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My guests for episode #185 are Karen Dunn Skinner and David Skinner and our topic, for the first time on the Podcast, is Lean in law firms and the legal profession. David and Karen are husband and wife, attorneys, from Quebec, and consultants for their firm Gimbal. I had a chance to meet up with them in Montreal earlier this year, after connecting via social media, and they're a delight to talk to – in person and in our podcast.
I think there are a lot of fascinating parallels between Lean in healthcare and Lean in law. There are opportunities to focus on payment for value instead of activity, big opportunities to reduce waste and errors, and to make sure people are doing the right work for their job level. “The way it's always been” seems very powerful in both professions and the “but we don't make cars” objection can be powerful.
In the episode, we discuss topics including:
For a link to this episode, refer people to www.leanblog.org/185.
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.
Podcasts Sponsored by KaiNexus
It's great to have Dr. John Toussaint back for episode #184 of the podcast (see links to previous episodes below). He is, of course, CEO of the ThedaCare Center for Healthcare Value and the author of two Shingo Award-winning books, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry and Potent Medicine: The Collaborative Cure for Healthcare.
In this podcast, we start by hearing John's thoughts on some of the top issues that healthcare CEOs are facing today, such as changes in payment structures and Accountable Care Organizations. We also talk about the “Enduring Excellence” program that Paul O'Neill and John are leading to teach healthcare senior leaders about Lean culture change and their important role.
This podcast was produced in conjunction with the Healthcare Value Network as a continuation of their previous podcast series.
For a link to this episode, refer people to www.leanblog.org/184.
Past episodes with Dr. Toussaint:
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.
Podcasts Sponsored by KaiNexus
My guest for episode #183 is Scott Sambucci, who I met at the 2012 Lean Startup Conference. Scott is author of an excellent book, Startup Selling: How to sell if you really, really have to and don't know how. Scott is also founder of SalesQualia, a firm that helps people improve sales performance. His latest project is the Sales Model Canvas, an online tool.
Scott and I talk about getting better at sales (something I've honestly struggled with, as an engineer, during my time with KaiNexus). Scott talks about how “sales is a process,” what some of the biggest mistakes people can make with sales, what some common “vanity metrics” are (to be avoided), and how to look out for “vampires and gatekeepers” as you sell.
For a link to this episode, refer people to www.leanblog.org/183.
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.
You can also listen via Stitcher.
Podcasts Sponsored by KaiNexus
Joining me for episode #182 are Michael Grogan and Dr. Brenda Dmello, joining me via Skype from Tanzania where they are working together to use Lean to improve health care at the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT). Michael is Irish born and left his career in the United States to work in Africa (which you can read about in his guest post that I published earlier this month).
In the episode, we talk about their mission to reduce maternal death rates and “needless suffering” by creating “engaging, problem solving managers” as “everything rises and falls with leadership.” They are developing leaders who can “stop blaming” and treat people with respect, eliminating the “culture of fear” that we see in far too many organizations around the world. Dr. Brenda says, “I don't think it's ethical to allow change to happen so slowly” and that “clinical skills alone” won't solve healthcare's problems.
Links about their work:
My guest for Podcast #181 is a good friend, Ron Pereira of Gemba Academy, an outstanding provider of online Lean (and now Six Sigma) education.
Ron's blog posts can now be found at the Gemba Academy blog.
I was recently a guest on episode #8 of his podcast series. Ron was also the guest host for episode #143 of my podcast, where he interviewed me with follow up questions from a webinar I did for Gemba Academy on SPC.
Before I moved to San Antonio, Ron and used to live just about five miles apart in Keller, Texas and would meet for coffee regularly… but, today, we are talking via Skype. We're talking about his background with both Six Sigma and Lean and about how these methods can be used together. Ron tells a story about a time he used statistical methods to solve something that might have been difficult with standard Lean approaches.
For a link to this episode, refer people to www.leanblog.org/181.
Conflict of interest disclosure: Gemba Academy is a formal partner of KaiNexus, a technology company I work with and have an ownership stake in. I have received a free subscription to the Gemba Academy training classes.
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.
Joining me for episode #180 of the Lean Blog Podcast is Dan Florizone, who served from 2008 until last month as Deputy Minister of Health in the Canadian province of Saskatchewan.
Dan has just recently transitioned into his new role as the Deputy Minister of Education and he will also focus on the application of Lean principles across all departments of the government.
Dan previously had over 25 years of healthcare management experience, including a five-year stint as CEO of the Five Hills Health Region. Dan and I first met a few years back when we were at a Lean healthcare conference hosted by Cindy Jimmerson. I really enjoyed talking with Dan and have closely followed the Lean healthcare transformation work being done in the province.
In the episode, we talk about Dan's introduction to Lean, his 2005 visit to Seattle to learn more, and how Lean is part of their “patient first” model. Lean has been a shift from “traditional cost cutting” to a “patient-centered, not provider-centered” approach to care. Lean has helped change their leadership model, where “the barrier to our change was thinking,” as Dan says.
For a link to this episode, refer people to www.leanblog.org/180.
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.
You can also listen via Stitcher.
Podcasts Sponsored by KaiNexus
My guests for Podcast #179 are my friends Judy Worth and Tom Shuker, two of the co-authors of the book Perfecting Patient Journeys, which was published earlier this year by the Lean Enterprise Institute.
About the book: “Perfecting Patient Journeys” is a guide for leaders of healthcare organizations who want to implement lean thinking. Readers will learn how to identify and select a problem, define a project scope, and create a shared understanding of what's occurring in the value stream. Readers will also learn to develop a shared vision of an improved future, and how to work together to make that vision a reality.”
We'll talk about their book, what types of value streams and “extended value streams” are being worked on in healthcare (including “end-to-end” flows), breaking down silos, improving quality and cost as a result of taking time out of the value stream, and more.
For a link to this episode, refer people to www.leanblog.org/179.
Other links and info:
Conflict of interest disclosure: I received a free copy of the physical book and e-Book from the Lean Enterprise Institute and I am formerly an employee of LEI.
For earlier episodes, visit the main Podcast page, which includes information on how to subscribe via RSS or via Apple Podcasts.
You can also listen via Stitcher.
Podcasts Sponsored by KaiNexus
From the publisher's feed
Lean Blog Interviews: Real-World Lean Leadership Conversations features thoughtful, in-depth discussions with leaders, authors, executives, and practitioners who are applying Lean thinking in the real world.
Hosted by Mark Graban—author of Lean Hospitals, Measures of Success, and The Mistakes That Make Us—the podcast explores Lean as a management system, a leadership philosophy, and a people-centered approach to continuous improvement.
Episodes span healthcare, manufacturing, startups, technology, and professional services. Guests share candid stories about what actually works—and what doesn’t—when organizations try to improve.
This is not a podcast about chasing tools, jargon, or “Lean theater.” Instead, you’ll hear honest conversations about leadership behaviors, culture, psychological safety, learning from mistakes, and building systems that help people do their best work.
If you believe improvement starts with respect for people—and that better systems beat blaming individuals—this podcast is for you.
Find show notes and all episodes at LeanCast.org.
Learn more about Mark Graban at MarkGraban.com.

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