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: When a leader yells, people learn fear–not lessons. True coaching means helping others learn from mistakes instead of punishing them. Whether on the football field or in the workplace, the best leaders build confidence, not compliance. I was happy…
When I recently interviewed Paul O’Neill and Dr. Richard Shannon about the amazing improvements in patient safety that had been made in the Pittsburgh Regional Health Initiative organizations, they each seemed a bit frustrated that these simple, yet effective, methods…
Listen: Podcast #128 turns the tables a bit, as your host Mark Graban is, this time, interviewed by Dirk Dusharme and Ryan Day from the online video show “Quality Digest Live.” Thanks to Quality Digest, I’m able to share the…
A note from 2026: I wrote a fuller version of this same argument recently, with more sources and a fairer look at what Six Sigma actually offers. This post stays up because the comments below are still some of the…
Dr. Richard Shannon shares how Lean and Toyota-inspired methods dramatically reduced hospital-acquired infections at Allegheny General and the University of Pennsylvania. This episode explores leadership, standardized work, and why disciplined problem solving saves lives and reduces costs. Podcast #127 is…
In my segment, we talk about Lean in healthcare, including my recent article on Healthcare Kaizen, quality and patient safety improvement, unique challenges in healthcare, and more.
Last week, I posted a podcast with Mike George, founder of Strong America Now, an organization that is promoting Lean and Six Sigma methods to our political leaders and government. Much of the discussion, maybe unfortunately, was focused on Mr.…
What happens when a Fortune 500 CEO brings a long-term mindset and a bold commitment to safety into healthcare? In this conversation with Paul O’Neill, former U.S. Treasury Secretary and CEO of Alcoa, we explore how leadership, transparency, and aiming…
I was at the ThedaCare Center for Healthcare Value office a few months ago when Dr. John Toussaint reported that he had gotten a call from Dr. Don Berwick, the head of Medicare and Medicaid. Dr. Berwick wanted a collection…
Today’s post is from my friend Naida Grunden, author of the outstanding book The Pittsburgh Way to Efficient Healthcare: Improving Patient Care Using Toyota Based Methods. In 2003, in a meeting room in Pittsburgh, then-Treasury Secretary Paul O’Neill led a…
It’s great to see Lean mentioned in mainstream healthcare management publications, such as the article in HealthLeaders (print and online) called “Systemwide Process Improvement.” The article highlights one hospital you might know really well, Seattle’s Virginia Mason Medical Center (featured…
In the news yesterday, a General Motors recall over what could be just one isolated steering wheel problem in an Ohio-built Chevrolet (don’t call it Chevy) Cruze. Most news stories, like this one, about the recall just mention that one…