Lean Supports Healthcare Service and Leadership
Feb02

Lean Supports Healthcare Service and Leadership

It is paradoxical that despite all of the opportunities for professional satisfaction in healthcare,  one of the issues of greatest concern that challenges the Triple Aim is the emotional health and happiness of healthcare professionals. Healthcare is populated by very competent and caring people who chose their profession because of their desire to contribute to better care. Many of those same people are becoming disillusioned, angry...

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In Defense of Lean
Jan27

In Defense of Lean

Rarely do you see a clinician, researcher, teacher, philosopher, ethicist and writer all bundled up in one person inside one white coat. Jerome Groopman has been such a person. Dr. Groopman and his wife Dr. Pamela Hartzband, an endocrinologist, are one of healthcare’s power couples. Together they are providing the world access to their insights and to their biases in popular books like How Doctors Think and Your Medical Mind: How to...

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D. F. Wallace, Burnout, and Healthcare
Aug26

D. F. Wallace, Burnout, and Healthcare

What does David Foster Wallace have to tell us about burnout? More than most healthcare professionals might think. The publicity for The End of the Tour, a new film starring Jason Segel as Wallace, has reminded me of the message I took away from the first Wallace book I ever read, This Is Water: Some Thoughts, Delivered on a Significant Occasion, about Living a Compassionate Life (2009). Before 2009 I had missed out on David Foster...

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Community Engagement and Prevention
Jul27

Community Engagement and Prevention

We all agree on the  need for “physician engagement.” I rarely attend a meeting of physicians where someone doesn’t say that the problem with healthcare is that patients are passive, non-compliant and demanding and that a more effective form of “patient engagement” is necessary. Those wails usually sound like an excuse to me for the poor quality and high cost of care that is perpetuated by our collective behavior, but I do agree that...

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Everyone Gains from Lean
Jun05

Everyone Gains from Lean

Everyone, whether they are senior management, middle management, line management or the hands-on employee has much to gain from Lean. Lean can buffer the impact of chronic issues of emotional fatigue and performance pressure. It also helps with the stress of accountability in the face of difficult external and internal factors and and unrealized personal aspirations. Lean can combat the cynicism that arises from the pettiness of...

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Lean Can Address Burnout?
Mar10

Lean Can Address Burnout?

Why is it that the discussion of Lean so rarely becomes a discussion of how Lean can address the issues of burnout while reducing waste and improving value for patients? If Lean were presented with a more robust description and elucidation of its mechanisms that enhance the experience of everyone in the enterprise as a counter to the burnout that is so prevalent in healthcare, could it be possible that more executives and boards would...

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Lean: Look Back, Look Forward
Jan21

Lean: Look Back, Look Forward

This time of the year is terrific for what we call “Hansei” or deep reflection in Lean. One of my greatest sources of continuing satisfaction for 2014 was my work with others to spread Lean thinking. Most of my work with Lean was done with Simpler, in concert with Dr. Patty Gabow, the retired CEO of Denver Health. As Senior Advisors to Simpler, Dr. Gabow and I meet regularly with the Simpler leadership that also includes two other...

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Lean Leadership for ACOs
Jan10

Lean Leadership for ACOs

Last week I traveled from my new home in New London, New Hampshire to Farmington, Connecticut to participate in a leadership conference for a large physician group there. This group, like many physician groups across the country, is making that transition from the current reality of their total dependence on fee-for-service income to a future where they expect to be paid for quality and value. They know that to be successful in the...

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