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Lean Blog Interviews: Real-World Lean Leadership Conversations in Healthcare and Beyond

Mark Graban Podcasts
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Lean Blog Interviews: Real-World Lean Leadership Conversations features thoughtful, in-depth discussions with leaders, authors, executives, and practitioners who are applying Lean thinking in the real world. Hosted by Mark Graban—author of Lean Hospitals, Measures of Success, and The Mistakes That Make Us—the podcast explores Lean as a management system, a leadership philosophy, and a people-centered approach to continuous improvement. Episodes span healthcare, manufacturing, startups, technology, and professional services. Guests share candid stories about what actually works—and what doesn’t—when organizations try to improve. This is not a podcast about chasing tools, jargon, or “Lean theater.” Instead, you’ll hear honest conversations about leadership behaviors, culture, psychological safety, learning from mistakes, and building systems that help people do their best work. If you believe improvement starts with respect for people—and that better systems beat blaming individuals—this podcast is for you. Find show notes and all episodes at LeanCast.org. Learn more about Mark Graban at MarkGraban.com.

  1. Creating Value Without Command-and-Control — John Rizzo

    JAN 21

    Creating Value Without Command-and-Control — John Rizzo

    John Rizzo joins Mark Graban to discuss why sustainable improvement depends on empowering people — not command-and-control leadership or short-term value extraction. Links and more:  John is a senior executive, investor, and change leader who has led transformational improvement efforts across manufacturing, healthcare, retail, services, and nonprofit organizations. He is the author of Creating Value: Empowering People for Sustainable Success, a book that deliberately avoids Lean jargon while describing a holistic continuous improvement business system rooted in humility, listening, and people development. In this episode, John shares lessons from Wiremold, private equity–backed companies, and healthcare organizations, including the powerful “six-inch move” story that shows how small acts of listening can unlock trust and transformation. The conversation explores what real empowerment means (and what it does not), why leaders must shift from firefighting to developing problem solvers, and how organizations can create lasting value for employees, customers, and owners. This episode is especially relevant for CEOs, executives, managers, and internal change agents looking to improve results without burning out their people or relying on command-and-control leadership.

    53 min

  2. JAN 17 • SUBSCRIBERS ONLY

    $ Creating Value Without Command-and-Control — John Rizzo

    $ Early access and ad-free listening -- John Rizzo joins Mark Graban to discuss why sustainable improvement depends on empowering people — not command-and-control leadership or short-term value extraction. Links and more: John is a senior executive, investor, and change leader who has led transformational improvement efforts across manufacturing, healthcare, retail, services, and nonprofit organizations. He is the author of Creating Value: Empowering People for Sustainable Success, a book that deliberately avoids Lean jargon while describing a holistic continuous improvement business system rooted in humility, listening, and people development. In this episode, John shares lessons from Wiremold, private equity–backed companies, and healthcare organizations, including the powerful “six-inch move” story that shows how small acts of listening can unlock trust and transformation. The conversation explores what real empowerment means (and what it does not), why leaders must shift from firefighting to developing problem solvers, and how organizations can create lasting value for employees, customers, and owners. This episode is especially relevant for CEOs, executives, managers, and internal change agents looking to improve results without burning out their people or relying on command-and-control leadership.

    53 min

  3. JAN 7 • SUBSCRIBERS ONLY

    $ Why “More” Drives Better Operations: Kathy Miller on Meaning, Optimism, and Leadership

    Ad-free listening for subscribers What if operational excellence depends less on doing more with less—and more on how leaders create meaning, optimism, and relationships at work? In this episode, Mark Graban is joined by Kathy Miller, senior operations executive, leadership coach, and author of More Is Better: Leading Operations with Meaning, Optimism, and Relationships for Excellence. Drawing on decades of experience in manufacturing and aerospace, along with research from positive psychology, Kathy explains how leadership behavior directly shapes safety, quality, engagement, and performance. The conversation explores why “soft skills” are not soft at all, how leaders can practice realistic optimism without ignoring real problems, and how everyday interactions either build psychological safety or quietly undermine it. Kathy also shares practical insights for leading under pressure, balancing compassion with accountability, and helping people find meaning even in highly segmented operational work. This episode is especially relevant for leaders in manufacturing, healthcare, and operations who want sustainable results without burnout, fear, or disengagement.

