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

Episode Page 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 audio from my segment on the show with you in this format. You can view the episode here, if you like. In this episode, we talk about lean healthcare and quality. We'll be back to the regular show next week. For a link to this episode, refer people to  www.leanblog.org/128. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Show notes: https://www.leanblog.org/127 Remastered audio June 2021 Podcast #127 is a very special conversation with a leader and a hero of mine in the world of patient safety, Richard P. Shannon, MD. Dr. Shannon is a cardiologist and is Chair, Department of Medicine, University of Pennsylvania School of Medicine and the Hospital of the University of Pennsylvania as well as the Senior Vice Chair for Clinical Affairs, Department of Medicine. We'll be talking about his work in using Lean methods to reduce patient infections and other clinical outcomes. According to data published by the Institute for Healthcare Improvement, the improvements at Allegheny indicated that “the VAP rate dropped by 83 percent and the CLI rate fell by 87 percent.” Savings lives and reducing cost go hand in hand, as his work shows. This work is now being repeated successfully at UPenn. Leaders at Allegheny General estimate that patients diagnosed with VAP average a 34-day stay, with a net loss to the hospital of $24,435 after reimbursement; patients diagnosed with CLI average a 28-day stay, at an operating loss of $26,839. For an investment of about $35,000 in improvement work, Shannon estimates that the hospital experienced a $2 million improvement Dr. Shannon was an early pioneer in the use of Lean and Toyota methods to improve outcomes and patient safety, namely the reduction of hospital-acquired central line bloodstream infections when he was at Allegheny General Hospital, near Pittsburgh, as documented in Naida Grunden's book The Pittsburgh Way to Efficient Healthcare: Improving Patient Care Using Toyota Based Methods. You can see inside the book and some of the mentions of Dr. Shannon via Google Books. In Pittsburgh, as part of the PRHI effort, Dr. Shannon learned from Paul O'Neill, read or hear my interview with O'Neill. This podcast was produced in conjunction with the Healthcare Value Network as a continuation of their previous podcast series. For a link to this episode, refer people to  www.leanblog.org/127. Scroll down this page for a transcript of this episode. Related Posts: Toyota video about Lean at Allegheny Interview with Dr. Shannon Some Data on Patient Safety and Quality Improvement, including PRHI and Allegheny Podcast with Paul O'Neill For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Episode Page My guest for Podcast #126 is Bob Lutz, author of the book Car Guys vs. Bean Counters: The Battle for the Soul of American Business. Retiring in late 2010 as vice chairman of General Motors, he currently runs Bob Lutz Communications. During his 47-year career in the auto industry, he worked for GM, Ford, BMW, and Chrysler and he's a legend in Detroit, where I grew up. In this podcast, we discuss his new book, his thoughts on designing products that create value and excitement for customers, as well as some of his thoughts on leadership. Bob's a “car guy” and a designer through and through, so what he says isn't always classic “lean thinking,” but it's interesting and thought provoking. What's a “blanderizer”? You'll have to listen (or read) to find out. I hope you'll take a listen and/or read the transcript below. Be sure to share your thoughts and reactions by posting a comment on this post. I have my own thoughts and reactions, which I've added as comments to the transcript – notated by [MG1]. As I wrote about in my preview post, Lutz says he is a fan of “autocratic” leadership, saying that the pendulum had swung too far during the “total quality” era toward too much slow consensus building and too much employee participation. In talking with him, much of what he's complaining about isn't what we'd recognize as Lean or Toyota thinking, but it's perhaps a reaction to the way the “Detroit Three” were using these TQM ideas in dysfunctional or extreme ways. He says we need more autocratic leadership, yet he doesn't think he's an autocratic leader, nor would he want to work for one. Interesting stuff. For a link to this episode, refer people to  www.leanblog.org/126.

My guest for Podcast #125 is Mike George, the founder of Strong America Now, a “nonprofit organization dedicated to mobilizing and educating citizens to support only those Presidential candidates who commit to eliminating the deficit with no new taxes.” In this episode, George talks about his efforts to get candidates to commit to getting personally educated in Lean Six Sigma methods and to use these methods in their administration if elected. You can also read my previous blog post about his initiative. Michael L. George is best known as the founder of The George Group, a consulting firm that was acquired by Accenture in 2007. As the author of books including Lean Six Sigma for Service: How to Use Lean Speed and Six Sigma Quality to Improve Services and Transactions, George is often listed as being the “creator” of Lean Six Sigma, which I know is somewhat controversial to some in the Lean community. That said, I appreciate that Mr. George is working to create awareness amongst our elected officials that we can indeed eliminate waste in government by providing higher quality services at a lower cost by using process and quality improvement methods like Lean and Six Sigma. As in any industry, we can do better through “reducing waste” instead of just slashing costs. For a link to this episode, refer people to  www.leanblog.org/125. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

