Quotes from Healthcare Kaizen

QUOTES FROM
HEALTHCARE KAIZEN

by Mark Graban & Joseph E. Swartz

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visit www.HCkaizen.com

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Quotes from Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements by Graban & Swartz www.hckaizen.com

About This e-Book

This e-Book is a collection of
quotes and inspirational
messages that appear
throughout our larger book,
Healthcare Kaizen, a practical
how-to guide for starting and
growing a Kaizen program.

Charles Darwin

It is not the strongest of
the species that survives,
nor the most intelligent,
but the one most
responsive to change.


Author Unknown

The largest room in
the world is the
room for
improvement.


Old Japanese Proverb

Fall seven times.
Stand up eight.


Henry Ford

Failure is only the
opportunity to
begin again more
intelligently


Henry Ford

Our own attitude is that we
are charged with
discovering the best way of
doing everything, and that
we must regard every
process employed in
manufacturing as purely
experimental.

Mark Twain

The secret of getting ahead
is getting started. The
secret of getting started is
breaking your complex
overwhelming tasks into
small manageable tasks,
and then starting on the
ﬁrst one.

About Healthcare Kaizen

Healthcare Kaizen focuses on the principles methods of daily continuous improvement, or “Kaizen,” for healthcare
professionals and organizations. Kaizen is a Japanese word that means “change for the better,” popularized by
Masaaki Imai in his 1986 book KAIZEN and through the books of Norman Bodek, both of whom contributed
introductory material for this book.

In 1989, Dr. Donald M. Berwick, founder of the Institute for Healthcare Improvement and former administrator of the
Centers for Medicare & Medicaid Services, endorsed the principles of Kaizen in the New England Journal of Medicine,
describing it as “the continuous search for opportunities for all processes to get better.” Healthcare Kaizen shows how
to make this goal a reality.

Healthcare Kaizen shares some of the methods used by numerous hospitals, including Franciscan St. Francis
Healthcare, where co-author Joe Swartz has led these efforts. Most importantly, the book covers the management
mindsets and philosophies required to make Kaizen work effectively in a hospital department or as a organization-
wide program.

All of the examples in the book are real examples that were shared by leading healthcare organizations, with over two
hundred full-color pictures and visual illustrations of Kaizen-based improvements that were initiated by Chief Operating
Officers, nurses, housekeepers, and other staff members at all levels.

Healthcare Kaizen will be helpful for organizations that have embraced weeklong improvement events, but now want
to follow the lead of ThedaCare, Virginia Mason Medical Center, and others who have moved beyond just doing
events into a more complete management system based on “Lean” or the “Toyota Production System.”

It’s often said, without much reflection, that “people hate change.” The experiences shared in this book will prove that
people actually love change when they are fully engaged in the process, they get to make improvements that improve
patient care and make their day less frustrating, and when they don’t fear being laid off as a result of their
improvements.


Henry Ford

There are no big
problems, there
are just a lot of
little problems.

Mohandas Gandhi

Be the change
you want to see
in the world.

Masaaki Imai

The Kaizen philosophy
assumes that our way of life
– be it our working life, our
social life, or our home life –
deserves to be constantly
improved.


Mark Graban

Why is there a lock on
your suggestion box?
Are you afraid that the
competing hospital
across the street is
sending people over to
steal your good ideas?!
!

Taiichi Ohno

Kaizen is about changing
the way things are. If you
assume that things are all
right the way they are,
you can’t do Kaizen. So
change something!

Bruce Hamilton

Many companies assume that
the failure of the suggestion
box approach is with
employees that don’t care, but
if we dig a little deeper we
find it is the system itself that
squashed enthusiasm.

