Lean Blog Interviews - Healthcare, Manufacturing, Business, and Leadership

Why do people fear change? Why are adults afraid of talking about their fears? My guest today is eminently qualified to answer such questions and to provide advice that can help us. My guest for Episode #315 is Robert Maurer, Ph.D., author of the outstanding book Mastering Fear. Bob was previously my guest for Episode #153, where we discussed one of his earlier books on Kaizen, One Small Step Can Change Your Life: The Kaizen Way. By the way, earlier this year I noticed that his other book The Spirit of Kaizen was one of the few books by an American author that Toyota was selling at the Toyota Commemorative Museum of Industry and Technology in Nagoya (see photo below). I hope you enjoy today's discussion on Mastering Fear. As the subtitle says, can we "harness emotion to achieve excellence in health, work, and relationships"?

314 - Skip Steward & Brandon Brown, on TWI & Kata in Healthcare Today I have two guests joining me for Episode #314 of the podcast. They are Skip Steward, the Chief Improvement Officer at Baptist Memorial Health Care in Tennessee and Brandon Brown, the owner and "Master Kata Coach" of his firm, Continuous Coaching Commitment, LLC. In this episode, we discuss their use of methods such as "Training Within Industry" and "Toyota Kata" in the important work of healthcare improvement. Skip and Brandon both have backgrounds in manufacturing, but they have been able to translate Lean skills and mindsets into healthcare. We'll also talk about their dynamic as consultant / client and how the roles of "coach" and "learner" are often very situational and how we can be both at different times.

Today's episode (#313) of the podcast is a bit of a departure from the norm. Instead of interviewing a guest about their book or other work, I'm reading what's basically an audiobook-style excerpt of the first part of my new book Measures of Success: React Less, Lead Better, Improve More. I say "audiobook-style" because it's not professionally produced and my voice has been bad after being sick last week... but I thought this would be one way to share some of this material and promote the book. I won't be doing a full-blown audiobook because the book is so full of charts, I don't think it all translates well to the audiobook format. But, here I'm reading the foreword, the preface, the introduction, and part of Chapter 1.

Joining me today for Episode #312 of the podcast is Jeff Hunter, author of the excellent book "Patient-Centered Strategy: A Learning System for Better Care." Jeff was with the ThedaCare in Wisconsin, where he was Senior Vice President, Strategy and Marketing for the health system. After retiring from ThedaCare, he has been a faculty member for Catalysis and has started his own consulting firm, Jeff Hunter Strategy. In today's podcast, we discuss a number of topics, including how a good strategy is a necessary input for a "strategy deployment" management process, some of the problems with traditional approaches to strategic planning, and why an iterative PDSA approach works better than static plans.

http://www.leanblog.org/311 My guest for Episode 311 is Jess Orr, a continuous improvement practitioner at WestRock, a large paper and packaging company, where she helps plants foster a culture of continuous improvement and employee engagement. Her experience includes working directly for Toyota Motor Manufacturing Kentucky. She is particularly passionate about sharing best practices across industries, which motivated her to found Yokoten Learning. In today's episode, we talk about her path from Six Sigma Black Belt to a Lean-thinking engineer at Toyota. How did she progress from solving problems herself to developing others? We'll talk about a blog post that she wrote for this blog earlier this year, Lean and ROI, leadership and culture, and much more. What is it like working outside of Toyota again? I hope you enjoy the discussion.

Steve Shortell, The Impact of #Lean on Healthcare Quality http://leanblog.org/310 Joining me again for Episode 310 is Stephen M. Shortell Ph.D., 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 was previously a guest on Episode 267 talking about the establishment of the Center for Lean Engagement and Research (CLEAR) at the University of California, Berkeley, where he is the director.  In this episode, we talk about some initial research that they released in a paper that was published in The Joint Commision Journal on Quality and Patient Safety: "Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results From a National Survey"

