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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. How Don Kieffer Applies Toyota Thinking to Modern Knowledge Work

    DEC 3

    How Don Kieffer Applies Toyota Thinking to Modern Knowledge Work

    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

  2. DEC 1 • SUBSCRIBERS ONLY

    $ How Don Kieffer Applies Toyota Thinking to Modern Knowledge Work

    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
  3. From Firefighting to Flow: Darren Walsh on Lean Leadership Routines that Sustain Results

    NOV 12

    From Firefighting to Flow: Darren Walsh on Lean Leadership Routines that Sustain Results

    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

  4. NOV 5 • SUBSCRIBERS ONLY

    $ From Firefighting to Flow: Darren Walsh on Lean Leadership Routines that Sustain Results

    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
  5. How to Cut Through Workplace Chaos: Nelson Repenning on Lean, Flow & Dynamic Work Design

    OCT 29

    How to Cut Through Workplace Chaos: Nelson Repenning on Lean, Flow & Dynamic Work Design

    My guest for Episode #538 of the Lean Blog Interviews Podcast is Nelson Repenning, Faculty Director of the MIT Leadership Center and co-creator of Dynamic Work Design. Episode page with video, transcript, and more Nelson describes himself as an "organizational engineer," helping leaders redesign the routines and decisions that determine how work really gets done. He joins host Mark Graban to discuss his new book, There's Got to Be a Better Way: How to Deliver Results and Eliminate the Chaos of Modern Work, co-authored with Donald Kieffer. In this conversation, Nelson shares insights drawn from his decades of experience studying system dynamics, Lean thinking, and organizational learning. He explains how leaders often fall into the "capability trap" -- spending their days firefighting immediate issues instead of improving the underlying system. From the arms race of hospital alarms to the collapse of fast-growing companies, he connects examples from healthcare, manufacturing, and technology to show why even good intentions can create destructive feedback loops if we don't understand the system. Mark and Nelson also explore how Dynamic Work Design translates Lean principles like flow, visualization, and problem-solving into knowledge work. They discuss the five core principles -- including "Structure for Discovery" and "Connect the Human Chain" -- that help organizations make work visible, surface problems early, and evolve systems continuously. Listeners will learn how to move from firefighting to focus, and from chaos to sustainable improvement. Questions, Notes, and Highlights: How did you first get involved in the field of system dynamics at MIT? For those unfamiliar, what exactly is system dynamics -- and how does it apply to management and organizations? Why hasn't system dynamics had the impact on practice that it deserves? What lessons can we learn from the classic examples you've taught, like the Mississippi River levee arms race or the "People Express" airline simulation? How do those feedback loops and unintended consequences show up in today's industries, like healthcare or tech? What led you and Donald Kieffer to write There's Got to Be a Better Way? What core problems were you trying to address? Can you explain the "capability trap" and how firefighting keeps organizations from improving? Why is it so hard for people to commit to prevention and long-term improvement when firefighting feels more rewarding? How does Dynamic Work Design help leaders "structure for discovery" and surface problems earlier? What role does psychological safety play in making it safe to raise problems? How do you define "Dynamic Work Design," and what makes it different from traditional management systems? Why is it important for leaders to "go see the work" firsthand? Can you walk us through the five principles of Dynamic Work Design -- and how they connect to Lean? What does "Connect the Human Chain" mean, and why do so many organizations get communication wrong? Can you share an example where these principles led to measurable improvement -- such as the hospital case you mentioned? What can leaders learn from Toyota and other high-reliability organizations about making improvement continuous rather than episodic? How do leaders shift from reactive, one-off change programs to daily, ongoing learning? What message do you hope managers take away from There's Got to Be a Better Way? This podcast is part of the #LeanCommunicators network.

    56 min

  6. OCT 24 • SUBSCRIBERS ONLY

    $ How to Cut Through Workplace Chaos: Nelson Repenning on Lean, Flow & Dynamic Work Design

    Ad-free and early access for subscribers My guest for Episode #538 of the Lean Blog Interviews Podcast is Nelson Repenning, Faculty Director of the MIT Leadership Center and co-creator of Dynamic Work Design. Nelson describes himself as an "organizational engineer," helping leaders redesign the routines and decisions that determine how work really gets done. He joins host Mark Graban to discuss his new book, There's Got to Be a Better Way: How to Deliver Results and Eliminate the Chaos of Modern Work, co-authored with Donald Kieffer. In this conversation, Nelson shares insights drawn from his decades of experience studying system dynamics, Lean thinking, and organizational learning. He explains how leaders often fall into the "capability trap" -- spending their days firefighting immediate issues instead of improving the underlying system. From the arms race of hospital alarms to the collapse of fast-growing companies, he connects examples from healthcare, manufacturing, and technology to show why even good intentions can create destructive feedback loops if we don't understand the system. Mark and Nelson also explore how Dynamic Work Design translates Lean principles like flow, visualization, and problem-solving into knowledge work. They discuss the five core principles -- including "Structure for Discovery" and "Connect the Human Chain" -- that help organizations make work visible, surface problems early, and evolve systems continuously. Listeners will learn how to move from firefighting to focus, and from chaos to sustainable improvement. Questions, Notes, and Highlights: How did you first get involved in the field of system dynamics at MIT? For those unfamiliar, what exactly is system dynamics -- and how does it apply to management and organizations? Why hasn't system dynamics had the impact on practice that it deserves? What lessons can we learn from the classic examples you've taught, like the Mississippi River levee arms race or the "People Express" airline simulation? How do those feedback loops and unintended consequences show up in today's industries, like healthcare or tech? What led you and Donald Kieffer to write There's Got to Be a Better Way? What core problems were you trying to address? Can you explain the "capability trap" and how firefighting keeps organizations from improving? Why is it so hard for people to commit to prevention and long-term improvement when firefighting feels more rewarding? How does Dynamic Work Design help leaders "structure for discovery" and surface problems earlier? What role does psychological safety play in making it safe to raise problems? How do you define "Dynamic Work Design," and what makes it different from traditional management systems? Why is it important for leaders to "go see the work" firsthand? Can you walk us through the five principles of Dynamic Work Design -- and how they connect to Lean? What does "Connect the Human Chain" mean, and why do so many organizations get communication wrong? Can you share an example where these principles led to measurable improvement -- such as the hospital case you mentioned? What can leaders learn from Toyota and other high-reliability organizations about making improvement continuous rather than episodic? How do leaders shift from reactive, one-off change programs to daily, ongoing learning? What message do you hope managers take away from There's Got to Be a Better Way? This podcast is part of the #LeanCommunicators network.

