Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement

Don Davis, former CEO of Stanley Works, passed away in 2010 and left an unfinished book in progress. One of my friends (and former colleagues from Dell in the late '90s), Steve Cook and a number of other alumni completed the book, working with Don's daughter Ruthie Davis (of the eponymous shoe company).The book is Do the Right Thing: Real Life Stories of Leaders Facing Tough Choices.

Do the Right Thing highlights Don's "leadership mantras" and real-life stories from alumni who leaned upon these mantras to make tough decisions in their careers.

It's not uncommon to hear statements thrown around about Lean that are more of a myth than anything resembling reality.I remember the time a professor told a group that if Toyota ran a health clinic, a buzzer would go off at the end of the planned appointment time and the patient would be kicked out of the room. That's ridiculous. That's a myth (and it's not one of the widely spoken myths).

A Lean myth might be an example of L.A.M.E. or "Lean As Mistakenly Explained."

This post addresses other myths, including the idea that "Lean is not patient centered."

I love to cook and I"m the primary chef in my home. I often get asked a question - sometimes it’s serious and sometimes it’s smart-alecky - “Do you 5S your kitchen?” If by that, they mean, “Do you label the outside of your cabinets and put tape outlines around everything?” then the answer is no. And I’m not sure why anybody would want to… but if doing so makes your life easier, then great - that’s what Lean is all about, solving problems and being more effective.

I do, however, try to apply Lean principles in our kitchen. I can’t help it....

Here's my latest post for LinkedIn through their "Influencers" series. It might be old hat to readers of this blog, but I hope what I shared is useful for a wider audience that I have there.10 Key Lean Mindsets for Factories, Hospitals, Startups, and More

http://leanblog.org/audio54

http://leanblog.org/audio53

In my first post about the on-site Kaizen learning experience at Franciscan St. Francis Health, an event I came to call "Kaizen Live," I wrote about some of the initial presentations and discussions from Franciscan leaders. You can also see my tweets from the days.A big part of the 1.5-day event was the three "gemba visits" that took place. Each attendee had the chance to visit pharmacy, endoscopy, and the NICU. I had visited all three departments before (when we shot this series of videos last October) and I focused this time on the NICU, going there all three times. Why did I go three times? Some of it was logistics, as I was the person responsible for getting each group there and I don't know my way around the hospital that well. It was easier to learn one path - how to get to the NICU and back.

Since my last visit in October 2014, the NICU movedinto a new physical space (in November). The old unit was the traditional NICU of days past - a big open room with curtains that divided the space for each infant incubator, but didn't provide too much privacy. The new, modern NICU was built with private rooms with sliding glass doors - providing more quiet and privacy than before.

While the NICU team had implemented hundreds of Kaizens in previous years, the chance to design a brand new space was a rare opportunity for radical Kaizen, or what might be called "Kaikaku." Since it's difficult to continuously improve many elements of a physicallayout (such as the location of walls), the team experimented with full-size Styrofoam mockups of the space. Staff and parents were able to give input at a stage when you could still Adjust easily in the PDSA model of Plan, Do, Study, Adjust.

http://leanblog.org/audio52

There's been a back and forth of views about the state of pediatric emergency medicine recently in the Wall St Journal.Let me start first, actually, with the more recent statement, a rebuttal from Michael Gerardi M.D., FACEP, President of the American College of Emergency Physicians, in the form of a letter to the editor.

He wrote:

"Emergency care of children in the U.S. is the best in the world. Emergency physicians treat more than 22 million sick and injured children under age 15 each year, and the vast majority of them have good outcomes. If a child has a medical emergency, parents should get that child to the nearest emergency room and have confidence that they are receiving top-quality care in the right place from the right physicians."

It's "the best in the world." Is that an opinion? Where is the data to back that up?

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....