I had a chance to attend the Lean Kanban North America conference this week. It was a different “tribe” to be a part of, as the topics focused on software and IT settings, including agile development, “kanban” project management, and broader lean management topics.
I gave a talk on “lean healthcare,” which is always an interesting challenge when it's not an audience of healthcare professionals.
Here are notes and links that I cited in my slides, including data and key references:
You can also view this as a Google Doc.
- 98,000 deaths due to preventable medical errors
- Institute of Medicine: http://bit.ly/IOM-report
- One in seven Medicare patients harmed in hospital
- HHS Report: http://1.usa.gov/YiSez5
- One in 300 patients dying due to hospital errors
- Collected stats on quality and patient safety problems worldwide
- Collected stats on IMPROVEMENT
- Institute of Medicine Report on healthcare waste
- $765 Billion of $2.5 Trillion annual U.S. healthcare spending wasted
- Hand washing data
- “Ask me if I've washed my hands”
- UPenn data on reduction in Central Line Associated Bloodstream Infections
- ThedaCare improvement of Cardiac Bypass surgery patient data
- Two pillars of the Toyota Way management system
- “Respect for people”
- “Continuous improvement”
- Blog post
- Toyota web site
- Mary McClinton case at Virginia Mason Medical Center
- Virginia Mason patient safety alerts
- Darrie Eason case
- Seattle Children's hospital Lean Design
- John Toussaint & Kim Barnas (ThedaCare)
- Journal article
- Book on their Lean journey
- My podcasts with John (episodes 54, 62, 72, 146, 159)
- Paul O'Neill's three questions
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- Are my staff and doctors treated with dignity and respect by everyone in our organization?
- Do my staff and doctors have the training and encouragement to do work that gives their life meaning?
- Have I recognized my staff and doctors for what they do?
- Lean vs. L.A.M.E.
- Article about bad 5S in the British news
Picture via Twitter.
Tweets about the talk:
1/3 of healthcare spending = waste (including medical errors which are preventable) – @MarkGraban #LKNA13 #lean #healthcare
— Tonianne DeMaria (@Sprezzatura) April 29, 2013
CEO's aren't asked to wear a badge saying "why are we understaffed?" Yet doctors are asked to wear one for hand washing #lkna13 @MarkGraban
— Marc Johnson (@marcjohnson) April 29, 2013
Lean tools are just a tip of iceberg. Org culture, mindset and mgmt system are underwater part – not seen at 1st sight @markgraban #lkna13
— Pawel Brodzinski (@pawelbrodzinski) April 29, 2013
Managers, are we looking for bad apples to blame when we should be looking for bad processes? @MarkGraban #lkna13
— Michael Mumau (@Mumau) April 29, 2013
Being careful is not sufficient. Would careful deva create bug-free software? @markgraban #lkna13 same as "do the work right at 1st attempt"
— Pawel Brodzinski (@pawelbrodzinski) April 29, 2013
#lkna13 "The Five Who's" — @MarkGraban the result of a name/shame/blame culture
— Eric Willeke (@erwilleke) April 29, 2013
And on cord is not only to stop the line. It's a call for help in the first place. @markgraban #lkna13 Same as blockers on Kanban board
— Pawel Brodzinski (@pawelbrodzinski) April 29, 2013
If your managers say things like "My people are very careful", this is an indication that you have a systemic quality problem #lkna13
— Jason Yip (@jchyip@mastodon.online) (@jchyip) April 29, 2013
W/#lean,hospitals able to double amt of time nurses have bedside. Improves quality/curbs waste (less waiting/falls) – @MarkGraban #lkna13
— Tonianne DeMaria (@Sprezzatura) April 29, 2013
The ultimate arrogance is to change the way people work without changing the way we manage them @markgraban #lkna13
— Pawel Brodzinski (@pawelbrodzinski) April 29, 2013
#LKNA13 Child at risk story from @MarkGraban illustrates 1 issue w lean adoption in software: our risks are seldom as grave (death, harm)
— Derek W. Wade @derekwwade@mstdn.io (@DerekWWade) April 29, 2013
Great talk by @markgraban on lean healthcare. Nice job! #lkna13
— Nayan Hajratwala (@nhajratw) April 29, 2013
Inspiring talk from @MarkGraban on lean in healthcare. Plenty of transferable thoughts. Important to get an alternative perspective. #lkna13
— Thom Leggett (@thomleg) April 29, 2013
The goal is not #Lean or #Agile or #Kanban. I hope we can continue to remember that. #lkna @markgraban
— Eb (@eikonne) April 29, 2013
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