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A3s (11) Show All »
Welcome to the MTL A3 Dojo
By: Shook, John | February 9, 2011
A3s; Columns
Welcome to this MTL-mini site within www.  lean.  org a destination for thought leadership in lean management in general, "managing to learn" and the A3 process in particular.  The goal of this site is to narrow the gap between reading about how to create an A3 and actually doing A3 management. This site within a site is meant to be a shared space for A3 thinking, a place for you to engage with others on the nitty-gritty daily challenges of your specific problems. Even for you to create an A3 and own it in the process.  This mini-site emerged out More »
Detailed A3 Template (from Managing to Learn)
By: Shook, John | July 19, 2010
A3s; Forms and Templates
A PDF of the A3 template provided in the book Managing to Learn. More »
Audio (9) Show All »
The Gold Mine (Audiobook - CD)
By: Freddy Ballé and Michael Ballé | November 9, 2010
Audio; Books
An unabridged audio version of The Gold Mine: A Novel of Lean Turnaround, a Shingo Research Prize recipient in 2006.    More »
Interview: Mark Graban - HealthCare Value Leaders Network
By: Wilson, Steve; Graban, Mark | August 7, 2010
Mark Graban, Director of Communication & Technology for the Healthcare Value Leaders Network, talks with host Steve Wilson about the Network and how members engage and interact, particularly around the formal on-site "Gemba Visits" that are facilitated by the Network.  Listen to the show:  More »
Case Studies (16) Show All »
Toyota Partners with Nonprofit to Rebuild Homes and Lives
By: by Chet Marchwinski | July 10, 2015
When the flood waters of Hurricane Katrina receded, they uncovered tens of thousands of ruined homes in devastated areas like St. Bernard Parish, Louisiana. But the subsiding waters also exposed a rebuilding process that needed rethinking. In this LEI case study, we take a close look at how lean management principles are improving disaster recovery around New Orleans and the U.  S. overall. More »
Transforming Healthcare: What Matters Most? How the Cleveland Clinic Is Cultivating a Problem-Solving Mindset and Building a Culture of Improvement
By: David Drickhamer | May 28, 2015
Imagine if you could create a culture of excellence and improvement in a large healthcare organization. That’s the challenge that pushed the Cleveland Clinic to reinvent its continuous improvement program and push for a true cultural transformation.    More »
Columns (431) Show All »
Rethinking Disaster Recovery on the 10th Anniversary of Hurricane Katrina
By: Chet Marchwinski | July 31, 2015
As the 10th anniversary of Hurricane Katrina approaches on August 23rd-29th, read about how lean thinking is changing how New Orleans and the rest of the U.  S. is recovering from disasters. Then read or bookmark the full case study. More »
Why Meaningful Improvement Requires a “Growth Mindset”
By: Katrina Appell | July 30, 2015
Ever feel frustrated, constricted, or powerless to do the right thing in your organization? Katrina Appell says it all has to do with whether or not we work in an "enabling" bureaucracy or "coercive" one. More »
Events (9) Show All »
2014 Lean Healthcare Transformation Summit
January 10, 2014
June 4-5, 2014 - Los Angeles, California. Two days when you can learn directly from the lean healthcare leaders who are making real change and getting real results in how we deliver and pay for healthcare. More »
2014 Transformation Summit
October 21, 2013
March 5-6, 2014 - Orlando, Florida. Improve the work, develop the people - the building blocks for continuous innovation. More »
Outside Resources (2) Show All »
"Training Within Industry" Program Resources for Healthcare
August 20, 2009
The "Training Within Industry" program was a U.  S. government program during World War II that focused on ramping up war production. The methodology for creating job instructions, managing continuous improvement, and training employees became the foundation for Toyota's approach to Standardized Work as it was taught to them after the war.  The TWI approach was also used in healthcare during the war. The approach is being utilized today in a growing number of hospitals as that history is rediscovered.  The TWI Institute has resources and historical documents about TWI in healthcare. More »
Links to Hospital Lean Websites
By: Compiled by the Lean Enterprise Institute | August 14, 2009
Here is a list of healthcare organizations that have their own website about Lean:Virginia Mason Medical Center (WA)Avera McKennan (SD)Beth Israel Deaconness (MA)PRHI Perfecting Patient Care (PA)Seattle Children's (WA)  Univ. of Michigan Quality System (MI)ThedaCare Improvement System (WI) More »
Research (2)
Mistake-proofing healthcare: Why stopping processes may be a good start
By: Grout, John; Toussaint, John | February 24, 2010
