Thanks for sharing your thoughts on this. I guess this makes you our "cult leader," John.

I was disappointed to hear the "cult" comments from Saskatchewan (the people saying that don't know the real definition of a cult).

But they have a point that overdoing the Japanese terms can be offputting to some and that can get in the way of learning and improvement, which is unfortunate. We can demystify things by using English words where we can (waste instead of "muda," for example). Coach instead of "sensei."

I wrote about this in 2010, the overuse of the term sensei, for one:

http://www.leanblog.org/2010/01/10-lean-things-to-not-say-2010/

It's lazy to cite Wikipedia, but here's what it says about the term "sensei" not always being a positive in Japan:

“Sometimes enthusiastic supporters and admirers use it fawningly, as when addressing or talking about charismatic business, political, and spiritual leaders. Japanese speakers are particularly sensitive to this usage when it concerns members of an in-group who spontaneously associate or identify sensei with a particular person – many if not most Japanese speakers readily see this usage as indicative of adherents speaking of a charismatic spiritual or cult leader. When talking about such situations, Japanese speakers will sometimes use the term sarcastically to ridicule overblown adulation…”

Would you agree with that John, based on your knowledge of Japan?

When there's such a big push for "we have to implement Lean," that's not nearly engaging as having a push for solving the problems that matter (as John points out so well in the Lean Transformation Model video). There I go, praising our cult leader. Sorry.

I'm sure there is really high alignment in Saskatchewan about the need to improve quality and patient safety, reducing waiting times, reduce cost, and create a better work environment for nurses, etc.

These aren't just Sask. problems, they are global problems. I hope the focus would be on providing the best patient care possible. 

But, "it's gotten political" as somebody from Sask. complained to me about. Of course it's political... it's government healthcare that reports up through politicians. 

Being surprised about it being political is like being surprised that a rooster crows when the sun comes up. That's just what they do.

Check out our government's lean efforts here:

http://thinklean.gov.sk.ca/

It's perhaps an unfair comparison with a health system of 35,000+ (40,000?) employees, but one of the things I love about the story of Sami Bahri, DDS is that he never used a consultant (although he did get help from his patients who were part of the local lean community). He didn't have a book on "Lean Dentistry" to read.

He read the core source Toyota books and Deming books and he worked, experientially and experimentally, with his staff to figure out what problems to solve and how lean applies to them.

Again, I don't know if it's fair to assume that approach would scale, but I think elements of it can be emulated.

Dr. Bahri has been dubbed "the Lean Dentist" but I don't think his goal was to "get Lean" or "implemement Lean" or "Lean out his practice."

I was pleased to see government as John's Lean Post topic.
At City Of Melbourne we have worked hard over the past five years to make Lean Thinking 'the way we work around here'. Hundreds of processes have been improved for external and internal customers. We can inspect more restaurants with the same staff, get permits to buskers faster so they can perform on our streets,assess and review more aged care clients, deliver care to more children within our child care centres and recruit staff faster and more cheaply. We feel like we have just scratched the surfface of what needs to be done. 

But lean thinking has deliverred so much more to the organisation and the 1300+ people who within it. 

Across 30 discrete businesses it has helped us see things horizontally for the first time and challeneged so many long held traditions and assumpitions about the way we work. It has broken down silos and really helped us work collboratively as one  organisation. Across those silos it has given us a common language, and brought together people from all over the business from all levels to learn and improve together. It has gioven us many reasons to celebrate our efforts. 

It has challenged us on purpose; what do we make, for whom and is what we are doing really making a difference to the community?

Like my previous experience in healthcare we constantly learn  the extraordinary benefits of making our processes and work visible (thanks Dan Jones for that lesson many years ago). 

I am priveledged to bo supporting a lean transformation that is led from the top and is totally dfocussed on making things better, faster, and easier for our customersand staff and financially sustainable for the organisation. 

We still have a lot to learn, and we learn every day by doing, with so much more doing required,our learning will be rich.  in the words of Jim Womack "every day is hard, but life is good". 

John Shook - for you to be unaware of Lean Government efforts, when LEI even has a government Lean forum with 60 topics, is suprising.

Tennessee is in regular conversation with more than a dozen other state governments at various stages of statewide LEAN initiatives, including the State of Washington. The Maine LEAN Summit pulls together many of these people from the New England area, and you can find some great results on the Minnesota, Iowa, Colorado, and Ohio state government websites, to mention a few of the more notable efforts.

Some years ago Ken Miller wrote a thoughtful piece for Government Magazine: "Lean Government's Promise of Going Lean" (http://www.governing.com/blogs/public-great/lean-government.html). More recently,  Harry Kenworthy pulled together a nice document (see http://www.leangovcenter.com) for Government Finance Review on getting started with LEAN Projetcs. EPA at the federal level has a treasure trove of resources, see for example: The Lean Government Methods Guide (http://www.epa.gov/lean/government/pdf/lean-methods-guide.pdf).

In short, Lean efforts in government are well respected in many parts of our country, We are learning from each other, and we are making a difference. We invite you to Nashville to come see!

Thanks, Emily. I didn't mean to imply that I know nothing of what's going on in this realm. I've heard of many of the initiatives you mention. But, I have UNFORTUNATLEY never been to Saskatchewan so only know what I've read or heard. And, overall, I do think it's still early days for most of this stuff. However, that doesn't mean it's not exciting and full of promise. I just resturned from a visit to the City of Melbourne where I was blown away by what I saw: a deeply engaged CEO of the City along with her staff of directors, and teams of individuals in a diverse set of city servives engaged in breaking messy problems down by making them visual and attacking them at root cause and system levels. Impressive, indeed. You can read about it at Planet-lean.com (http://www.planet-lean.com/index.php/case-studies/530-making-a-city-great).

And I will take you up on your offer to check out what's going on in Nashville. Hope to be there in July. Send me an email at jshook@lean.org. - John