About the Authors

Mark Graban is an internationally-recognized expert in the field of “Lean
Healthcare,” as a consultant, author, keynote speaker, and blogger. He is the
author of Lean Hospitals: Improving Quality, Patient Safety, and Employee
Engagement (2nd edition). Mark has worked as a consultant and coach to
healthcare organizations throughout North America and Europe. He was formerly
a senior fellow with the Lean Enterprise Institute and continues to serve as a
faculty member. Mark is also the Chief Improvement Officer for KaiNexus, a
startup software company that helps healthcare organizations manage continuous
improvement efforts. Mark earned a BS in Industrial Engineering from
Northwestern University and an MS in Mechanical Engineering and an MBA from
the MIT Sloan Leaders for Global Operations Program. Visit his website at
www.MarkGraban.com and his blog at www.LeanBlog.org. mark@leanblog.org

Joseph E. Swartz is the Director of Business Transformation for Franciscan St.
Francis Health of Indianapolis, IN. He has been leading continuous improvement
efforts for 18 years, including 7 years in healthcare, and has led more than 200
Lean and Six Sigma improvement projects. Joseph is the co-author of Seeing
David in the Stone and was previously an instructor at the University of
Wisconsin. Joseph earned an MS in Management from Purdue University as a
Krannert Scholar for academic excellence. joeswartz14@gmail.com


Masaaki Imai

[If] the new standard has been set
up by the worker’s own volition, he
takes pride in the new standard and
is willing to follow it. If, on the
contrary, he is told to follow a
standard imposed by management,
he may not be as willing to follow it.


Toyota

From a 2010 Toyota publication:
“Continuous Improvement implies that all
employees must not let themselves
become complacent about the status
quo, but put forth their best ideas and
efforts to seek greater added-value. In
accordance with the second principle,
‘Respect for People,’ Toyota respects all
stakeholders and believes that the
success of its business is created by
individual efforts and growth.”

Pat Hagan

Patrick Hagan, former COO
of Seattle Children’s
Hospital, says, “We rarely
talk about cost. We talk
about waste, quality, and
safety, and we find our
costs go down.”

Adam Smith

Such is the delicacy of
man alone, that no
object is produced to
his liking. He ﬁnds that
in everything there is
need for improvement.


Theresa Amabile

We define innovation as the
successful implementation
of creative ideas within an
organization.
—Theresa Amabile

Professor and Director of Research Harvard Business School


Alan G. Robinson and Dean M. Schroeder

Employee ideas
are key to
building a
culture of high
performance.

Henry Ford

Most people spend
more time and
energy going around
problems than trying
to solve them.

Lewis Carroll

“No use trying,” Alice said, “one
can’t believe impossible things.” “I
daresay you haven’t had much
practice,” said the Queen. “When I
was your age, I always did it for half-
an-hour a day. Why, sometimes I’ve
believed as many as six impossible
things before breakfast.”
—Lewis Carroll Alice’s Adventures in Wonderland


Vince Lombardi

Perfection is not
attainable, but if we
chase perfection we
can catch excellence.


Saint Francis of Assisi

Start by doing what’s
necessary; then do
what’s possible; and
suddenly you are doing
the impossible.

Robert F. “Bob” Bennett

We all seek to control our lives:
our careers, our relationships,
our reactions to events and
situations. People who gain
control automatically become
more productive.
—Robert F. “Bob” Bennett
Former CEO of Franklin Quest and former United
States Senator from Utah


Peter Drucker

The purpose of
business is to
create and keep
a customer.

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W. Edwards Deming, Ph.D.

Management’s job is to
create an environment
where everybody may take
joy in his work.


Mother Teresa

We can do no
great things,
only small
things with
great love.


Unknown

You can’t learn
how to ride a bike
by reading a book
on physics.


Muhammad Ali

It’s lack of faith
that makes people
afraid of meeting
challenges, and I
believed in myself.

Taiichi Ohno

Why not make the work easier
and more interesting so that
people do not have to sweat? The
Toyota style is not to create
results by working hard.
It is a system that says there is no
limit to people’s creativity.
People don’t go to Toyota to
“work” they go there to “think.”

Marie Curie

You cannot hope to build a
better world without improving
the individuals. To that end,
each of us must work for our
own improvement and, at the
same time, share a general
responsibility for all humanity.

R. D. Laing

The range of what we think and do
is limited by what we fail to notice.
And because we fail to notice that
we fail to notice there is little we
can do to change until we notice
how failing to notice shapes our
thoughts and deeds.
—R. D. Laing
Scottish psychiatrist

Quotes from Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements by Graban Swartz www.hckaizen.com

Albert Einstein

If I had an hour to solve
a problem, I’d spend 55
minutes thinking about
the problem and 5
minutes thinking about
solutions.

