Lean Blog Audio

Following up on yesterday's post on seemingly successful experiments with ACOs, here's another article, from HBR, on "safety huddles" in healthcare:"How Every Hospital Should Start the Day"

You might be considered "wonky" for enjoying the topics discussed here at LeanBlog.org... but that's fine. This is a safe environment for being wonky about Lean and improvement.From Vox.com, Sarah Kliff normally does a great job covering healthcare topics, including this latest piece: "This small, wonky Obamacare program saved $384 million over 2 years"

http://leanblog.org/audio49 I was quoted in two articles that appeared in "Today's Hospitalist":"Discharging Mr. Wood: Time to get serious about waste" and "Standardized work: Improving quality by reducing practice variation." Reducing Waste The author, David A. Frenz, MD, points out that it's a "collective delusion" that the U.S. spending so much more on healthcare leads to safer or higherquality care. People are waking up to the fact that there is too much waste in healthcare. We have poorly designed systems and processes -- it's not the fault of individuals, nor is the waste due to a lack of clinical expertise or a lack of technology.

http://leanblog.org/audio48 On April 22 and 23, I collaborated with Joe Swartz and a countless number of his colleagues to host 24 visitors from different health systems (and an Indiana state government organization) to learn about the "Kaizen" approach to continuous improvement first hand at Joe's health system - Franciscan St. Francis Health in Indianapolis.I tend to "take notes" these days via Twitter and you can read all of my tweets and quotes if you like. Here are a few highlights, incorporating some of these tweets, as appropriate....

http://leanblog.org/audio47 One of the many things I admire about W. Edwards Deming is how hard he worked into his 90s. He must have had "pride and joy" in his own work.I learned from this IndustryWeek piece that Dr. Deming was teaching seminars up until two weeks before his death at age 93. IndustryWeek was kind enough to share Dr. Deming's last interview, originally published in January 1994, on their website in three parts....

Chris Van Gorder, CEO of Scripps Health in California, wrote this article in HBR back in January: "A No-Layoffs Policy Can Work, Even in an Unpredictable Economy."

Forgive me for being a bit of an Industrial Engineering geek here in this post. After all, my bachelor's degree is in Industrial Engineering, even though I sometimes get called "a healthcare guy" after focusing on healthcare for just about ten years now.One of the things we learned about in our IE organizational psychology class was something called "the Hawthorne Effect." In the past few months, I can recall maybe three different occasions where somebody referred to the Hawthorne Effect in a positive light, as in: "We'll have to see if the data improves, maybe we'll get the Hawthorne Effect." People have meant this in a positive light in the context of the flow of the conversations. I remember somebody almost bragging that the improvement in an area was due to the Hawthorne Effect. I cringed... that's not really anything to hope for.

Dr. W. Edwards Deming advised against relying on slogans and posters as a way of trying to improve quality.Point 10 of his famed 14 points said: Eliminate slogans, exhortations, and targets for the work force asking for zero defects and new levels of productivity. Such exhortations only create adversarial relationships, as the bulk of the causes of low quality and low productivity belong to the systemand thus lie beyond the power of the work force.

http://leanblog.org/audio43 You might know my friend Karl Wadensten, the president of VIBCO, a small manufacturer in Rhode Island. I've interviewed him for episode #84 of my podcast series (which was also episode #10 of my video podcast series).I've had a chance to visit his factory a few times (mostly in the 2009-2011 timeframe). Each time, I've been impressed with the visible employee enthusiasm for improvement and the way VIBCO has used Lean to meet business objectives of better customer service and performance. Then, and over time, I've been impressed with Karl's transformation into a Lean leader. Beyond VIBCO, Karl has been a tireless proponent of Lean for the state of Rhode Island. These efforts have led to Governor Gina M. Raimondo supporting Lean and signing an executive order that will mandate the use of Lean principlesand methods in state government.

have been going through some old papers recently and I found two sheets of paper with hand-written thoughts or "truisms" that I had scribbled down in early 2002. The word truism, it turns out, doesn't mean "true" so much as it means "a statement that is obviously true and says nothing new or interesting." Oops.This was a list of things I had learned after two years at GM, two years at MIT, two years at Dell Computer, and just over a year at a startup. These aren't all original thoughts, by any means, but I had written them down when I was in between jobs (the startup had a real cash crunch after 9/11).If Twitter had existed, I might have tweeted many of the thoughts on that paper. Not all of them are under 140 characters, but here some of the things on that sheet from 13 years ago.