Lean Blog by Mark Graban

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 […]

The post A Lean Management System That Doesn’t Depend on the Lean Team — Emily Swaney, OhioHealth by Mark Graban appeared first at Lean Blog by Mark Graban.

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 […]

The post Assembly-Line Nursing Was Meant to Be Temporary by Mark Graban appeared first at Lean Blog by Mark Graban.

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 […]

The post The Toyota Andon System in South Africa: Two Buttons Instead of a Cord by Mark Graban appeared first at Lean Blog by Mark Graban.

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 […]

The post Ryan McCormack’s Operational Excellence Mixtape: September 25, 2026 by Ryan McCormack appeared first at Lean Blog by Mark Graban.

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 […]

The post A British Hospital Missed a Killer for Two Years. The Recommendations Are Mostly Hardware. by Mark Graban appeared first at Lean Blog by Mark Graban.

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 […]

The post What The Rehearsal Gets Wrong About Pilots–and Right About Leadership Training by Mark Graban appeared first at Lean Blog by Mark Graban.

Training as a Countermeasure? The “Fix” You Can Finish by Friday.

Mark Graban — Thu, 10 Sep 2026 08:33:00 +0000

In 2006, regulators cited a hospital in Madison, Wisconsin for six violations of state and federal rules after a patient died — three federal, three state. They threatened its license and its Medicare contract. The hospital updated its policies and re-educated its nurses, and the citations were withdrawn. Training as a countermeasure “worked,” in the only sense anyone measured. Think about what you'd have to believe for that to be the right remedy. You'd have […]

The post Training as a Countermeasure? The “Fix” You Can Finish by Friday. by Mark Graban appeared first at Lean Blog by Mark Graban.

What 21,050 Clinicians Told Us About Fear and Futility

Mark Graban — Wed, 09 Sep 2026 08:16:00 +0000

Hospitals have Quiet Rooms now. There's soft lighting. There's a chair. There's a noise machine, which is a machine that makes calming noises. There's sometimes a succulent in a small white pot. The succulent is doing fine, which makes sense, because the succulent doesn't have a patient assignment. The nurse, on the other hand, hasn't had water since her shift started. She can't tell you the last time she used the bathroom. The hospital has […]

The post What 21,050 Clinicians Told Us About Fear and Futility by Mark Graban appeared first at Lean Blog by Mark Graban.