Linus Pauling

The best way
to have a good
idea is to have
lots of ideas.


One cannot be successful on
visible ﬁgures alone ... the most
important ﬁgures that one
needs for management are
unknown or unknowable, but
successful management must
nevertheless take account of
them.



He that expects to quantify in dollars
the gains that will accrue to a company
year by year for a program for
improvement of quality expounded in
[Out of the Crisis] will suffer delusion.
He should know before he starts that
he will be able to quantify only a
trivial part of the gain.

Leonardo da Vinci

I have been impressed
with the urgency of doing.
Knowing is not enough; we
must apply. Being willing is
not enough; we must do.


Albert Einstein

Make everything
as simple as
possible, but not
simpler.

Thomas Jefferson

The most valuable
of all talents is that
of never using two
words when one
will do.

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templates you can use today

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John Locke

The improvement of
understanding is for two
ends: first, our own
increase of knowledge;
secondly, to enable us to
deliver that knowledge
to others.

Soichiro Honda

Man
can
put
out
about
1/20th
of
a

horsepower.
He
has
to
rest
at

least
9
hours
a
day.
He
also
has
to

eat
and
drink.
As
a
power
source,

we
are
terrible.
However,
it
is

when
man
starts
thinking
of
ideas

that
the
diﬀerence
between
man

and
machine
emerges.


Albert Camus

You are forgiven for
your happiness and
your successes only if
you generously consent
to share them.

There is no joy other than the joy of
creating. There is no man who is truly
alive other than one who is creating.
All others are just shadows on the
earth with nothing to do with being
alive. The joy of living, whether it is
love or action, is the joy of creating.
—Romain Rolland
Nobel Prize Laureate in Literature


Henry Ford

Whether you think
that you can, or
that you can’t, you
are usually right.


Mark Twain

Nothing so needs
reforming as other
people’s habits.


Shigeo Shingo

90% of
resistance is
cautionary.!

John Arthur Porter

People underestimate their
capacity for change. There is
never a right time to do a
difficult thing. A leader’s job is
to help people have vision for
their potential.
—John Arthur Porter
Canadian sociologist

1 Peter 2:17

Show proper
respect to
everyone.

Coaching Workshops

How can we help you?
Does your organization need coaching or support
with your Kaizen efforts?
Mark Graban and Joe Swartz can help you with anything from a 1-hour talk or
presentation, a multi-day on-site visit, or an ongoing coaching relationship. Our passion
is healthcare, but we have experience in other industries. These ideas can also be
taught and applied in manufacturing, services, retail and restaurant, non-profit settings,
and more. Ask us how we can teach you Kaizen and get you started.

Visit:

http://www.hckaizen.com/resources/

Sir Winston Churchill

Courage is what it
takes to stand up and
speak, Courage is
also what it takes to
sit down and listen.

Steve Jobs

If you are working on
something exciting that
you really care about, you
don’t have to be pushed.
The vision pulls you.


Friedrich Wilhelm Nietzsche

Man will put up
with any “how” if
he has a “why.”


Kurt Lewin

People support
what they create.


Nowadays, I make it a practice to call
[my workers] into consultation on any
new work. I observe they’re more
willing to set about a piece of work
when their opinions are asked and
their advice followed.
—Columella
Roman landlord, 100 A.D.


The greatest source of
competitive advantage is not
really cost or quality, but
creativity.
—John Micklethwait
Editor-in-Chief, The Economist


If there is no sense of trust in
the organization, if people are
preoccupied with protecting
their backs ... creativity will
be one of the ﬁrst casualties.

—Manfred F. R. Kets de Vries

Clinical professor of leadership, INSEAD


George Bernard Shaw

Those who cannot
change their
minds cannot
change anything.


