http://www.leanblog.org/audio300

I had a phone conversation yesterday with an emergency medicine physician after her shift at an unnamed hospital in an undisclosed state.

She had a number of frustrations to share and she doesn't really have an outlet (and doesn't want her name out there for fear of retaliation). More importantly, this isn't about one institution. She works in a well respected system. So this lack of preparedness and leadership could be widespread. When I posted my concerns about hospital preparedness for Covid-19, I guess they weren't unfounded.

I'm sharing these concerns in a public way because I think it's important to try to inspire other healthcare professionals and improvement specialists who CAN be on site to drive improvements.

I also hope it serves as a reminder to the public to NOT GO to the hospital unless it's a life-or-death emergency right now.  "When should I go to the hospital?" and more questions were be covered in a webinar that was done on Wednesday. Listen, watch, or read a synopsis here.

http://www.leanblog.org/audio299

I normally love the public radio program "Marketplace" and have listened to it (on radio or as a podcast) for 15 years or so.

But, I was very disappointed with this recent piece, which you can read here:

Yes, many factories have been shut down in China, which disrupts global supply chains. However, if you're a company that decided to move all of your production to China (to then ship out to customers around the world), that wasn't a "Lean" strategy.

It's really difficult to support "just in time" delivery over such long distances. If it were a "Lean" approach to move all of your production to China, then Toyota would have done that. But, Toyota didn't.

http://www.leanblog.org/audio298

I've been thinking a lot about hospitals and how they're preparing for the expected tsunami of Covid-19 patients who will need ICU beds and ventilators (when it's expected that there won't be enough of either).

There have also been recent preparations (and ongoing actions) to screen patients who arrive at emergency rooms and outpatient clinics.

I was at one organization last week that was in the process of installing new protocols and procedures in an outpatient clinic setting and I was able to have a tiny amount of input into that. Now, I'm home and trying to help remotely with the situation.

I hope this blog post helps more broadly.

http://www.leanblog.org/audio297

Looking back at a blog post and an article from 2012 and 2014...

http://www.leanblog.org/shingo2020

Thanks to the Shingo Institute for inviting me to facilitate a half-day workshop at the Shingo Conference, being held this year in Orlando, April 16 and 17. The workshop covers concepts and methods from my book Measures of Success: React Less, Lead Better, Improve More.

I hope you can join us for the conference, as this is an event I have enjoyed in the past — and if you're going to be there, please say hi and, better yet, come to my session.

My workshop will be a concurrent session on Friday at 8:30 AM. Here is a video they asked me to make where I share a little bit about the workshop:

http://www.leanblog.org/audio295

Here's an article from Bloomberg BusinessWeek:

GE's Larry Culp Faces Ultimate CEO Test in Trying to Save a Once-Great Company

Very early on, the article mentions Culp's advocacy for "Toyota-style lean manufacturing." Or is he pushing "Danaher-style lean manufacturing" and is that different? And does that matter?

Culp was "in his element" visiting a GE factory in Pensacola -- can that be said about most CEOs?

http://www.leanblog.org/audio294

Today, I'm sharing a question from a reader who started their career at Toyota and now works at another company. See previous posts with reader questions.

The reader has given me permission to share this -- to get your input -- and there are no identifying details included:

I came across something interesting at work around goals that I wanted to share with you and perhaps get your thoughts.

At the beginning of the fiscal year, our manufacturing sites submitted their cost savings targets to me. I looked them over to make sure they both seem reasonable yet challenging and asked questions as needed. From there, I submitted them to the operations VP for final approval. The VP accepted them without question.

We're at the end of the first quarter, and 3 of the 9 sites are not meeting their run rate target...

From 2014 -- http://www.leanblog.org/audio293

We had an excellent English-speaking tour guide for our visit (she lived in Hawaii at one point). As we talked through the facility (up in a "catwalk" that gave good visibility down into the process), she would occasionally stop at pre-determined points to explain something about the process or about the Toyota Production System and its elements.

At each stop, there was a box with a microphone and other audio/visual equipment and speakers. She didn't have to carry a microphone with her.

The guide was carrying a bag, something between a briefcase and a large purse.

One of our sharp-eyed tour attendees, a Chief Medical Officer from a Canadian hospital, noticed a hook that she would hang her bag on while stopped and talking. He asked her about the hook.

Sure enough, it was a Kaizen improvement! And, it was her idea.

From 2012: http://www.leanblog.org/audio292

Dr. Iida talked about the connections between "Kaizen" (small improvements) and innovation (larger improvements) and how, together, they lead to breakthroughs. He also talked about how one is absolutely necessary for the other to occur.

Dr. Iida has been the CEO for just over 20 years and his hospital receives visitors from around the world, including Europe and Africa. They were on the verge of bankruptcy when he took the job in 1991 and they are now "in the black" and had the money to build a new hospital, while most Japanese hospitals are losing money today, he said.

http://www.leanblog.org/audio291

Last week was our fifth annual KaiNexus User Conference (or "KaiNexicon" as we now call it).

One of our keynote speakers was Jess Orr, a former Toyota engineer who shared perspectives on what it was like to now lead continuous improvement in another company. Jess has previously presented three webinars for us at KaiNexus (see links at the end of the post) and she always has something insightful to say.

I took a lot of notes during her talk, so here are some of the highlights as I captured them.