Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement

Alternate title:“Lean is an Integrated System. Of Course Just Implementing Pieces Leads to Failure.” Throughout the 10 years that I’ve been involved with Lean healthcare efforts, I’ve heard multiple stories of organizations that ended their formal Lean initiatives. They do so, as I’ve been told, because they need to cut costs... http://leanblog.org/audio118

At KaiNexus, we've been fortunate to have a good relationship with Professor Ethan Burris, from the University of Texas McCombs School of Business. He has done a lot of research and publishing around employee engagement and idea systems, as I've mentioned here on the blog before: "Is Fear the Only Reason Employees Don't Speak Up?"Burris has a new article on the Harvard Business Review website: "Employee Suggestion Schemes Don't Have to Be Exercises in Futility"

In the article posted today, Pamela Hartzband, M.D., and Jerome Groopman, M.D. (the later the author of the popular book How Doctors Think), rant about all sorts of things… some of which have nothing to do with Lean... http://leanblog.org/audio116

http://leanblog.org/audio115 A hat tip goes to Brian Buck for sharing this quote via email recently. Samuel Clemens, aka Mark Twain, was a pithy and wise man. I didn't remember this quote, but it is attributed to him. It's very appropriate for the type of work we do. I shared it last Saturday in my "Key Tweets" post, but it's worth discussing here in a separate post, I think.

I had a bit of a new year's resolution about being positive and not fretting about organizations that don't "get it" when it comes to Lean. But, resolutions are meant to be broken, I guess.It's very frustrating when I hear people in healthcare complain that their hospital or health system has equated Lean with cost savings -- only focusing on cost reduction or primarily focusing on it. Hospitals that say to their staff that Lean is just about cutting costs (or demonstrate that) willfail to engage their most important asset -- their employees. http://leanblog.org/audio114

http://leanblog.org/audio113 This article, from December, was floating around social media the other day (hat tip to Paul Levy):Don Berwick Offers Health Care 9 Steps to End Era of 'Complex Incentives' and 'Excessive Measurement' Among the points that Berwick makes, here is the one most directly related to Deming, Lean, and continuous improvement: 5. Recommit to improvement science: For improvement methods to work, you have to use them, and most of us are not. I'm trying to be polite, but I am stunned by the number of organizations I visit today in which no one has studied [W. Edwards] Deming's work, no one recognizes a process control chart, no one has mastered the power of testing PDSA (plan-do-study-act), Nathaniel's Method or the route to the top. You can see the proof of concept. This is beyond theory now.

How is it that we have two realities out there in healthcare... in parallel, Lean is awesome and Lean is horrible. It depends on where you are, unfortunately. I had an amazing day yesterday with a major health system...

Humility is an important part of the Lean management philosophy... it also means being willing to admit that there is a problem. Humility means "we don't really know so we must understand and then try many things to see if we have the right solution."

When we see a simple error, even in something as silly as sports memorabilia, we would ask "why?" or "how?" instead of "who?" Blaming individuals doesn't help... http://leanblog.org/audio110

When I was at the recent Lean Startup Conference, somebody I know somewhat randomly introduced me to another attendee. As we chatted, I learned her background was social work and she was founder of a technology startup that solves a problem that was important to her and her work. I never met people like that when I worked in manufacturing... again, I've really grown to appreciate the perspectives and experiences of those who have different educational backgrounds than my own.We were talking about healthcare, continuous improvement, and such topics and she suggested that I look into a framework called "motivational interviewing" (MI) as something that might be helpful in my Lean coaching.