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

Remastered January 2022 Episode page: https://www.leanblog.org/228 Labor Day is Monday, so maybe it's appropriate that my guest for episode #228 of the podcast is Zeynep Ton, an Adjunct Associate Professor of Operations Management at the MIT Sloan School of Management. You may have recently seen her being interviewed by Fareed Zakaria on CNN. Read her full bio here. She is author of the 2014 book The Good Jobs Strategy: How the Smartest Companies Invest in Employees to Lower Costs and Boost Profits. I saw Ton give a lecture at an MIT alumni event back in June and immediately bought and read the book (read my blog post about the book and parallels to Lean and healthcare). I highly recommend it and I wish more hospitals and health systems would pursue this “good jobs strategy” instead of being so focused on cutting labor costs. As Ton explains in the book and our discussion, this strategy is not about being kind or nice — it's just good business that drives better long-term results for all.   In the podcast, we talk about: How she transitioned from industrial engineering and supply chain management to studying retail companies. In the vicious cycle of the “bad jobs strategy, ” why is this considered conventional wisdom that the way to maximize profits in a low-margin industry is to offer minimal pay, training, and hours? What are the components (and system) of “the good jobs strategy?” What connections do you draw between the good jobs strategy and Toyota or Lean? Do the companies or founders that have a good jobs strategy sort of naturally embrace it? Of the “good jobs” components, is it most difficult to help people see that 100% utilization is often very harmful and that “slack” is necessary? Is it easier for privately held companies to pursue the good jobs strategy having less quarterly financial pressure? Any thoughts on why society focuses so much on wages, while seemingly ignoring other aspects of workplace conditions that need to be improved?

Joining me for episode #227 are Ruthie Davis and Stephen Cook, talking about the book that they edited, Do the Right Thing: Real Life Stories of Leaders Facing Tough Choices.' Episode page: https://www.leanblog.org/227  While this episode isn't focused on Lean, per se, I think you'll enjoy the discussion and I highly recommend the book, which highlights the role of ethics and integrity in leadership… hence “doing the right thing” and being a great leader who others chose to follow. The book is inspired by the life and lessons of Don Davis, who served as CEO of Stanley Works (now Stanley Black & Decker) from 1966 to 1988. After retiring as CEO, Don volunteered to teach a leadership seminar for the MIT Leaders for Global Operations program, which I was fortunate to take as a student there. You can read his obituary here. Ruthie is Don's daughter and Steve was, like me, a student of Don's at MIT, so they combined their efforts to publish a compilation of compelling stories from Don's students about real life leadership challenges that they faced and how Don's “leadership mantras“ helped them in those times. Stephen Cook is currently a co-founder and Executive Managing Director of the private equity firm, LFM Capital. Previously, he was a Principal with TVV Capital, following his role as COO of MFG.com, and 11 years of operations leadership roles at Dell. Prior to joining Dell, Steve served as a Lieutenant in the United States Navy, where he flew combat missions in support of Desert Shield. He is a fellow graduate of the MIT Leaders for Global Operations program, a year ahead of me, and we worked together at Dell at the turn of the century and have kept in touch since. Read his bio. Ruthie Davis is an entrepreneur and designer, the founder and CEO of the high-fashion Ruthie Davis shoes. Her shoes are a “top choice of celebrities and fashion tastemakers including… Beyoncé, Lady Gaga, and Jennifer Lopez; Halle Berry, Sofia Vergara, Taraji P. Henson and Shailene Woodley… and Emma Roberts, Zendaya Coleman, and Rumer Willis.” Ruthie was a recipient of Babson College's “Entrepreneur Hall of Fame” award in 2015. Read her full bio here.

