Lean Frontiers: Are they differences in getting middle management on board from getting executive management support?
Are there differences in getting middle management from executive management on board for 1) developing the lean enterprise and 2) direct engagement on their part? What are the differences, if any?
Posted on May 9, 2015
Author Archive
Mark Graban

Mark Graban: The focus should be on improvement, in a balanced set of measures, not just a single number

By Mark Graban, - Last updated: Thursday, February 26, 2015
Percent value-added is an interesting thing to measure in a process or a value stream, but we have to be careful putting too much emphasis on that metric. Let's say I am managing an optometrist clinic where the average appointment length is 60 minutes. There are three value adding steps: 1) the assistant doing an initial exam, 2) a machine that does an eye check, and 3) the optometrist exam. Those three steps take a total of 15 minutes, so the % VA time is 25%. The waits in between the three process steps are where a Lean thinker would look ...

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Mark Graban

Mark Graban: hiring inexperienced employees for the Kaizen Promotion Office is a recipe for failure

By Mark Graban, - Last updated: Sunday, November 9, 2014
The other posts answering this question have made me reflect a bit on a troubling trend in healthcare: hospitals far too often filling their KPOs (or process improvement departments) with very inexperienced employees. They are often inexperienced with or brand new to Lean and/or they are also new to healthcare. I'll go out on a limb and say that this is a recipe for failure. What NOT to do is to put your youngest, most inexperienced people into a KPO. I don't see how a KPO member can effectively teach and mentor others if they have no experience with Lean or ...

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Mark Graban

Mark Graban: No time for improvement? Then find time

By Mark Graban, - Last updated: Sunday, March 30, 2014
The Lean Edge: How do you make time for improvements? As CEO of my company I have a grasp of lean and have experienced it in my career, but now that I'm CEO, I find it difficult to ask my people to make time for improvement work. They’re already completely busy doing their regular work. Moreover, this company is in the outdoor sports industry, and many people join these companies because they want time to climb, backpack, canoe, etc., and I'm reluctant to ask them to work more hours and sacrifice time for these activities. Any advice?" It's a very common complaint ...

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Mark Graban

Mark Graban: Good lean practices which start with an obsession with customers

By Mark Graban, - Last updated: Tuesday, May 21, 2013
I think the Lean Startup movement is off to a good start. When I first saw Eric Ries give a presentation about this at MIT in late 2009, I worried that it was just going to be a buzzword... but there's some real Lean Thinking there. It's not quite the complete management system and philosophy that Lean / TPS provides, but there are some good Lean principles that are spreading, including: Customer focus: The Lean Startup (TLS) is pretty customer obsessive... understanding the day in the life of your customer ("get out of the office!" as they say) and what their ...

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Mark Graban

Mark Graban: Focusing on staff morale, quality, and waiting times leads to better productivity, but as an end result not a primary goal

By Mark Graban, - Last updated: Sunday, January 27, 2013
In hospitals, productivity measures are typically based on direct labor productivity or financial calculations (such as the oft-dreaded "Worked Hours Per Unit of Service" measure). These raw productivity measures are often easy to tabulate, but it doesn't mean that it's the most important thing or that it's meaningful to staff. A hospital can measure revenue per employee or the lab department can measure the number of tests completed per hour of labor, but they often struggle to measure things that are more important - like safety, quality, and waiting times. My ...

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Mark Graban

Mark Graban:”What has been will be again, what has been done will be done again; there is nothing new under the sun.” Ecclesiastes 1:9

By Mark Graban, - Last updated: Friday, July 8, 2011
I sometimes hear people say that lean concepts and philosophies are just a restatement of Dr. Deming's teachings or it's all copied from Henry Ford or it has been lifted from Benjamin Franklin. But it could be argued that each new "restatement" leads to incrementally improved definitions and understandings of core principles from the past. One hospital laboratory director I worked with had been studying Peter Senge's "The Fifth Discipline" with his managers, but when introduced to lean and the Toyota Production System, he found a framework that allowed him to "operationalize" the concepts of systems thinking so they could ...

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Mark Graban

Mark Graban: The lean approach to capital expenditure, inspired by Toyota’s philosophy and practices, is also thankfully being applied in healthcare

By Mark Graban, - Last updated: Friday, March 11, 2011
The traditional approach to increasing capacity (beds and equipment) in healthcare is "more, more, more." More space, more money, more people. This is one reason for our rapidly increasing healthcare costs. Hospitals don't always do a good job of maximizing the use of existing resources - they often just build more space instead of improving flow, reducing variation, and reducing hospital length of stay. I remember meeting a Chief Medical Officer at a hospital in Puerto Rico. They had long patient delays in the emergency department and the CMO, through her political power, forced through the construction of 9 more E.D. ...

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Mark Graban

Mark Graban: Lean is about continuous improvement and respect for people

By Mark Graban, - Last updated: Monday, November 22, 2010
As helpful as Wikipedia can be, it's also not the definitive source on many topics. In this case, the description of "Lean" is sorely lacking the people element. Lean and the Toyota Way are about both "continuous improvement" and "respect for people." Taiichi Ohno wrote that these were "equally important pillars." Equally important - let's emphasize that. Too many organizations focus on just the "continuous improvement" piece, even if "continuous" means a series of infrequent kaizen events to them. We have to focus, also, on the people side of things. One could argue if you focus ONLY on the people side, ...

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Mark Graban

Mark Graban: Every Employee Is An Innovator

By Mark Graban, - Last updated: Tuesday, May 11, 2010
"Innovation" is a trendy business buzzword - it's much more appealing, generally speaking, to executives than the term "lean" is. Innovation is sexy and fun. Lean sounds dull and monotonous. Improve continuously -- who has the patience for that? Not those who would rather swing for the fences and find that one silver-bullet home run innovation that will ensure future profits. Lean organizations, while not ignoring large innovations (think Toyota Prius), also focus on daily innovation through Lean and process improvement methods, like kaizen. It's often thought, mistakenly, that Lean and innovation can't go together. Those who think Lean created rigid, ...

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Mark Graban

Mark Graban: Same Misunderstanding Occurs in Hospitals

By Mark Graban, - Last updated: Thursday, April 29, 2010
There's a fallacy in the question as stated - that "lean" means there's a major risk of not having what you need to get your work done. This is one way the word "lean" is sometimes misunderstood (going back to the  1980s book "Zero Inventories," the title of which was taken too literally by some). During my graduate school studies in the 1990s, I worked with a manufacturer who had taken "zero inventories" and what they thought was "lean" to an extreme. They slashed finished goods inventory and very soon after couldn't make shipments to customers! They had a process ...

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