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.

How many times do we hear people say things like“We don’t have time for Lean” or “We don’t have time for Kaizen“? It happens a lot, right? As I’ve said before (and this video) a “lack of time” is a problem to solve... so how did I get hospitals to dedicate staff time for 12 to 16 weeks?

http://leanblog.org/audio108

The "five" in the "five whys" methodology is not a magic number, be it Lean or Lean Startup approaches.

http://leanblog.org/audio107

Why do we need to move beyond "The Five Whys" into a more robust problem solving model for Lean or Lean Startup settings?

http://leanblog.org/audio106

In discussing Lean and working with people in different organizations, I so very often hear things like "we don't build cars" or "we're different." I know I'm not the only one who hears that. The implication is "Lean won't work here, because we're different" in some way. Different country, different industry, different hospital department, different patient or payer mix, etc.