U.S. Treasury Secretary from 2000 to 2001 and former CEO of Alcoa. Show Notes: https://www.leanblog.org/124 Remastered June 2021 I have a very special guest for Podcast #124 –  he is Paul O'Neill, the U.S. Treasury Secretary from 2001 to 2002 and former CEO of Alcoa. 2020 Update: Read my reflections on Mr. O'Neill's passing Mr. O'Neill shares his thoughts on patient safety and healthcare, including his time spent as the Chair of the Pittsburgh Regional Health Initiative and his work with Dr. Richard Shannon in dramatically reducing hospital-acquired infections to near their “theoretical limit” of zero. Dr. Shannon will be a podcast guest next month. Mr. O'Neill talks about the leadership required to have such an impact on safety and quality, drawing on lessons from his years as Alcoa's CEO. This podcast was produced in conjunction with the Healthcare Value Network as a continuation of their previous podcast series. For a link to this episode, refer people to  www.leanblog.org/124. Scroll down for quotes in readable form. Quotes and Excerpts: In summary, O'Neill talks about: Leadership mindsets required for dramatic workplace safety and patient safety improvement, including a near 100% reduction in hospital-acquired infections at Pittsburgh's Allegheny General Hospital Why the United States has accomplished “practically nothing” nationally since the famed 1999 Institute of Medicine report “To Err Is Human” Why society's most lacking skill is “leadership” Alternative ways of compensating patients who are harmed by the healthcare system while ensuring real improvements are made by learning from each problem Why Rep. Paul Ryan (R-WI) needs to shift his focus from “financial engineering” to visiting ThedaCare to learn about “the real way” we should improve health care.

This episode is a discussion with two leaders from Group Health Cooperative, a consumer-governed, nonprofit health care system based in Seattle, Washington. My guests are  Claire Trescott, MD, Primary Care Medical Director, and Alicia Eng, Vice President of Primary Care. We will be talking about their use of Lean principles in the design and management of their “Medical Home” approach to primary care and wellness. You can read a PDF of a Health Affairs article that describes the benefits to patients and caregivers. This podcast was produced in conjunction with the Healthcare Value Network  as a continuation of their previous podcast series. For a link to this episode, refer people to  www.leanblog.org/123. For a 2007 interview with Group Health leaders, visit www.leanblog.org/23. About Medical Home (from Group Health): The Group Health Research Institute conducted a two-year study of the Factoria Medical Home Pilot. Results of that study were published in the May 2010 issue of the journal Health Affairs. The study compared the medical home prototype at Factoria to care at Group Health's other medical centers, and found that: The quality of care was higher at Factoria; patients reported better experiences and clinicians said they felt less “burned out.” Patients had 29 percent fewer visits to the emergency room and 6 percent fewer hospitalizations, resulting in a net savings of $10 per patient per month. Patients with chronic conditions managed them more successfully, and followed medical orders better with the aid of everyone on the medical home team. For every dollar Group Health invested, mostly to boost staffing, it recouped $1.50. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

This episode is a conversation with Paul Akers, founder and president of FastCap LLC, based in Bellingham, WA. FastCap is an international product development company founded in 1997 with over 2000 distributors worldwide. Paul and FastCap have also embraced Lean, with an unmatched enthusiasm for kaizen – small, daily improvements made by people in the workplace, as you can see in their collection of Lean videos. We're also talking in this episode about his LeanAmerica.org initiative. For a link to this episode, refer people to www.leanblog.org/122. For earlier episodes, visit the  main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Today's episode is a discussion with Mrinalini Gadkari, a Senior Lecturer at the Fisher College of Business. Today, we're talking about the new  Master of Business Operational Excellence (MBOE) for Healthcare Program starting this fall. We'll talk about how the program is structured, who the intended students are, and delve a little into the curriculum that includes Lean, Six Sigma, and other improvement methodologies. Mrinalini Gadkari is a physician trained in India. She practiced in India for three years as a family physician. She came to the US 9 years ago to pursue her passion in Process Improvement in Healthcare. Mrinalini received MHSA (Masters in Healthcare Services Administration) from George Washington University. She worked as an administrative resident at the John's Hopkin's Bayview Medical Center focusing on Quality and Process Improvement. She worked at the Dana Farber Cancer Institute and Brigham and Women's Hospital over five years and helped multidisciplinary teams apply lean principles to improve efficiency and safety of their clinical and business processes. For a link to this episode, refer people to  www.leanblog.org/121. For earlier episodes, visit the  main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Today's episode is a chat with Jody Crane, MD, MBA and Chuck Noon, PhD. They are talking about their outstanding book The Definitive Guide to Emergency Department Operational Improvement: Employing Lean Principles with Current ED Best Practices to Create the “No Wait” Department. Dr. Crane is an Emergency Physician practicing at Mary Washington Hospital in Fredericksburg, Virginia. From 2002 to 2009, he served as the Business Director of his group, Fredericksburg Emergency Medical Alliance. He currently serves as a faculty member in the Institute for Healthcare Improvement and is also faculty at the University of Tennessee's College of Business. Dr.  Noon is a Professor of the Management Science Program in the Department of Management. He joined the faculty in the fall of 1987 after completing his Ph.D. in Industrial & Operations Engineering from the University of Michigan. He is also a founding member of the UT Physician Executive MBA Program. For a link to this episode, refer people to www.leanblog.org/120. For earlier episodes, visit the  main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.

Produced in partnership with the Healthcare Value Network, episode #119 is a discussion with Dean Gruner, MD, the president & CEO of ThedaCare. Here, we talk about Strategy Deployment as a Lean management system and how it fits into their ongoing management and improvement efforts in their health system. To learn more about strategy deployment, visit YouTube for a free preview clip of a new educational DVD produced by the ThedaCare Center for Healthcare Value. You will also find a link to a free white paper about strategy deployment at ThedaCare, Group Health, and St. Boniface General Hospital. For a link to this episode, refer people to  www.leanblog.org/119. For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.