episode #159 is John Toussaint, MD, the CEO of the ThedaCare Center for Healthcare Value and the author of the books On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry and Potent…
Recently, the Wall Street Journal put some focus on the issue of so-called “door to balloon” times in our hospitals. “Door to balloon” is a measure of time from a patient with a serious type of heart attack (“STEMI“) arriving…
When I kicked off the “Lean Memes” contest last month, I had no idea what I was starting… I figured I’d get a handful of entries. Well, I got well over 100 from a number of people, including 5 or…
Many of you have emailed me about this horribly sad story: “Toledo hospital nurse accidentally throws away healthy donor kidney during transplant surgery.” As a blogger, I wish I could go to the “gemba” to really help investigate and find…
Mark’s Note: Today’s post is a another guest post from Chad Walters. Chad and I share a strong interest in sports — me as a fan and Chad as somebody who is working to bring Lean thinking to sports franchises,…
Last week, I blogged about the 1989 New England Journal of Medicine article by Dr. Donald M. Berwick, “Continuous Improvement as an Ideal in Health Care.” Dr. Berwick wrote that kaizen (as continuous improvement) is not alien to healthcare, as…