Professor John Grout and John Toussaint, M.  D.  , combine their lean experience to write a peer-reviewed journal article from Indiana University's "Business Horizons".  Grout teaches an LEI workshop called Mistake-Proofing Healthcare: Designing Processes to Reduce Medical Errors. Toussaint is CEO of the ThedaCare Center for Healthcare Value, a partner in the Healthcare Value Leaders.  The link below is a PDF file of the article. More »
Fixing Healthcare from the Inside, Today
By: Spear, Steven J. | August 16, 2009
In this oft-cited Harvard Business Review piece, Dr. Steven J. Spear presents a framework for hospital improvement, called the 'Rules in Use.  'Work is designed as a series of ongoing experiments that immediately reveal problems.  Problems are addressed immediately through rapid experimentation.  Solutions are disseminated adaptively through collaborative experimentation.  People at all levels of the organization are taught to become experimentalists Spear makes the case that hospitals must move beyond a culture of ambiguity and workarounds. More »
Value-Stream Maps (2) Show All »
Value-Stream Map Zones (from Perfecting Patient Journeys)
By: Lean Transformations Group | January 29, 2013
Developing a current-state map creates a common understanding of how things really work today in the value stream (not necessarily what the documentation says or some might believe) so that the stakeholders can work together to identify and address problems and make improvements. Remember, see together, learn together, act together.  All value-stream maps are laid out in a horizontal format. They capture major categories or zones of fact finding. We find it helpful to think about value-stream maps in terms of the following six zones: customer, supplier, processes, information flow, process data, and a timeline and summary.  Perfecting Patient Journeys, More »
Value-stream Mapping Icons for Excel
By: Lean Enterprise Institute | January 1, 2003
At the request of some of our readers we have posted the most commonly used mapping icons so that they can be downloaded for Excel spreadsheets. More »
Workshops (53) Show All »
3D Problem-Solving with Legos
Throughout the day, you will be guided deeper and deeper into understanding what is at the core of some of the struggles we commonly face to implement lean principles. More »
5S - Visual Workplace
5S methodology helps organizations achieve more consistent operational results through maintaining an orderly workplace. This workshop will introduce you to the 5S methodology and help you learn basic implementation steps including evaluation and audit. More »
Articles (219) Show All »
Leadership Q&A: Lisa Yerian, MD, Medical Director of Continuous Improvement, Cleveland Clinic Foundation
By: David Drickhamer | May 28, 2015
From the LEI senior executive series on lean leadership: Lisa Yerian, MD, director of Hepatobiliary Pathology and medical director of continuous improvement, Division of Clinical Transformation, Cleveland Clinic, discusses how to engaging staff, doctors and senior leaders, healthcare reform’s impact, where to start a lean transformation, and why she took on responsibility for continuous improvement. More »
Maximizing People Systems in a Lean Transformation
By: Bartholomew, Doug | January 22, 2015
Don't make the mistake of overlooking the important role of that human resources plays in a lean transformation. Learn how to align HR policies and practices with your effort to create a lean culture of continuous improvement. More »
Books (45) Show All »
Management on the Mend
By: John Toussaint | June 3, 2015
Five years after his debut book, On the Mend, showed how a large, cradle-to-grave health system revolutionized the way care is delivered, Dr. John Toussaint returns with news for healthcare leaders. There is a clear framework for success for such a transformation. And senior leaders need to be far more intimately involved.  While studying and assisting hundreds of organizations transitioning to lean healthcare, Dr. Toussaint witnessed many flaws and triumphs. Those organizations that win – creating better value for patients while removing waste in the system – have senior managers that lead by example at the frontline of care. The best More »
Management On the Mend / On the Mend 2-book Set
By: John Toussaint and Roger Gerard | June 3, 2015
On the MendIn On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry John Toussaint, MD, former CEO of ThedaCare, and Roger A. Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out:How lean techniques of value-stream-mapping and rapid improvement events cut the average “door-to-balloon” time for heart attack patients at two hospitals from 90 minutes to 37.  What ThedaCare leaders did to More »
Charts, Graphs and Diagrams (1) Show All »
Begin from Need
October 28, 2010
"Begin from need" is attributed Taiichi Ohno, a key developer of the Toyota Production System. It means, as shown on these charts, what does the customer (the organization, the worker, the gemba) need right now? It's  another way of articulating the principle of PDCA, plan-do-check-act.    It helps us begin problem solving by grasping the situation, and avoid jumping to conclusions. More »
eLetters (208) Show All »
What the heck is a dojo?
