Lean Blog by Mark Graban

What If Every Hospital Learned From Every Other Hospital’s Safety Incidents?

Mark Graban — Fri, 14 Aug 2026 19:31:15 +0000

On Thursday, I wrote about the death of Donald Gough at the University Hospital of Wales in Cardiff. He received insulin during liver surgery even though he was not diabetic and had no clinical reason to be given it. That post was about one hospital. This one is about learning from patient safety incidents everywhere else. The hospital made changes after the inquest. Insulin is no longer kept in the fridges in the anesthetists' room. […]

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An Insulin Error Killed a Hospital Patient. How Does Every Other Hospital Learn From It?

Mark Graban — Thu, 13 Aug 2026 08:37:00 +0000

A man named Donald Gough died in a Cardiff hospital in November 2022, four weeks after an insulin error during surgery. He was 77, a retired NHS radiographer who had spent more than 50 years working in the same health system that was now caring for him. He had bowel cancer that had spread to his liver, and he agreed to surgery to remove the secondary tumors. He was told the operation carried a risk […]

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Toyota Copied Ford’s Suggestion System–and Got Far Better Results

Mark Graban — Wed, 12 Aug 2026 08:19:00 +0000

I've been reading The Birth of Lean, a collection of talks and interviews with the people who helped build the Toyota Production System. One passage stood out because it explains something I had never seen described this clearly: Toyota copied its employee suggestion system directly from Ford. That might be surprising to those who think everything associated with Lean originated inside Toyota. It didn't. Toyota learned from many sources, including Ford. The history also has […]

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“Most People Wouldn’t”: Fear, Gratitude, and Reporting Medical Errors

Mark Graban — Tue, 11 Aug 2026 08:15:00 +0000

Somebody on the r/nursing subreddit asked what the worst medication error was that people had seen or heard about. Almost six hundred replies came in. I've read the whole thing, and there are a few ideas I want to come back to. This is the first. A word on the material before I use it. These are anonymous accounts. I can't verify any of them; some are secondhand, and none come with an investigation attached. […]

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GE Aerospace’s Greenville Plant Proves Larry Culp’s “Safety First” Wasn’t Just Talk

Mark Graban — Mon, 10 Aug 2026 08:27:00 +0000

Three years ago, I wrote about GE CEO Larry Culp's habit of beginning every investor meeting with a safety briefing and his insistence that the company's priorities should be safety, quality, and delivery–before cost. See “GE's CEO Larry Culp on SQDC and Putting Safety First.“ At the time, the story was mostly about tone from the top: how a CEO talks, what he chooses to emphasize in front of Wall Street analysts, and the order […]

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Ryan McCormack’s Operational Excellence Mixtape: August 7, 2026

Ryan McCormack — Fri, 07 Aug 2026 13:04:52 +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. This edition covers AI and improvement work: rethinking fishbone diagrams and SPC, five reasons organizations aren't ready for agentic AI, and a former lululemon CIO on the messy reality of adoption. The culture section […]

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Thirty Years Later, “Keep the Line Running” Is Still the Message

Mark Graban — Thu, 06 Aug 2026 08:51:00 +0000

When I was a young engineer at GM's Livonia Engine Plant in the mid-1990s, I wrote down some of the things production workers said to me. One of them stuck, a worker in a machining department: “I want to stop the line to do my quality checks, but management says to keep the line running.” I've told that story in a few places since, including in Practicing Lean. I always thought of it as a […]

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Highlights From Five Conversations With Karen Martin

Mark Graban — Wed, 05 Aug 2026 08:12:00 +0000

Karen Martin has been on my Lean podcast five times over 12 years, talking through clarity, value stream mapping, whether Lean is dead, and mistake-proofing. For the 20th anniversary series, here are some of the moments from those conversations that stand out. My friend and colleague Karen Martin has been on the podcast five times. First, in 2012, talking about The Outstanding Organization. Most recently, in 2024, talking about mistake proofing. In between: value stream […]

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