The blog post

In this Lean Blog Audio episode, Mark Graban explores two silent killers of improvement—fear and futility—and how leaders can dismantle both to unleash the full potential of their teams.

Drawing from his book Lean Hospitals and more recent research by organizational psychologist Ethan Burris, Mark explains how fear (“What will happen if I speak up?”) and futility (“Why bother? Nothing will change.”) combine to silence ideas, suppress learning, and stall continuous improvement.

Through real-world healthcare examples—including Virginia Mason Medical Center’s Patient Safety Alert system and Allina Health’s Kaizen program—Mark shows what it looks like when organizations replace fear with trust and futility with action. The results? More engagement, faster problem-solving, and safer care for patients.

Key themes include:

• Why “Respect for People” must go beyond posters and become daily practice

• How psychological safety grows when leaders respond with curiosity, not criticism

• The link between timely follow-up on staff ideas and sustained Kaizen participation

• How Lean thinking offers practical antidotes to fear and futility

This episode is a reflection on what’s still holding many organizations back—and how leaders can make it safe and worthwhile for people to speak up, share ideas, and improve the systems around them.

Listen and ask yourself:
What invisible barriers might be silencing improvement in your workplace?