    56 min
  7. Building Excellence Through Quality and Psychological Safety -- ASQ Cincinnati 2025 Preview

    OCT 22 · BONUS

    Building Excellence Through Quality and Psychological Safety -- ASQ Cincinnati 2025 Preview

    In this special bonus episode of Lean Blog Interviews, Mark Graban is joined by C.J. Kaufman, Education Chair for the ASQ Cincinnati Section, to preview the ASQ Southwest Ohio 2025 Conference, themed “Excellence Through Quality.” Episode page with transcript, video, and more Taking place Saturday, November 8, 2025, in Mason, Ohio, the event brings together quality professionals from the Cincinnati and Dayton regions for a half-day of engaging speakers, practical insights, and networking — plus an optional afternoon workshop with Mark. C.J. shares how the conference was designed collaboratively by the Cincinnati and Dayton ASQ Sections, what attendees can expect, and why psychological safety is a cornerstone topic for today’s quality and Lean leaders. Highlights Event Overview: ASQ Southwest Ohio 2025 — a collaboration between Cincinnati and Dayton sections. Theme: Excellence Through Quality — exploring leadership, teamwork, and continuous improvement. Keynote: Mark Graban on Psychological Safety, Quality, and Continuous Improvement. Featured Speakers Include: Deb Coviello — Leading Quality Susan Marshall — FDA Perspectives on ROI in Quality Management Colleen Soppelsa — Group Intelligence in Problem-Solving Optional Workshop: Hands-on Lean learning with Mark Graban in the afternoon session. Why It Matters: Quality and continuous improvement thrive when organizations foster safety, trust, and engagement. Quotable Moments “Psychological safety is essential for positive change — without it, continuous improvement can’t sustain.” — Mark Graban “We want people to leave with practical things they can use Monday morning.” — C.J. Kaufman “Excellence through quality isn’t just a theme — it’s how we build better systems and better workplaces.” — Mark Graban Event Details Location: Mason, Ohio Date: Saturday, November 8, 2025 Time: 8:00 a.m. – 1:00 p.m. (Workshop to follow) Includes: Breakfast + Lunch More Info & Registration -- ASQ Cincinnati Section Website Related Links Mark Graban – Psychological Safety Resources Lean Blog Interviews Archive

    15 min

  8. OCT 18 · BONUS • SUBSCRIBERS ONLY

    $ Building Excellence Through Quality and Psychological Safety -- ASQ Cincinnati 2025 Preview

    Ad-free and early access for subscribers In this special bonus episode of Lean Blog Interviews, Mark Graban is joined by C.J. Kaufman, Education Chair for the ASQ Cincinnati Section, to preview the ASQ Southwest Ohio 2025 Conference, themed “Excellence Through Quality.” Taking place Saturday, November 8, 2025, in Mason, Ohio, the event brings together quality professionals from the Cincinnati and Dayton regions for a half-day of engaging speakers, practical insights, and networking — plus an optional afternoon workshop with Mark. C.J. shares how the conference was designed collaboratively by the Cincinnati and Dayton ASQ Sections, what attendees can expect, and why psychological safety is a cornerstone topic for today’s quality and Lean leaders. Highlights Event Overview: ASQ Southwest Ohio 2025 — a collaboration between Cincinnati and Dayton sections. Theme: Excellence Through Quality — exploring leadership, teamwork, and continuous improvement. Keynote: Mark Graban on Psychological Safety, Quality, and Continuous Improvement. Featured Speakers Include: Deb Coviello — Leading Quality Susan Marshall — FDA Perspectives on ROI in Quality Management Colleen Soppelsa — Group Intelligence in Problem-Solving Optional Workshop: Hands-on Lean learning with Mark Graban in the afternoon session. Why It Matters: Quality and continuous improvement thrive when organizations foster safety, trust, and engagement. Quotable Moments “Psychological safety is essential for positive change — without it, continuous improvement can’t sustain.” — Mark Graban “We want people to leave with practical things they can use Monday morning.” — C.J. Kaufman “Excellence through quality isn’t just a theme — it’s how we build better systems and better workplaces.” — Mark Graban Event Details Location: Mason, Ohio Date: Saturday, November 8, 2025 Time: 8:00 a.m. – 1:00 p.m. (Workshop to follow) Includes: Breakfast + Lunch More Info & Registration -- ASQ Cincinnati Section Website Related Links Mark Graban – Psychological Safety Resources Lean Blog Interviews Archive

    15 min
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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.

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