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.

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.

Tom Bouthillet, Lean and Fire Fighting (the Real Kind)

Since 2006, the Lean Blog Interviews podcast has featured in-depth, candid conversations with leaders, thinkers, and doers in the world of Lean and continuous improvement. Hosted by Mark Graban—author, consultant, and longtime Lean practitioner—the show explores how Lean principles are being applied across industries, including healthcare, manufacturing, startups, and more.
What sets this podcast apart? We go beyond tools and buzzwords. Our guests share real-world stories of success, struggle, learning, and leadership. Whether you’re a seasoned Lean veteran or just getting started, you’ll gain practical insights and fresh perspectives that you can take back to your own organization.
Topics include:
<ul>
<li>
Lean as a management system and cultural transformation—not just a toolbox
</li>
<li>
Continuous improvement and problem-solving, at every level
</li>
<li>
Leadership behaviors that support real change
</li>
<li>
Psychological safety as a foundation for improvement
</li>
<li>
Lessons from the Toyota Production System, Lean Startup, and beyond
</li>
<li>
Candid stories about mistakes—and what we learn from them
</li>
</ul>
We don’t talk much about “Lean Six Sigma” here. But if you believe improvement is about people first—this podcast is for you.
Many episodes feature a special focus on Lean in healthcare, reflecting Mark’s deep work in that field. Hear from leaders working to improve patient safety, reduce waste, and build cultures of respect and learning.
Find all episodes and show notes at <a class="decorated-link" href="https://www.leancast.org">www.LeanCast.org</a>. Learn more about Mark and his work at <a class="decorated-link" href="https://www.leanblog.org">www.LeanBlog.org</a>. Questions or feedback? Email <a class="decorated-link cursor-pointer">mark@leanblog.org </a>

Business

Management

Since 2006, the Lean Blog Interviews podcast has featured in-depth, candid conversations with leaders, thinkers, and doers in the world of Lean and continuous improvement. Hosted by Mark Graban—author, consultant, and longtime Lean practitioner—the show explores how Lean principles are being applied across industries, including healthcare, manufacturing, startups, and more. What sets this podcast apart? We go beyond tools and buzzwords. Our guests share real-world stories of success, struggle, learning, and leadership. Whether you’re a seasoned Lean veteran or just getting started, you’ll gain practical insights and fresh perspectives that you can take back to your own organization. Topics include: Lean as a management system and cultural transformation—not just a toolbox Continuous improvement and problem-solving, at every level Leadership behaviors that support real change Psychological safety as a foundation for improvement Lessons from the Toyota Production System, Lean Startup, and beyond Candid stories about mistakes—and what we learn from them We don’t talk much about “Lean Six Sigma” here. But if you believe improvement is about people first—this podcast is for you. Many episodes feature a special focus on Lean in healthcare, reflecting Mark’s deep work in that field. Hear from leaders working to improve patient safety, reduce waste, and build cultures of respect and learning. Find all episodes and show notes at www.LeanCast.org.Learn more about Mark and his work at www.LeanBlog.org.Questions or feedback? Email mark@leanblog.org

Since 2006, the Lean Blog Interviews podcast has featured in-depth, candid conversations with leaders, thinkers, and doers in the world of Lean and continuous improvement. Hosted by Mark Graban—author, consultant, and longtime Lean practitioner—the show explores how Lean principles are being applied across industries, including healthcare, manufacturing, startups, and more.
What sets this podcast apart? We go beyond tools and buzzwords. Our guests share real-world stories of success, struggle, learning, and leadership. Whether you’re a seasoned Lean veteran or just getting started, you’ll gain practical insights and fresh perspectives that you can take back to your own organization.
Topics include:
<ul>
<li>
Lean as a management system and cultural transformation—not just a toolbox
</li>
<li>
Continuous improvement and problem-solving, at every level
</li>
<li>
Leadership behaviors that support real change
</li>
<li>
Psychological safety as a foundation for improvement
</li>
<li>
Lessons from the Toyota Production System, Lean Startup, and beyond
</li>
<li>
Candid stories about mistakes—and what we learn from them
</li>
</ul>
We don’t talk much about “Lean Six Sigma” here. But if you believe improvement is about people first—this podcast is for you.
Many episodes feature a special focus on Lean in healthcare, reflecting Mark’s deep work in that field. Hear from leaders working to improve patient safety, reduce waste, and build cultures of respect and learning.
Find all episodes and show notes at <a href="https://www.leancast.org" rel="noopener noreferrer">www.LeanCast.org</a>. Learn more about Mark and his work at <a href="https://www.leanblog.org" rel="noopener noreferrer">www.LeanBlog.org</a>. Questions or feedback? Email <a rel="noopener noreferrer">mark@leanblog.org&nbsp;</a>

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Tom Bouthillet, Lean and Fire Fighting (the Real Kind)

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