In the Lean community (and in businesses and hospitals, as well), people often talk about "fire fighting" in a colloquial way. Today, my guest for episode #278 of the podcast is an actual professional fire fighter, Tom Bouthillet (@tbouthillet on Twitter). He serves as Fire Captain / Paramedic for the Hilton Head Island Fire Rescue where he is the Cardiac Care Program Manager (STEMI and CARES Site Coordinator). In this episode, we discuss the role of Lean and process improvement in fire departments and EMS, why blame is "completely ineffective" as a strategy, why "unsafe supervision" is a problem (and what that means), and why it's necessary to build in quality instead of just inspecting for quality.