    54 min
  4. Why “More” Drives Better Operations: Kathy Miller on Meaning, Optimism, and Leadership

    JAN 7

    Why “More” Drives Better Operations: Kathy Miller on Meaning, Optimism, and Leadership

    What if operational excellence depends less on doing more with less—and more on how leaders create meaning, optimism, and relationships at work? Episode page with video, transcript, and more In this episode, Mark Graban is joined by Kathy Miller, senior operations executive, leadership coach, and author of More Is Better: Leading Operations with Meaning, Optimism, and Relationships for Excellence. Drawing on decades of experience in manufacturing and aerospace, along with research from positive psychology, Kathy explains how leadership behavior directly shapes safety, quality, engagement, and performance. The conversation explores why “soft skills” are not soft at all, how leaders can practice realistic optimism without ignoring real problems, and how everyday interactions either build psychological safety or quietly undermine it. Kathy also shares practical insights for leading under pressure, balancing compassion with accountability, and helping people find meaning even in highly segmented operational work. This episode is especially relevant for leaders in manufacturing, healthcare, and operations who want sustainable results without burnout, fear, or disengagement.

    54 min
  5. Toyota Thinking for Knowledge Work: Don Kieffer on Dynamic Work Design

    2025-12-03

    Toyota Thinking for Knowledge Work: Don Kieffer on Dynamic Work Design

    Don Kieffer has spent more than fifty years redesigning how real work gets done. In this episode, he explains why so many improvement efforts stall—and how Dynamic Work Design offers a clearer, more practical way forward. Episode page with video, transcript, and more Don traces his path from machinist to Vice President of Operational Excellence at Harley-Davidson and senior lecturer at MIT Sloan. He shares what he learned working with Toyota legend Hajime Oba, including the moment he realized that copying Toyota’s rituals was the wrong goal. The real power, he argues, lies in understanding the thinking behind great work design. We break down the five principles of Dynamic Work Design—solving the right problem, structuring for discovery, connecting the human chain, regulating flow, and making work visible—and discuss how they apply far beyond the factory floor. Don explains why intellectual work is “almost infinitely compressible,” why executives misdiagnose morale problems, and why most leaders can draw their org chart but not the actual flow of work. Along the way, he shares stories from Harley, MIT, and client organizations that learned to shift from firefighting to flow. His message is consistent: when you redesign the work, you change the culture. Engagement follows the system, not the other way around. This episode pairs well with Episode 538 with Nelson Repenning and is essential listening for leaders trying to improve performance, reduce frustration, and create environments where people can do their best work. Key ideas • Copying Toyota’s practices isn’t the same as understanding Toyota’s thinking • Why Dynamic Work Design starts with a specific problem—not a program • How to create real-time management systems in knowledge-work environments • Why most dysfunction is a work-design issue, not a people issue • How better work design restores flow, learning, and joy in the work Representative Quotes “Five percent of the problem is people. Ninety-five percent is bad work design.” “Most executives can draw the org chart, but not the work.” “Intellectual work is almost infinitely compressible.” “Culture emerges from how the work is designed—not from what leaders say.”

