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

Christian Wolcott, Lean Trips to Japan with Kaizen Institute

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

Erin S. DuPree, M.D., FACOG, Joint Commission Center...

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?

The Lean CEO: Why Culture and Leadership Matter More Than Tools – with Jacob Stoller

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

Dr. Bob Wachter, The Digital Doctor

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.

Tristan Kromer, Lean Startup Coaching

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.

Baldrige and Lean in Healthcare Quality — Karen Kiel-Rosser (Mary Greeley Medical Center)

My guest for episode #218 is Karen Kiel-Rosser, Vice President/Quality Improvement Officer at Mary Greeley Medical Center in Iowa. You can see her full bio below in this post. You might remember Karen from a recent post where she told a great story about putting patient safety first. We're talking today about the Malcolm Baldrige National Quality Award and how that framework and process is mutually supportive of Lean and quality improvement. In December, Mary Greeley Medical Center was named a recipient of Gold level recognition in the 2014 Iowa Recognition for Performance Excellence (IRPE) program - the state level Baldrige award. They previously received the Silver level in 2011. In the podcast, we talk about why and when Mary Greeley decided to pursue the Baldrige award, what it was like to be reviewed at the state level, and their future plans for applying at the national level. Karen also shares thoughts about how Baldrige ("the what") and Lean ("the how") fit together, some of their key quality outcomes measures, and how the recognition has helped internally with staff. She also talks about their safety huddles, the importance of "engaging those closest to the work," and the need for a "systematic approach" to capture Rapid Improvement Events and daily improvement work and how their use of KaiNexus has supported those efforts. The hospital was previously featured in episode #201: Ron Smith & Suz Kaprich, the KaiNexus WorkOut at Mary Greeley Medical Center. For a link to this episode, refer people to www.leanblog.org/218. 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.

Alan Robinson, The Idea-Driven Organization

Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com Our guest today is Alan G. Robinson, PhD, an award-winning author, educator, researcher and consultant. He has co-authored six books, including Modern Approaches to Manufacturing Improvement: The Shingo System, Ideas Are Free, and his latest, The Idea-Driven Organization. His specialties include managing continuous improvement, creativity, ideas and innovation, and Lean production, being one of the earliest professors to visit Japan to study the Toyota Production System. In this episode, we talk about the history of suggestion programs (and a surprising detail about their history), why 80% of an organization's improvement comes from staff ideas, and why high-performing idea systems are rare. We also talk about some of the pitfalls of traditional cost-benefit analysis, the role of leaders and humility, and a company, Scania, that intentionally overstaffs to provide time for Kaizen, leading to 12-15% annual productivity improvement. Why is mankind still battling against command-and-control management systems? And what's the real story behind American Airlines famously removing an olive from their salads? We cover all of that and more in this episode. For a link to this episode, refer people to www.leanblog.org/217. 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.

Dan Jones, Lean Outside of Manufacturing

Podcasts are sponsored by KaiNexus and their continuous improvement software platform -- www.KaiNexus.com Returning to the podcast after his first appearance in Episode #188 is Daniel T. Jones, founder and chairman of the UK-based Lean Enterprise Academy. You can find him on Twitter now as @DanielJonesLean. Dan collaborated with Jim Womack on the books The Machine That Changed the World, Lean Thinking, and Lean Solutions and published other books through the LEA. He is also a senior advisor to the relatively new website and journal "Planet Lean." In this episode, we talk about some of the progress being made in areas outside of manufacturing. Dan says there's "awareness everywhere" but asks if there's "real depth" in Lean progress? We'll discuss how we can reframe Lean for the public sector and healthcare as a way of going beyond mere cost cutting programs. What does Dan seeing happen in software and startup sectors with Lean in companies like Spotify in Sweden? How is interest in the core "respect for people" leading to a search for "more holistic management methods?" For a link to this episode, refer people to www.leanblog.org/216. 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.

John Ervin, Lean & Patient Safety in Operating Rooms (ORs) *

Today's guest is my friend John Ervin and we were able to sit down together here in San Antonio to record this episode. John has about 20 years of healthcare leadership experience, including in military medicine and the civilian sector. He's been a manager and director of operating rooms in many types of hospital and surgical center settings.
2022 update: John is now a part of the team and is my colleague with the firm Value Capture and we were able to collaborate on an engagement with a Philadelphia health system.
We share a passion for Lean and, more importantly, patient safety. We believe strongly that you need the right type of culture and leadership to encourage and support a culture of safety and that's what we'll talk about today.
For a link to this episode, refer people to www.leanblog.org/215.
For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.  You can also subscribe and listen via Stitcher.

Michael Ballé, Lead With Respect, His New Lean Management Novel

Today's guest is Michael Ballé, an author of many novels about Lean management, published by the Lean Enterprise Institute. He joins us for this episode from Paris (he shares many photos of “Paris moments” via his Twitter account @Michael_Balle).
Michael and his father, Freddy, have collaborated on these books and have learned about as directly from Toyota as anybody (Freddy was CEO of the French automotive supplier Sommer-Allibert and was coached by Toyota there).
The three novels are:
The Gold Mine
The Lean Manager
Lead With Respect
See all of his books via Amazon
As we joke about in the podcast, I'm not a fiction reader, in general, so I don't care for business novels. But, many people do!
I read Michael's non-fiction essays and articles, including:
“The Gemba Coach” column on Lean.org
His answers to questions on leanblog.org (where I'm also a contributor)
Michael is a first-time podcast guest (which we were both shocked to discover), but I did host a four-part written Q&A with him back in 2009.
For a link to this episode, refer people to www.leanblog.org/214.
For earlier episodes of my podcast, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.  You can also subscribe and listen via Stitcher.