The blog post

In this audio edition of the Lean Blog, Mark Graban revisits a 2014 case study co-authored with Gregory Clancy about Allina Health’s early Kaizen journey. What began as four pilot units became a model for engaging everyone in improvement—from nurses to leaders. Mark reflects on concrete examples that still resonate today: reducing wasted motion, improving safety, and building psychological safety so staff feel safe to speak up with ideas.

Ten years later, the lessons endure: small ideas create big impact, leaders must coach not control, and improvement thrives only where people feel respected and safe to experiment.

Learn how Allina’s story connects to enduring principles from Healthcare Kaizen and The Executive Guide to Healthcare Kaizen, and how psychological safety remains the foundation for continuous improvement in healthcare today.

The blog post

In this episode of Lean Blog Audio, Mark Graban reads and expands on his article, Leader Standard Work Is About Behavior, Not Just Your Calendar.

Too many organizations treat “Leader Standard Work” (LSW) as a scheduling exercise—a calendar full of gemba walks, huddles, and recurring meetings. But true Lean leadership isn’t about where you go or how often you show up—it’s about how you show up.

Mark explores the deeper intent behind LSW: to make leadership behavior intentional, consistent, and aligned with the principles of respect for people and continuous improvement. He contrasts superficial routines with authentic engagement, drawing on a real complaint from a hospital employee who saw a painful disconnect between a CEO’s Lean rhetoric and their daily behavior.

The episode also introduces Mark’s Behavior-Based Leader Standard Work Checklist—ten daily reflection questions to help leaders practice curiosity, humility, and genuine respect, from “Did I listen without interrupting?” to “Did I follow up on yesterday’s concern?”

Whether you’re a frontline supervisor or a CEO, this reflection-driven view of LSW will challenge you to think less about your calendar and more about your conduct.

Lean leadership isn’t a set of appointments—it’s a set of habits.

Listen now and consider: what does your behavior say about the kind of culture you’re building?

The blog post

In this episode of Lean Blog Audio, Mark Graban reads and reflects on his recent article, From Know-It-All to Learn-It-All: Leadership Lessons from Mistakes.

Drawing from themes in his Shingo Award–winning book The Mistakes That Make Us and interviews with leaders Phillip Cantrell and Damon Lembi on My Favorite Mistake, Mark explores the transformative shift from being a leader who must always be right to one who is willing to learn.

You’ll hear stories of humility in action—from Cantrell’s reinvention of Benchmark Realty after the housing collapse to Lembi’s recovery from near-bankruptcy during the dot-com bust. Both leaders learned that progress doesn’t come from certainty, but from curiosity, reflection, and the courage to say, “I might be wrong.”

Mark also connects these lessons to healthcare leader Dr. John Toussaint’s evolution from “all-knowing” executive to facilitator and coach—showing how psychological safety, experimentation, and evidence-based learning drive true continuous improvement.

If you’ve ever felt pressure to have all the answers, this episode is a reminder that the best leaders aren’t know-it-alls—they’re learn-it-alls.

Listen, reflect, and consider: how might humility strengthen your own leadership practice?

The blog post

In this episode, Mark Graban shares a small but revealing story from a local post office — and what it teaches us about bad metrics and broken systems. When a clerk tapped the “green smiley face” on a customer feedback device for the customer, it raised an important question: was this about genuine service, or just gaming the system?

Mark explains why the issue isn’t the clerk, but the system around him — a system that encourages scoring over substance, compliance over improvement. Drawing on Lean thinking and Deming’s philosophy, he explores how poorly designed metrics push people to protect themselves instead of serving customers.

You’ll hear why:

• Metrics without context mislead more than they inform

• People naturally adapt to meet incentives, even if it means gaming the numbers

• Most performance is a function of the system, not individual effort

If you’ve ever wondered why “customer satisfaction scores” or other simplistic measures don’t always match reality, this episode will resonate. Leaders everywhere — in healthcare, government, and business — need to ask not “why did they do that?” but “what about the system made that behavior the best option?”

Because when we fix the system, we don’t need people to game it.

The blog post

In this episode, Mark Graban shares a powerful story from an operating room that highlights the importance of culture, leadership, and psychological safety in healthcare. A nurse noticed a small break in sterility, spoke up, and apologized. The surgeon’s response? “Don’t be sorry, you’re being safe.”

That short exchange changed the tone of the entire room. Instead of discouraging or shaming, the surgeon encouraged and reinforced the nurse’s action — preserving not only sterility, but also trust.

