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

My guest for Episode #268 is a long-time friend of mine in the Lean community and Lean Enterprise Institute circles, Tom Ehrenfeld (@tomehrenfeld). Tom is a writer and editor living in Cambridge, MA. A former writer/editor with Inc. Magazine and Harvard Business Review, he is the author of The Startup Garden: How Growing A Business Grows You. He works as a consulting editor for LEI and with many other Lean authors. He's a regular contributor to LEI's "The Lean Post." Eight of his edited books have won the Shingo Research Award. Today, we talk about some of the books he's played a role with, we'll talk about the evolution of the understanding of Lean, and his thoughts on shifting from his experience covering startups to thinking about "The Lean Startup" methodology in more recent years.

Joining me for Episode #267 is Stephen M. Shortell PhD, 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 is the director of the Center for Healthcare Organizational and Innovation Research (CHOIR). Today, we are talking about Lean healthcare and a new initiative that's part of CHOIR called CLEAR: the Center for Lean Engagement & Research in Healthcare. You can read a release about CLEAR, which highlights funding coming from the Lean Enterprise Institute, the ThedaCare Center for Healthcare Value, and Rona Consulting Group. In this episode, we talk about the Center, their planned research, and some reasons why there is variation in what organizations would describe as "Lean" - variation in methods and approach as well as variation in results.

My guest for Episode #266 of the podcast is Karyn Ross (KRCLean4Service on Twitter), co-author of the new book (with Jeff Liker): The Toyota Way to Service Excellence: Lean Transformation in Service Organizations. Karen first learned about and applied Lean in companies like Paychex, Zurich Insurance, and Liberty Mutual Insurance and has worked with other service sector companies as a consultant. In this episode, we'll discuss her book and the important applications of Lean in service settings. Karyn says delighting customers requires something different than a "mechanistic Lean implementation" approach - and I agree, completely. I hope you enjoy the conversation as much as I did.

Joining me for Episode #265 of the podcast is Bernita Beikmann, AIA, EDAC, LSSBB, a Principal and Director of Lean Strategy at HKS, an international architecture firm. Bernita is originally from Kansas and has a Bachelor of Architecture from Kansas State University and a Certificate in Regional and Community Planning. She moved to Dallas in 1996 and has been employed by HKS, Inc in Dallas since that time. We first crossed paths when we had the opportunity to work together on a project for Riley Hospital for Children in Indianapolis to work with staff and leaders on designing parts of a new patient tower. You can read a bit about that work here. I hope you enjoy our conversation.

My guest for Episode #264 is a friend from here in the Dallas / Fort Worth area, Tyrone Butler. He is LSS Managing Partner at his company, Butler Active Business Solutions LLC. He has a background in the Air Force, he pre-dated me at Dell Computer in the 1990s, and he's being doing a lot of work all over the world with Lean, Six Sigma, and other methodologies for improving software and project delivery, like ITIL. Tyrone is one of the first to hold the "Certified Executive Master Black Belt (CEMBB)" certification through Mikel J. Harry, PhD. We first met probably back in 2010 when we were both part of a Lean group that went to visit the Toyota plant in San Antonio (which I blogged about here and here). In this episode, he'll share some of his experiences, including a presentation to Michael Dell, his thoughts on the combination of Lean and Six Sigma, and methods that he has seen work in software development and other settings.

My guest for Episode #263 is another returning guest, Pascal Dennis (@AuthorPascal on Twitter). He was previously a guest on Episodes #96 and #239, talking about two of his previous books (see a full list here). Today, we're talking about his most recent book, a business novel called Andy & Me and the Hospital: Further Adventures on the Lean Journey. I don't normally read much fiction, and I generally don't read business novels, but I really enjoyed this book and tore through it in a few days. It was really compelling and many of the scenarios felt quite familiar. I think this is a helpful book for painting a picture of what it could feel like to start a Lean journey in healthcare. The book is, of course, a sequel to his earlier book Andy & Me, Second Edition: Crisis & Transformation on the Lean Journey.

My guest for Episode #262 is Steven J. Spear (@stevenjspear on Twitter). He is author of the fantastic book The High-Velocity Edge: How Market Leaders Leverage Operational Excellence to Beat the Competition. He's a Senior Lecturer at the MIT Sloan School of Management and recently taught a summer course on Lean and Six Sigma for the Leaders for Global Operations program (I graduated from that program in 1999 when MIT was teaching TQM in that summer course) and he also teaches executive education programs for MIT Sloan. Steve was previously a guest in Episodes #58 and 87. I'm glad to have him back on the show after six years. Steve is going to be one of the keynote speakers at the upcoming Northeast L.E.A.N. Conference, being held October 4th and 5th in Massachusetts. I hope you'll check it out, as I've participated in past years and it's always been great (and you get to meet Bruce Hamilton of "Toast Kaizen" fame).

Joining me for Episode #261 is an old friend and trusted mentor, Jamie Flinchbaugh. Among other things, he's the co-author of the book The Hitchhiker's Guide to Lean. He writes for a number of publications, has his own blog, and was previously a guest blogger here on LeanBlog.org. He's a speaker, investor (including in KaiNexus), and a great guy. Jamie was previously a guest on episodes #5, #6, #10, #50 (where he interviewed me), and #64. We were long overdue for another one. This episode is intentionally more conversational than most, with no more of a plan than me asking Jamie, "What's new?" He's also in final editing of a chapter for the book Practicing Lean, so I'm happy to be adding that to the book. Jamie is also going to be giving a keynote talk at our upcoming KaiNexus User Conference.

See http://www.leanblog.org/260 My guest for Episode #260 of the podcast is Brad White, author of the recently-released book Lean Daily Management for Healthcare: A Strategic Guide to Implementing Lean for Hospital Leaders. He is currently a Senior Process Improvement Advisor at Grady Health System in Atlanta, but I first met Brad a few years back when we were both in San Antonio and he was working for a health system there. In San Antonio, Brad helped spread these "Lean Daily Management" practices at the Baptist system and University Health System. I was able to come visit and see how this process was engaging leaders and staff at UHS (see photos below). You can learn more about Brad's book at his website, which includes a two-page PDF on how these methods can improve patient flow. http://leandailymanagement.com/

See http://www.leanblog.org/259 Remastered audio 2025 Today's episode #259 is Part 2 of a discussion I started with Steve Bera in episode #256. Steve was one of the original 16 “NUMMI Commandos” that General Motors sent to work with Toyota in the 1980s, as discussed in the outstanding book Comeback: The Fall & Rise of the American Automobile Industry. In Part 1, we talked about his experience at NUMMI. Today, we talk about what happened after his two years at NUMMI, why he feared getting lost back in the regular old GM, what he's done to teach and spread Lean in various industries over the past 30 years, and other thoughts on the current state of Lean. A transcript of the discussion can be found at the bottom of the post. You can also read a summary I wrote of the two posts on LinkedIn. Topics Covered In This Episode: The book describes the confusion about the lack of a “repatriation plan” – what happened? To you? At GM? Why was it hard to spread lessons back into GM? What have you done since leaving GM? How do you see the “state of Lean/TPS” in America? How much progress are we making? Do you have any experience working with healthcare or seeing the opportunity for Lean as a patient? What's the “risk” of a poorly executed Lean initiative?