By: Ballé, Michael | July 27, 2015
Columns; eLetters
Dear Gemba Coach,  What is a “dojo”? I hear about it but don’t find it referenced in the lean tools. Is it important? More »
Am I doing lean right? How can I tell?
By: Ballé, Michael | July 20, 2015
Columns; eLetters
Dear Gemba Coach,I’m spending a lot of time at the gemba, but how do I know if I’m doing good lean? More »
Forms and Templates (15) Show All »
Problem Definition Worksheet
By: Lean Transformations Group | June 17, 2013
In order to continuously improve, you must be able to find problems in order to solve them.  Once you have found a problem, the first step you must take is to make sure you have properly defined the problem.  One way to look at problems (i.  e.  , gaps) is to think in terms of standards. A gap can exist between current performance and an established standard or a new standard that you are attempting to achieve. A problem also can be unwanted variation in performance even when average performance appears acceptable. When even a single out-of-specification event is a More »
Root Cause Template
By: Shook, John and David Verble | June 13, 2013
When trying to solve a problem, you want to identify underlying causes, which will help you to prevent fires rather than just extinguish them. By identifying the underlying causes down to the root causes, you can reduce the likelihood that a given problem will recur.  The most common root-cause analysis technique in lean is the "Five Why's.  " This is practice of asking why repeatedly whenever a problem is encountered in order to get beyond the obvious symptoms to discover the root cause.  For instance, Taiichi Ohno gives this example about a machine that stopped working (Ohno 1988, p. 17):Why did More »
Presentations (11) Show All »
WE ARE ALL APPRENTICES
By: By Destin Sandlin | May 2, 2015
Don't assume that your narrative is reality. Practice the Improvement Kata pattern to learn scientific thinking! Destin Sandlin of Smarter Every Day taught himself to ride a backward-steering bicycle. It took months of practice. Then he tried to go back to riding a normal bicycle.  .. More »
KATA CASE EXAMPLE - GKN SINTER METALS
By: By Wayne Meyer | July 1, 2014
This month's video is a case example of deploying the Improvement Kata & Coaching Kata. Wayne Meyer illustrates GKN's application, explains how to get an organization to change and provides highly-useful lessons learned. Be sure to watch the final Q&A portion of the video for extra insights. More »
Software (1)
eVSM v8 - Electronic Value-Stream Mapping
March 10, 2014
Accessories; Software; Value-Stream Maps
Walking the shop or office floor with a paper and pencil to collect data and observe actual conditions is how value-stream mapping (VSM) is done. But for a long time, members of the Lean Community have been sharing these hand-drawn maps by creating their own electronic templates from scratch in various software programs. eVSM makes the process of turning hand-drawn maps into electronic ones easier and faster.  As a companion – not a substitute – to paper-and-pencil mapping, the software allows lean practitioners to easily create, modify, and disseminate electronic value-stream maps. More »
Videos and Webinars (29) Show All »
Webinar: How to Lead With Respect
September 9, 2014
How to Lead With Respect webinar featuring Michael Ballé More »
Webinar: The Two Basic Forms of Coaching for Lean
May 22, 2014
The Two Basic Forms of Coaching for Lean with David Verble More »