As presented in San Antonio

1. Mark Graban
@MarkGraban
www.PracticingLean.com
www.LeanBlog.org
Slides & More:
www.MarkGraban.com/LFMay16
Reflections on 20 Years
Trying to Get Better at Lean
in Manufacturing & Healthcare

2. Practicing Medicine

3. Practicing Law

4. Practicing Lean?
© Nicole Yearly (“chicagozen“ on Flickr), used under Creative Commons License

5. Implementing

6. Practicing

8. Learning

9. Learning
By
Doing

10. Learning
By
Doing*
*With a Qualified Coach

11. “I’m Jim Pell.
I’ve been
learning Lean
for 25 years.”

12. Learning
Through
Mistakes

13. We All
MAke
Mistaks

14. Your
Going to
Make
Mistakes

16. One of
My
Mistakes
(2004)

17. “My” Kanban System
When inventory reaches 2160,
take care to Level 4
Meterbody kanban board.
Qty to build: 660 units
Actual Build Qty:

19. Or…

20. ean
s
isguidedly
xecuted

21. Or…
Just not good
at this yet?

22. Their Kanban System

23. We All Start
Somewhere

24. ean
s
istakenly
xplained

25. “Toyota would tell you
to kick the patient out
of the room at 19:59
because you have to
keep on takt time.”

26. We All Start
Somewhere

27. “Which
Lean Tool
Should I
Start With?”

28. Start from need.

29. What problem are
we trying to solve?

30. “Which
Lean Tool
Should I
Start With?”

31. “Always start
with 5S”

32. “Always start
with 5S?”

33. We’ve
Always
Done it
That Way

34. We’ve
Always
Done it
That Way??

35. Toyota
Production
System

36. Thinking
Production
System

37. Learn, But Don’t Copy

38. ean
s
isguidedly
xecuted

39. Mistakes
in
Manufacturing
(1995)

41. Right Tool, Wrong Culture
7 am
8 am
9 am
10 am
11 am
12 am
1 pm
2 pm
92
92
92
92
92
92
92
92
BLOCKS • Plan
• Actual
• Reasons why

42. Right Tool, Wrong Culture

43. Right Tool, Wrong Culture
7 am
8 am
9 am
10 am
11 am
12 am
1 pm
2 pm
92
92
92
92
92
92
92
92
BLOCKS
60
60
60
60
45
60
14
30

44. My GM Mistakes
• Gemba observation
• Ergonomic assist
• Kanban tooling board
• Quality or cost?

46. 1996 Current State at GM
• Worst performing engine plant
• Worst performing part of GM Powertrain
• Worst performing part of GM N.A.
• Worst performing part of GM
• Worst performing automaker

49. Mistakes
in
Service
Settings
(2005-)

55. "We were offering suggestions
and getting pushback on safe
staffing, yet being told to reduce
the number of pens and pencils.”

56. ean
s
istakenly
xplained

57. “Go ahead and use Lean on
that quality problem…
you’ll speed up your quality problem
and make bad stuff faster.”

61. “Lean will help you to reduce or
eliminate [wastes] 1 through 6.
Six Sigma will help you to
reduce number 7 [defects].”

62. Jidoka Just-in-Time

63. Or…

68. Questions for Reflection
• Is this helpful?
• Is this kind?

70. Or…

71. Lack
of
Sustainment?

72. “We were only holding
the gains on about
40 percent
of those
[Kaizen Events]”

73. Why?

74. Lack
of
Adoption?

77. “We’ve been
implementing Lean
for 5 years…
now we’re focusing
on continuous
improvement.”

79. The
Power
of
Kaizen

80. The
Power
of Frontline
Staff

81. Franciscan St. Francis Health

82. Franciscan St. Francis Health
• ~27,000 improvements since 2007
• 33-40% staff participation each year
• Millions in hard cost savings
• And better patient & staff safety, quality,
patient satisfaction, waiting times

83. Why
Lean?

86. Why
Lean?

89. My Hypotheses:
• Reflecting and sharing mistakes and
lessons learned will encourage others
to have a “growth mindset”
• We’ll get better at getting better, which
helps others get better… better

91. www.louisebatz.org

92. Q&A / Contact Info
• www.MarkGraban.com
• www.LeanBlog.org
• mark@markgraban.com
• Slides& More:
www.MarkGraban.com/LFMay2016
www.PracticingLean.com