Never take a person’s
dignity—it is worth
everything to them and
nothing to you.
—Frank Barron

A pioneer in the psychology of creativity


Saying yes to Kaizen was easy for me. As a
leader, I recognize my role is to lead
others to create the future of our
organization. I knew our future required
the continuous development of the
improvement skills and abilities of all our
staff and their engagement in continually
improving the services we provide to our
patients and their families.
—Bob Brody
CEO, Franciscan St. Francis Health


John Toussaint

The key to successful Lean implementation is
that leaders have to change. We have to change
from the all-knowing, being “in charge,”
autocratic “buck stops with me,” impatient,
blaming person—who is a control freak—to the
person who is patient, knowledgeable, a good
facilitator, willing to teach, actually willing to
learn, be a helper, an effective communicator,
and be humble.
— John Toussaint

CEO, ThedaCare Center for Healthcare Value


The [servant] leader has a
vested interest in the
success of those being led.
Indeed, one of our roles as
a leader is to assist them in
becoming successful.
—James C. Hunter

Author


Jamie Flinchbaugh

Being “behind” an
initiative is quite different
than being in front of it
[leading the initiative].
—Jamie Flinchbaugh
Author and consultant



It is not enough that top management
commit themselves for life to quality
and productivity. They must know
what it is that they are committed to—
that is, what they must do. These
obligations cannot be delegated.
Support is not enough; action is
required.

Kaizen requires an upfront
investment of time and effort,
but it pays you back at least
ten times the upfront
investment in patient and staff
satisfaction and retention.
—Paula Stanﬁll
Manager, NICU, Franciscan St. Francis Health

Kathryn Correia

When you go to gemba, it’s an opportunity to
sincerely thank everyone involved for their
work. The funny thing is, as the leader, I also
would like to thank them for allowing me to
support them. I can’t give direct care, but,
contrary to the old style CEO walking around
to be seen, it is a privilege for me to see the
team. Every time I am in gemba it reminds me
of why, just like clinicians, I went into health
care. It feels good.
—Kathryn Correia
Former President of Appleton Medical Center and ThedaClark Medical
Center and Former Senior Vice President of ThedaCare



You have to
manage a system.
The system
doesn’t manage
itself.

Masaaki Imai

Kaizen is a mindset. Many
lean practitioners put
kaizen in their toolbox, but
those who strive to live it
each day are the people who
are making a difference in
people’s lives.

Albert Einstein

No problem can be
solved from the
same level of
consciousness that
created it.

The national numbers for waste
in healthcare are between 30%
and 40%, but the reality of what
we’ve observed doing minute-by-
minute observation over the last
three years is closer to 60%.

—Cindy Jimmerson, RN

Author and consultant


Masaaki Imai

[Toyota’s Taiichi] Ohno urged
managers, too, to visit gemba.
He would say, “Go to gemba
every day. And when you go,
don’t wear out the soles of your
shoes in vain. You should come
back with at least one idea for
kaizen.”


Rudyard Kipling

I keep six honest
serving men. They
taught me all I knew.
Their names are What
and Why and When
and How and Where
and Who.

Benjamin Franklin’s Root Cause Analysis:

For want of a nail a shoe was lost,
for want of a shoe a horse was lost,
for want of a horse a rider was lost,
for want of a rider an army was lost,
for want of an army a battle was lost,
for want of a battle the war was lost,
for want of the war the kingdom was lost,
and all for the want of a little horseshoe nail.



If you pit a good performer against
a bad system, the system will win
almost every time. We spend too
much time ﬁxing people who are
not broken and not enough time
ﬁxing organizational systems that
are broken. Only leadership has the
power and responsibility to change
the systems.

Shigeo Shingo

It had dawned on me that
the occurrence of a defect
was the result of some
condition or action, and that
it would be possible to
eliminate defects entirely
by pursuing the cause.

Julia Child

You want to be able to
find and stash everything
easily ... unless you’re
one of those people who
like to live in a mess.


Henry Ford

Coming together is a
beginning. Keeping
together is progress.
Working together is
success.


Chinese Proverb

If you want one year of
prosperity, grow seeds. If you
want ten years of prosperity,
grow trees. If you want 100
years of prosperity, grow
people.


Jenny Craig

It’s not what you do
once in a while, It’s
what you do day in and
day out that makes
the difference.

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Quotes from Healthcare Kaizen

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Quotes from Healthcare Kaizen