Lean Blog by Mark Graban

Peter Pronovost on Leading with Love: What the Checklist Needed All Along

Mark Graban — Mon, 12 Oct 2026 08:19:00 +0000

I recently recorded an upcoming episode of the Lean Blog Interviews podcast with Dr. Peter Pronovost, the Chief Quality and Clinical Transformation Officer at University Hospitals (UH) in Cleveland. Most people know him because of the ICU checklist that cut central line infections at Johns Hopkins and then across Michigan. While we were preparing, he pointed me to an article he wrote for Innovations, an MIT Press journal: “Living and Leading with Love: Transforming Healthcare […]

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Fear-Based Leadership Worked at Volkswagen. Until It Didn’t.

Mark Graban — Tue, 06 Oct 2026 23:03:00 +0000

In July 2013, on a test drive in the United States, Martin Winterkorn, the CEO of Volkswagen, noticed a paint imperfection on a Beetle. The paint was slightly thicker than the company standard. Less than a millimeter too thick, according to a VW source who spoke to Reuters. A difference you would not be able to see without a gauge. He stopped and lectured his engineers about the waste. This was 2013. Winterkorn was one […]

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A Lean Management System That Doesn’t Depend on the Lean Team — Emily Swaney, OhioHealth

Mark Graban — Wed, 30 Sep 2026 08:43:00 +0000

Emily Swaney, VP of Operational Excellence at OhioHealth, explains how a Lean Promotion Office of 11 people supports a Lean management system for 35,000 associates. The approach relies on developing leaders as problem-solving coaches and on connecting daily huddles and frontline KPIs to what the organization measures. Scroll down for how to subscribe, transcript, and more My guest for Episode #548 of the Lean Blog Interviews Podcast is Emily Swaney, Vice President of Operational Excellence […]

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Assembly-Line Nursing Was Meant to Be Temporary

Mark Graban — Tue, 29 Sep 2026 09:52:00 +0000

There's a nursing model where one nurse passes medications to every patient on the unit and does nothing else. Another nurse does treatments. An aide does baths and vital signs. Nobody is responsible for a patient. Everybody is responsible for a task. Nursing textbooks call it assembly line nursing. The formal name is functional nursing. But the assembly-line description is not something critics invented. In their 2004 review of nursing care delivery models, Tiedeman and […]

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The Toyota Andon System in South Africa: Two Buttons Instead of a Cord

Mark Graban — Sun, 27 Sep 2026 18:43:44 +0000

When the door from the office area opened onto the production floor at Toyota's plant in Durban, South Africa, I heard a familiar sound from other Toyota plants I've visited: the andon music. Earlier this month, before speaking at the KZN Lean Conference, I spent time at the plant learning how the Toyota andon system works there, and how it has changed. About a year ago, they replaced the overhead cords with buttons. ALSO: Scroll […]

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Ryan McCormack’s Operational Excellence Mixtape: September 25, 2026

Ryan McCormack — Fri, 25 Sep 2026 16:24:09 +0000

Thanks, as always, to Ryan McCormack for this. He always shares so much good reading, listening, and viewing here! Subscribe to get these directly from Ryan via email. News, articles, books, podcasts, and videos about how to make the workplace better. Today's mixtape looks at leading through constant change, including an HBR piece arguing that transformation works better when leaders adjust the destination as conditions change instead of sticking to a fixed plan. He also […]

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A British Hospital Missed a Killer for Two Years. The Recommendations Are Mostly Hardware.

Mark Graban — Tue, 15 Sep 2026 18:22:35 +0000

I'm traveling internationally for ten days and I turned on one of the British news channels. There's a major story about NHS England. First, the awful reality that a nurse would willfully kill babies in the NICU. Then, the second (and more believable) reality that bad management systems (and poor leadership) made the situation worse. So what happened? On July 11th, 2016, the Countess of Chester Hospital put deaths on its neonatal unit onto a […]

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What The Rehearsal Gets Wrong About Pilots–and Right About Leadership Training

Mark Graban — Mon, 14 Sep 2026 08:53:00 +0000

Season 2 of The Rehearsal opens in a cockpit. Two pilots are on final approach. The first officer thinks they're lined up wrong and says so, mildly. The captain brushes it off. The first officer tries again, a little more nervous this time, and the captain keeps descending. Then the alarms, a go-around attempted too late, and fire filling the screen. The camera pans left and Nathan Fielder is standing there on the set, looking […]

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