My guests for episode #226 are Steve Hoeft and Dr. Robert (Bob) Pryor from Baylor Scott & White Health in Texas. Bob serves as President, Chief Operating Officer and Chief Medical Officer for the system and was formerly CEO of Scott & White Health before their merger with Baylor Health Care System. Steve is the Chief of Operations Excellence for the system. hoeft-pryor bookThey are co-authors of a recently released book that I think is outstanding: The Power of Ideas to Transform Healthcare: Engaging Staff by Building Daily Lean Management Systems. Steve is also previously author of another book I really like, Stories from My Sensei: Two Decades of Lessons Learned Implementing Toyota-Style Systems. I'm sure you'll enjoy the podcast, as they combine the perspectives of an industrial engineer and Toyota-influenced automotive guy (Steve) and a pediatrician and physician executive (Bob). They share a passion for healthcare improvement AND a belief that we need to respect and engage everybody who works in healthcare as a way to better serve patients. For a link to this episode, refer people to www.leanblog.org/226. Podcasts are sponsored by KaiNexus and their software that helps spread continuous improvement -- Learn more at http://www.KaiNexus.com

Joining me once again on the podcast today is John Toussaint, MD, the founder and CEO of the ThedaCare Center for Healthcare Value. We're talking about his latest book, Management on the Mend. John wrote this new book to document "core elements of successful Lean transformations" that he's seen, not just at ThedaCare, but at other organizations around the world. The book outlines a "transformation model" that can be used to structure a Lean transformation, while John admits there's not just one prescription or framework that could work. John was previously a guest for episodes #184, #159, #146, #72, #62, and #54 going back to 2008. His previous books, which I highly recommend, are On the Mend and the follow up Potent Medicine, both are Shingo Research Award recipients. For a link to this episode, refer people to www.leanblog.org/225. Podcasts are sponsored by KaiNexus and their software that helps spread continuous improvement -- Learn more at http://www.KaiNexus.com

My guest for episode #224 of my podcast is a returning guest, Mike Grogan. About two years ago, we talked about his Lean work in Tanzanian healthcare, in episode #182. Mike is an international trainer, coach, and speaker, who works with successful but overwhelmed management teams, to help them understand the technical and behavioral elements of Lean leadership, so that they can realize a culture of constant and never-ending improvement in their organization. In this eposide, we talk about his experience with mentoring, in Tanzania and other settings. For a link to this episode, refer people to www.leanblog.org/224. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

My guest for podcast episode #223 is Christian Wolcott, a senior advisor and director of Kaizen Institute North America and their director for Japan tours. Christian was an integral part of the team for the Japan Lean Healthcare Tour that I participated in last November as an instructor. Christian taught Lean concepts and facilitated discussions with me and the global attendees. In this podcast, we talk about our reflections on Japan and the tour, lessons learned, and reasons to go (which include wonderful camaraderie, fine cuisine, and evening discussions with the attendees). You can learn the difference between sushi, shabu shabu, and shōchū, in addition to learning about Lean and Kaizen. We're planning another tour in September, so please contact me if you'd like to be sent more information and check out the website I've set up about the tours. See past posts I've written about the tours --- http://www.japanleantrip.com. For a link to this episode, refer people to www.leanblog.org/223. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

Joining me for episode #222 of the podcast is Erin S. DuPree, M.D., FACOG, the Chief Medical Officer and Vice President for the Joint Commission Center for Transforming Healthcare. Dr. DuPree is an OB/GYN by training, was previously the Chief Medical Officer and Senior Vice President for Medical Affairs at The Mount Sinai Medical Center in New York City. She is a certified Six Sigma Green Belt and is also a TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) master trainer. For a link to this episode, refer people to www.leanblog.org/222. One thing we have in common is both growing up around Detroit, being exposed to the auto industry and the ideas of W. Edwards Deming early in life. In this podcast, topics include: Her role in the Center for Transforming Healthcare (the Joint Commission does more than accreditation) How Dr. DuPree first got involved in healthcare quality improvement and, in particular, Lean and Six Sigma (two complementary practices, as we agree) Of the different estimates about the number of patients harmed or killed each year due to preventable medical errors, which numbers does she cite and why? There are pockets of improvement around healthcare, but what are some of the biggest barriers, that she sees, that prevent adoption of Lean and Six Sigma and, more importantly, the improvement of quality and patient safety? How does the idea of "High Reliability Organizations" fit with other improvement methodologies? What's the personal patient story that helped her see the preventable harm that occurs and the need for improvement?

