Lean Blog Interviews: Real-World Lean Leadership Conversations in Healthcare and Beyond

Joining me again for Episode #288 is Dean Gruner, MD, the recently retired CEO of ThedaCare, a health system in Wisconsin that has long been considered a worldwide leader in the practice of Lean in healthcare. Recently, in Episode #286, Dean shared his reflections on his work and ThedaCare's "Lean journey." Today, the topic is Accountable Care Organizations and other bigger-picture healthcare reform topics. Dean was also previously my guest in Episodes 119 and 144. I'm including a full transcript along with a three-page PDF summary, as I've been doing recently.

Joining me today for Episode #287 is another returning guest (see Episode #198), Harry Kenworthy. We're talking about his book, which will be released on Friday, Lean Government NOW! : Increase Service, Capacity and Employee Engagement While Reducing Costs and Wastes. The book is now available for pre-sale on Amazon at $19.95 (until September 7, 2017, at a $5.00 discount from list price). Harry was also a contributor to the book Practicing Lean, which is now available in audiobook format. I've been involved with some "government healthcare" organizations in different countries, but have never delved into other parts of government. I'm glad Harry is doing so! This seems like a big challenge, but an important and necessary one. We're seeing some examples of success with Lean at the local and state levels around the U.S., it seems. I hope we see more. I hope you enjoy our discussion whether you work in government or vote, pay taxes, or use government services (or all of the above!!). I'm including a four-page PDF summary, as I've been doing recently.

My guest for Episode #286 is Dean Gruner, MD, the recently retired CEO of ThedaCare, a health system in Wisconsin that has long been considered a worldwide leader in the practice of Lean in healthcare. See this article about his retirement, where he says "I've gotten more than I've given." Dean was previously my guest in Episodes 119 and 144 and I'm thrilled that he took time out of his retirement to talk with me about his lessons learned as he looks back on how ThedaCare's Lean journey has evolved, including some things he would consider to be missteps and challenges that they used as a springboard to get even better. I will also be releasing a separate episode where Dean talks about their experiences with Accountable Care Organizations (our topic from #144) and other "big picture" healthcare issues of the day. I'm including a full transcript along with a three-page PDF summary, as I've been doing recently.

In this episode, Mark and Karen discuss a provocative question she raised: "Is Lean Dead?" (or "dying?"). Karen is the author of books including "Value Stream Mapping" and "The Outstanding Organization." Her next book is titled "Clarity First" and we'll be discussing that in a future episode. http://www.leanblog.org/285 Is Lean dead—or just misunderstood? Karen Martin joins Mark Graban to explore why Lean often gets dismissed, how leadership habits and short-term thinking derail improvement, and why Lean still matters when practiced as a true management system—not a toolbox.

My guest today for episode #284 of the podcast is Dr. Margaret (Margie) Balfour, the lead author of an article, published in The Joint Commission Journal on Quality and Patient Safety, titled "Using Lean to Rapidly and Sustainably Transform a Behavioral Health Crisis Program: Impact on Throughput and Safety." Today, we're talking about that article, the important improvement work that led to it, and her belief, as stated in the article that "Lean methods can positively affect safety and throughput and are complementary to patient-centered clinical goals in a behavioral health setting." Dr. Balfour is the VP for Clinical Innovation and Quality at Connections Health Solutions, one of the largest providers of psychiatric emergency care in Arizona, and an Assistant Professor of Psychiatry at the University of Arizona. Dr. Balfour received her MD and PhD in Neuroscience from the University of Cincinnati and completed residency and a fellowship in Public and Community Psychiatry at the University of Texas Southwestern Medical Center in Dallas. A link to the article can be found at http://www.leanblog.org/284

Joining me today is Jim Lancaster, CEO of the company Lantech, a manufacturer that is the leader in stretch wrap technology and innovation, as well as case handling equipment. Jim is also author of the new book, published by the Lean Enterprise Institute, titled The Work of Management: A Daily Path to Sustainable Improvement. This episode is sponsored by the eVSM Group. It's almost 20 years now since the book "Learning To See" was published and value stream maps were established as central to a lean deployment. What has changed rapidly, however, is the supporting eVSM toolset that captures and analyzes the initial wall maps, making it easy to do "what-if" studies and prioritize improvements. Receive a free eBook and see the state of the art at evsm.com/2020.

My guests for Episode #282 of the podcast are two continuous improvement leaders from Cleveland Clinic: Dr. Lisa Yerian and Nate Hurle. Lisa is the Medical Director, Continuous Improvement and Nate is the Senior Director, Continuous Improvement.She's a doctor, he's an engineer, and they work together very closely in their efforts to help drive improvement at the Clinic. You can find them on Twitter as @LisaYerianMD and @NateHurle. In today's episode, we talk about topics including the Cleveland Clinic Improvement Model (see my previous posts on this), how their program is structured, what a "culture of continuous improvement" means to them and their staff, how to get others to accept Lean and C.I. methods, and some of the challenges they are facing in their work.

Joining me for Episode #281 of the podcast is Julie Firman, DNP, RN, FACHE, the Vice President/ System Chief Nursing Officer (CNO) at Southern Illinois Healthcare. We have the opportunity to chat about the Lean transformation efforts at SIH thanks to my partners at Catalysis, as they are presenting the annual Lean Healthcare Transformation Summit this year in Palm Springs, June 7 and 8. Julie and I will both be there and I'll be doing a full-day workshop called "Better Metrics." Come join us! In today's episode, we talk about how Lean has been helpful to nurses (and other healthcare professionals), Julie's role as a nurse leader, and different ways patients and the health system have benefitted.

A returning guest today for episode #280 is John Dyer, president of his consulting firm, JD&A, Inc., and a contributor for IndustryWeek.com. As we discussed in episode #229, John started his career at General Electric and later moved to Ingersoll-Rand, where he was VP of Operations for their Security and Safety sector. He also had the good fortune to learn directly from W. Edwards Deming, as he took the famed four-day seminar (that included the Red Bead Experiment) and was also invited to take the follow on course with a smaller group. You'll also want to scroll down to see the great picture that he posted on Twitter of him and Dr. Deming. Today, our focus is that famed "Red Bead Experiment." We'll talk about it, he'll share memories of Dr. Deming facilitating this, and we'll both share and discuss our reflections and our experiences with this, and the lessons learned. Tomorrow, I am facilitating the experiment as part of my "Better Metrics" workshop that I'm leading in Seattle through Catalysis. I'll also be doing this in June before the Lean Healthcare Transformation Summit (you can still sign up). And, of course, I'd love to come to your organization to do the workshop and help you with your approach to managing metrics, people, and improvement.

Back in 2012, I did a podcast interview (Episode 153) with a psychologist and family therapist, Robert Maurer, PhD. It's been almost five years since the discussion, but I'm often reminded of what I learned from his books and his advice about small change. It's human nature for us to be afraid of change. Instead of lecturing people to be brave, we need to work within our limitations. How do we avoid the "fight or flight" instinct and reaction from kicking in? We start by making change SMALL. That's a key Kaizen insight that Dr. Maurer is able to tie to the way our brain works. Here's our original discussion: https://www.leanblog.org/2012/07/podcast-153-robert-maurer-phd-the-kaizen-way/