Mark unpacks why moments like this matter so much, how leaders’ real-time reactions shape culture, and why “you’re being safe” should be the norm in every hospital. He connects the story to key themes from The Mistakes That Make Us and Lean Hospitals, emphasizing that safety and respect for people aren’t abstract ideals — they’re daily practices that save lives and build better systems.

Whether you work in healthcare, manufacturing, or any high-stakes environment, this episode challenges you to reflect: How do you respond when someone speaks up? Do you reward their courage — or risk silencing it?

The blog post

Are 95% of enterprise AI pilots really “failing”? And how does that compare to the long-repeated claim that 70% of Lean initiatives fail? In this episode of Lean Blog Audio, Mark Graban examines what’s really behind these numbers. He explains why many so-called “failures” stem not from flawed tools or technologies, but from leadership gaps, unrealistic goals, and a lack of psychological safety.

Drawing lessons from Lean practice and his book The Mistakes That Make Us, Mark highlights the importance of experimentation, learning from setbacks, and creating an environment where people feel safe to try, adjust, and improve. Whether you’re implementing AI, Lean, or any transformation, the key is shifting from fear of failure to a culture of continuous learning.

In this episode, Mark revisits a 2007 conversation with James P. (Jim) Womack, founder of the Lean Enterprise Institute and co-author of The Machine That Changed the World. Nearly two decades later, Jim’s reflections on the origins of the word “Lean” remain just as relevant.

The blog post

The discussion takes us back to MIT in 1987, when Womack and his colleagues were analyzing data from auto plants around the world. Toyota and Honda were clearly operating in a fundamentally different way—faster design cycles, fewer errors, less capital, less space, and more value. But they needed a name for this system. That’s when researcher John Krafcik suggested a term that captured the essence of “less”: Lean.

Womack reflects on how the word solved one problem—it shifted attention away from “Japanese manufacturing” or “the Toyota Production System” to something more universal. But the name also created challenges: because Lean rhymes with “mean,” too many managers misused it as shorthand for cutting jobs rather than creating more value while respecting people.

Mark reads Womack’s timeless warnings and lessons: Lean was never about headcount reduction; it was always about eliminating waste, improving flow, and engaging people in problem-solving. And while the term has traveled in many directions since that 1987 “naming moment,” its underlying principles—value for customers, respect for people, and continuous improvement—remain as important in 2025 as ever.

Listen in to hear Jim’s words from that original 2007 interview, plus Mark’s reflections on why this conversation still matters today.

Episode page

In this episode, I share a reading of my recent blog post, based on a Catalysis webinar where I explored what we can learn from Lean in Japan. Since 2012, I’ve been fortunate to travel to Japan six times with study groups, including those led by the Kaizen Institute, Honsha, and Katie Anderson. Each trip has reinforced the paradox that Lean is both easier and harder in Japan—and that the deepest lessons are not about tools, but about mindsets, culture, and leadership.

What You’ll Learn in This Episode

• Why Lean in Japan isn’t about “being Japanese,” but about cultivating long-term thinking and respect for people.

• How Ina Food practices “tree-ring management” and why profit is seen as a byproduct, not the goal.

• How Toyota reinforces its role as a “people development company” through problem-solving and Kaizen.

• The double-edged role of Japanese culture: precision and standardization on one hand, but reluctance to speak up on the other.

• How mechanisms like the andon cord create safer ways to surface problems.

• What Japanese hospitals are learning from American health systems—and vice versa.

• Why Kaizen isn’t about cost savings alone, but about making work easier and building capability.

• Memorable lessons from leaders like Dr. Shuhei Iida of Nerima General Hospital: “If you keep doing Kaizen, you will get innovation.”

Key Quotes from the Episode

• “Profit is like excrement produced by a healthy body. Nobody’s goal is to wake up and produce excrement — it’s just the natural result of living and doing things well.” — Chairman of Ina Food

• “The role of the leader is to set the vision — that cannot be delegated.” — Japanese executive

• “If you keep doing Kaizen, you will get innovation.” — Dr. Shuhei Iida, Nerima General Hospital

Why It Matters
Lean is not a set of tools to copy, but a system of beliefs and practices rooted in respect, learning, and long-term thinking. Speaking up about problems isn’t easy—whether in Japan or elsewhere—which is why leaders must create psychological safety and model improvement themselves.

Resources & Links

• Catalysis webinar recording (available soon)

• Learn more about upcoming Lean Healthcare Accelerator Experience in Japan

Work With Me
If you’re a leader aiming for lasting cultural change—not just more projects—I help organizations:

• Engage people at all levels in sustainable improvement

• Shift from fear of mistakes to learning from them

• Apply Lean thinking in practical, people-centered ways

📩 Let’s talk: mark@leanblog.org