    51 min

  6. 2025-12-01 • SUBSCRIBERS ONLY

    $ Toyota Thinking for Knowledge Work: Don Kieffer on Dynamic Work Design

    Ad-free and early access My guest for Episode #540 of the Lean Blog Interviews Podcast is Don Kieffer--executive consultant, former Vice President of Operational Excellence at Harley-Davidson, founder of ShiftGear Work Design, senior lecturer at MIT Sloan, and co-creator of Dynamic Work Design. Don has spent more than five decades helping organizations understand, redesign, and improve the way real work gets done. He and Nelson Repenning recently co-authored the new book There's Got to Be a Better Way. In this conversation, Don shares the arc of his career--from starting as a machinist and "factory rat" to becoming one of the leading voices on human-centered work design. He recounts how Toyota legend Hajime Oba challenged his thinking at Harley-Davidson and why he eventually diverged from the "copy the rituals" approach to Lean. That experience shaped his lifelong focus on understanding the thinking behind Toyota's methods--not the artifacts. We explore the core elements of Dynamic Work Design, including the five principles: solving the right problem, structuring for discovery, connecting the human chain, regulating flow, and making work visible. Don explains how these principles apply to factories, engineering teams, software organizations, finance groups, and healthcare. He draws sharp distinctions between work design and leadership style, arguing that good work design produces the behavior and culture leaders often try (and fail) to teach directly. Don also tells vivid stories--from crisis management at Harley, to working with MIT researchers, to confronting executives who blame "morale problems" rather than looking at broken work systems. His reflections connect deeply with psychological safety, respect for people, and systems thinking. He makes a compelling case that the biggest gains--often 30% or more in weeks--come from redesigning intellectual work, which he calls "almost infinitely compressible." This episode is packed with insight on designing better workflows, creating real-time management systems, and restoring joy in human work. It's a great follow-up to Episode #538 with Nelson Repenning and a must-listen for anyone responsible for improving performance in complex organizations. This podcast is part of the #LeanCommunicators network.

    51 min
  7. Lean Leadership Routines That Sustain Results: Darren Walsh on Moving Beyond Firefighting

    2025-11-12

    Lean Leadership Routines That Sustain Results: Darren Walsh on Moving Beyond Firefighting

    My guest for Episode #539 of the Lean Blog Interviews Podcast is Darren Walsh, author of Making Lean and Continuous Improvement Work: A Leader’s Guide to Increasing Consistency and Getting Significantly More Done in Less Time. Episode page with video, transcript, and more Darren is the Director and Leadership Coach at Making Lean Work Ltd and holds a master’s degree from the Lean Enterprise Research Centre at Cardiff University. He brings more than 25 years of experience helping leaders transform organizations in automotive, aerospace, medical devices, energy, and healthcare. In this episode, Darren and Mark explore why so many Lean and continuous improvement programs fail to sustain—and how leaders can build the right systems and habits to make improvement last. Darren explains the three common pitfalls he’s seen across industries: choosing the wrong improvement approach, relying on traditional “solution thinking,” and lacking consistent leadership routines. Darren also introduces his DAMI model—Define, Achieve, Maintain, Improve—as a way for organizations to avoid “kaizening chaos” and instead create a stable foundation for improvement. He shares stories from across sectors, including healthcare examples where better standards and daily management led to faster care, higher throughput, and dramatically lower mortality rates. Mark and Darren discuss the difference between problem-solving and firefighting, the danger of “shiny Lean” initiatives that don’t address core issues, and the leadership routines that keep everyone aligned and focused on the right problems. The conversation offers a grounded reminder that Lean isn’t about tools or jargon—it’s about building consistency, clarity, and capability throughout the organization. “You can’t kaizen chaos. First, you have to define and stabilize the standard.” “Most organizations say they want improvement—but they haven’t built the routines to sustain it.” “If every team in your business is working on the right problem, that’s an incredibly powerful organization.” “Firefighting feels heroic, but it hides the real causes and keeps us from solving them.” Questions, Notes, and Highlights: What’s your Lean origin story? How did you first get introduced to Lean and continuous improvement? You’ve worked across industries—from electronics to oil and gas. How do you overcome the “we’re different” resistance when applying Lean in new settings? Why do some organizations still associate Lean with cost-cutting instead of learning and improvement? What led you to write Making Lean and Continuous Improvement Work? What problems were you seeing again and again? Can you explain the three common pitfalls you describe in the book? What is the DAMI model—Define, Achieve, Maintain, Improve—and how can leaders use it effectively? How can organizations build a strong foundation for improvement before jumping into tools like 5S or Kaizen? What are the essential leadership routines for sustaining Lean and consistency? Why do so many teams fall into firefighting mode, and how can leaders break that habit? How can visual management and daily management systems help teams focus on the right problems? How do you balance working on small employee-driven Kaizen improvements versus larger, strategic problems? You’ve said, “You can’t Kaizen chaos.” What does that mean in practice? What lessons from the healthcare case study—cutting waiting times by 88%—stand out most to you? How can leaders ensure alignment and help every team work on the right things? What’s next for your work and research? What will your next book focus on? This podcast is part of the #LeanCommunicators network.