Episode page Back on the podcast for the sixth time is my friend David Meier, a Lean / TPS consultant who is a former Toyota leader at their plant in Georgetown, Kentucky. As we mentioned in our April episode (#304), he's gotten into what's, perhaps, the most Kentucky of industries… distilling bourbon (and more) at Glenn's Creek Distillery. Update — His “OCD #5” was named “US Micro Whisky of the Year” in the 2023 edition of the Jim Murray Whiskey Bible. Congrats, Dave!!! In this episode, there's a lot of bourbon talk, with some Lean concepts thrown in. If you share our interest in Lean and whiskey, then this might be your most favorite episode ever. Of course, if you don't have any interest in bourbon, you might well skip this one. Here is an article from IISE magazine about David's work: Helping the whiskey flow, Toyota style As David will talk about in the podcast: “Meier started work at Toyota in the 1980s and later became a traveling consultant. During his travels, he began thinking about establishing his own manufacturing-centered business closer to home. After researching his options, he came upon the original Old Crow Distillery that had been shut down since 1985. The 16-acre property had not been maintained since it closed, and Meier purchased the place in 2014.” I'll visit David and his distillery next week, so I'm sure I'll have more stories and photos. Topics and Links for this Episode: How did you get interested in distilling? Tell us the story about buying the business and getting things back up and running? There's lots of competition, long lead times before you can go to market… so why do this? Having solutions, versus understanding what's important, what the problems are, what the bottlenecks are… How do TPS / Lean principles apply to this business and the process? Are there annual cycles of strategy deployment to choose priorities and goals? Are there lessons from Toyota? “It's an area where I'm deficient.” What are needs vs. wants for the business? Bourbon usually requires a long value-added aging time in a warehouse… what can you do to reduce lead time in bourbon making? You can't level-load corn growing… Is there conventional wisdom, in Lean or whiskey making, that's superstition or proven in fact? Is there always a better way? Are you selling consistency or a product that's very different or better each year? In the IISE article, you said, “”When I was at Toyota all the Japanese guys would say, all we do is problem-solve,” he said.” — can you elaborate on that? “I took a one week class, so I'm an expert?” What's a “master distiller?” What's a “master?” The Japanese say you never achieve mastery no matter how good you get. “When you look at that mindset, you realize it's not about the savings. It's about the use of people, their creativity and directing that in a way that (pushes) them to think harder,” he said. – What do you do to be creative and encourage those who work with you to be more creative?

Joining me again for Episode #308 is Mike Grogan, a previous guest in episodes #182 (from Tanzania) and #224. Mike now lives in the Philippines, where he's helping and coaching many people and has written a new book, The MESSI Way. In this episode, we talk about the idea of "personal Lean" and being the best version of yourself. I appreciate Mike's reflections and honesty and I think we had a great conversation that was very thought provoking. What are your fears? Your failures? What have you learned about yourself in the last 12 months? What's a "thinking partner?" Those are just a few of things we discuss here today.

Joining me for Episode #307 of the podcast is my friend Andre DeMerchant, the President of DeMerchant Healthcare Solutions Inc., based in Kitchener, Ontario. We first crossed paths when we had the chance to work together with an American healthcare client via our then-affiliation with Pascal Dennis and Lean Pathways.  In today's episode, we talk about Andre's history working for Toyota in Canada and what he learned there -- and why it's important that he learned about "how flow works" at Toyota. We chat about the terms "Lean" and "The Toyota Production System" and what those words mean to him. How does TPS "transcend culture and language," as well as industries? We then shift to talking about healthcare and some of the common challenges, including "financial hardships," that are faced in many countries. Why are hospitals "poorly prepared for change" in many cases? Another main theme is "cost cutting" and why you can't cut your way to success. 

Podcast #306 - Mark D. Valenti, Motivational Interviewing and Health System Improvement My guest for Episode #306 is Mark D. Valenti, the manager of training, education, and workflow integration for the Enhanced Community Care Management (ECCM) at Highmark Health. In this episode, Mark and I talk about the use of "Motivational Interviewing" methods and mindsets in the ECCM program and how "everyday closer to better" is part of their mantra. We discuss the MI approach and how it's different than traditional healthcare or change management models that focus on telling people to change (or why they should change). There are many lessons that I think are helpful in any workplace or personal change context. ECCM is a "physician-led, patient-centered approach [that] focuses on prevention, high-quality and compassionate care, patient engagement and satisfaction, and health outcomes." According to Highmark, "In the first year, the ECCM program has provided a large Pennsylvania health plan with total medical care cost savings of greater than 19% for engaged members; equivalent to one inpatient admission per year per member engaged. More than 1,500 members are enrolled across more than 60 provider sites."