My guest for episode #221 is Jacob Stoller, author of a book that was just released: The Lean CEO: Leading the Way to World-Class Excellence. It's available now through Amazon or you can learn more through his book's website. As Jacob explains, he's a journalist, not a Lean practitioner, and he interviewed CEOs across different industries to get their thoughts on Lean management. We discuss topics including how CEOs get exposed to Lean thinking, why humility is so important, what "respect for people" means in the Lean context, and reasons why more CEOs don't embrace Lean. Did Six Sigma and Dr. Deming come up in his interviews? You'll also hear a bit about Bob Brody, the CEO at Franciscan St. Francis Health, which was featured in my Healthcare Kaizen books. For a link to this episode, refer people to www.leanblog.org/221. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com

My guest for episode #220 is somebody I've wanted to interview for a long time, Dr. Robert Wachter, one of the leading voices in the modern patient safety movement. He's most recently author of a brand-new book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age. His book was excerpted in this New York Times Op-Ed piece, "Why Health Care Tech Is Still So Bad." In this episode, we cover topics including: How Bob got into the patient safety field Of all of the estimates of patient harm and death caused by medical errors, which does he find most valid? His perspectives on the interface between Lean principles and practices and the modern patient safety movement What were some of the pros and cons of the $30 billion in federal government incentives for EMR/EHR adoption? Is it fair to say that EHR systems solve some patient safety problems while solving others? Some of the new waste introduced by new "meaningful use" regulations The story of a preventable medication error that harmed a child - a combination of technology problems, human factors, and bad process Finding the balance between "system problems" and personal accountability (see this article) Disclosure: I received an advance copy of The Digital Doctor from the publisher. I highly recommend the book for its balanced presentation of the promise, successes, and challenges of healthcare IT. The book discusses why electronic medical records haven't been adopted more quickly, why government incentives were introduced, and EMR/EHR systems are not the panacea that some had promised. Previously, Dr. Wachter has written books on patient safety (that I've read and recommend) including Understanding Patient Safety and Internal Bleeding. He received one of the 2004 John M. Eisenberg Awards, the nation's top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past seven years, the only academic physician to achieve this distinction. I was honored when Dr. Wachter recently interviewed me about Lean and patient safety for his AHRQ "Web M&M" series. Dr. Wachter is Professor and Associate Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine, and Chief of the Medical Service at UCSF Medical Center. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term "hospitalist" in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. For a link to this episode, refer people to www.leanblog.org/220. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.Joining me for episode #219 is Tristan Kromer, a professional "Lean Startup" coach who works with startups around the world and volunteers for the non-profit Lean Startup Circle.

Joining me for episode #219 is Tristan Kromer, a professional "Lean Startup" coach who works with startups around the world and volunteers for the non-profit Lean Startup Circle. In this episode, we discuss topics including how he got involved in the Lean Startup movement, the difference between a coach and a consultant, and lessons from various startups. When are you "pivoting" versus just giving up on an idea? Tristan also talks about why being data driven and scientific "is the aspiration" and why somebody who "starts from a profound state of ignorance" can be helpful by asking the right questions. You can find Tristan on Twitter @trikro and via his blog. Read his bio here. For a link to this episode, refer people to www.leanblog.org/219. Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com For earlier episodes of the Lean Blog Podcast, visit the main Podcast page at www.leanpodcast.org, which includes information on how to subscribe via RSS or via Apple iTunes.Joining me for episode #219 is Tristan Kromer, a professional "Lean Startup" coach who works with startups around the world and volunteers for the non-profit Lean Startup Circle. In this episode, we discuss topics including how he got involved in the Lean Startup movement, the difference between a coach and a consultant, and lessons from various startups. When are you "pivoting" versus just giving up on an idea? Tristan also talks about why being data driven and scientific "is the aspiration" and why somebody who "starts from a profound state of ignorance" can be helpful by asking the right questions. You can find Tristan on Twitter @trikro and via his blog. Read his bio here.