    53 min

  8. 2025-11-05 • SUBSCRIBERS ONLY

    $ Lean Leadership Routines That Sustain Results: Darren Walsh on Moving Beyond Firefighting

    Ad-free and early access for subscribers... My guest for Episode #539 of the Lean Blog Interviews Podcast is Darren Walsh, author of Making Lean and Continuous Improvement Work: A Leader’s Guide to Increasing Consistency and Getting Significantly More Done in Less Time. Darren is the Director and Leadership Coach at Making Lean Work Ltd and holds a master’s degree from the Lean Enterprise Research Centre at Cardiff University. He brings more than 25 years of experience helping leaders transform organizations in automotive, aerospace, medical devices, energy, and healthcare. In this episode, Darren and Mark explore why so many Lean and continuous improvement programs fail to sustain—and how leaders can build the right systems and habits to make improvement last. Darren explains the three common pitfalls he’s seen across industries: choosing the wrong improvement approach, relying on traditional “solution thinking,” and lacking consistent leadership routines. Darren also introduces his DAMI model—Define, Achieve, Maintain, Improve—as a way for organizations to avoid “kaizening chaos” and instead create a stable foundation for improvement. He shares stories from across sectors, including healthcare examples where better standards and daily management led to faster care, higher throughput, and dramatically lower mortality rates. Mark and Darren discuss the difference between problem-solving and firefighting, the danger of “shiny Lean” initiatives that don’t address core issues, and the leadership routines that keep everyone aligned and focused on the right problems. The conversation offers a grounded reminder that Lean isn’t about tools or jargon—it’s about building consistency, clarity, and capability throughout the organization. “You can’t kaizen chaos. First, you have to define and stabilize the standard.” “Most organizations say they want improvement—but they haven’t built the routines to sustain it.” “If every team in your business is working on the right problem, that’s an incredibly powerful organization.” “Firefighting feels heroic, but it hides the real causes and keeps us from solving them.” Questions, Notes, and Highlights: What’s your Lean origin story? How did you first get introduced to Lean and continuous improvement? You’ve worked across industries—from electronics to oil and gas. How do you overcome the “we’re different” resistance when applying Lean in new settings? Why do some organizations still associate Lean with cost-cutting instead of learning and improvement? What led you to write Making Lean and Continuous Improvement Work? What problems were you seeing again and again? Can you explain the three common pitfalls you describe in the book? What is the DAMI model—Define, Achieve, Maintain, Improve—and how can leaders use it effectively? How can organizations build a strong foundation for improvement before jumping into tools like 5S or Kaizen? What are the essential leadership routines for sustaining Lean and consistency? Why do so many teams fall into firefighting mode, and how can leaders break that habit? How can visual management and daily management systems help teams focus on the right problems? How do you balance working on small employee-driven Kaizen improvements versus larger, strategic problems? You’ve said, “You can’t Kaizen chaos.” What does that mean in practice? What lessons from the healthcare case study—cutting waiting times by 88%—stand out most to you? How can leaders ensure alignment and help every team work on the right things? What’s next for your work and research? What will your next book focus on? This podcast is part of the #LeanCommunicators network.

    53 min
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About

Lean Blog Interviews: Real-World Lean Leadership Conversations features thoughtful, in-depth discussions with leaders, authors, executives, and practitioners who are applying Lean thinking in the real world. Hosted by Mark Graban—author of Lean Hospitals, Measures of Success, and The Mistakes That Make Us—the podcast explores Lean as a management system, a leadership philosophy, and a people-centered approach to continuous improvement. Episodes span healthcare, manufacturing, startups, technology, and professional services. Guests share candid stories about what actually works—and what doesn’t—when organizations try to improve. This is not a podcast about chasing tools, jargon, or “Lean theater.” Instead, you’ll hear honest conversations about leadership behaviors, culture, psychological safety, learning from mistakes, and building systems that help people do their best work. If you believe improvement starts with respect for people—and that better systems beat blaming individuals—this podcast is for you. Find show notes and all episodes at LeanCast.org. Learn more about Mark Graban at MarkGraban.com.

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