Take Action with a Problem-Solving Process

Posted on by Kim Barnas

Big Deep Pothole

If you encourage staff to identify defects, you better have a process to solve them. Often the first step is to bring those defects forward to a huddle. In the book Beyond Heroes, we recommend that this conversation occurs at a huddle board (visual management) with your staff. During this huddle, you identify and discuss defects which have been brought forward from various sources—status sheets, staff, ancillary areas, or physicians. A system to prioritize these opportunities is essential.  Continue reading →

Did You See the Canaries?

Posted on by Brian Veara

Yellow bird sitting on a branch

Did you know that back in the early underground mining days, miners were dying because of deadly gases that would seep into the mines?  They learned that canaries, hanging in cages within the mines, would die long before the levels of gas were deadly to humans.  This was their early warning system for action. This is the purpose of a process measure.

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Be a Life-Long Learner


Graduation season is upon us, this is evident by my social media feeds flooding with pictures of recent graduates in their caps and gowns. These bright and smiling faces are proud of their accomplishments, as they should be.  Graduation marks a milestone in their lives.  Many are be excited to move on to the next chapter of their life. Some might believe their learning is over and rejoice thinking they will never have to read a book again.  Little do they realize that their learning is just beginning because learning continuously is essential to success.

Principles are the basis for building a lasting culture and achieving enterprise excellence. As an organization Catalysis uses the Shingo Guiding Principles as a foundation for our culture. In addition, we have added a few of our own. Learning continuously and seeking knowledge is not one of the Shingo principles; however, Catalysis has adopted this as a principle within our organization.  Continue reading →

Better Has No Limit


“Better has no limit.” This is a Yiddish proverb that Dr. Christine Nefcy shared during the physician panel at the 10thannual Lean Healthcare Transformation Summit in Washington, DC, last week. She says that she likes to use this proverb when talking with physicians about continuous improvement and the Shingo principle of seeking perfection. This really resonated with me as an important theme seen throughout the event.

Some additional ideas that stood out to me at this year’s Summit were:

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Changing Organization Culture is Like Renovating an Old House

ladder in empty room during renovation - home decoration, restoration concept

A continuous improvement journey is much more than the implementation of tools and alignment of work. Lean transformation requires cultural change. This change comes from defining principles and the behaviors that demonstrate these principles. Changing an organization’s culture takes time, effort and dedication.

Recently, I was talking with a colleague about the Shingo principles and organization culture. She said that culture change is hard because you are not building it from scratch; a culture already exists in every organization. This resonated with me and I started thinking that changing a culture is like renovating an old house. This I can relate to because my husband and I own an old character home, built nearly 100 years ago. Needless to say, we have a lengthy repair and renovation list.

Similar to renovating an old house, changing the culture of an organization requires starting from what exists and dealing with challenges and surprises as they arise. Here are some examples of how changing a culture reflects the process of home renovation:

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Know What to Work, When

Posted on by Kim Barnas


I’ve visited a number of organizations and one of the recurring problems I’ve seen is lack of an effective prioritization process. I think this is paramount. In this world of competing priorities and regulation, we must have a way to focus on the “vital few,” demonstrate and stabilize the improvement, and move on to the next “vital few.” We will accomplish more sustainable solutions with added focus.  Continue reading →

What is the Recipe for Success?

Grilled skewers on a grilled plate

Working in the Catalysis Healthcare Value Network (CHVN), I get to see many healthcare organizations that are working to improve value for patients. CHVN member organizations are at varying places along their lean journey. Some just starting out and others are more mature in their thinking. No matter what, each time I visit an organization I learn from them.

Recently, I visited Catalysis Healthcare Value Network member organizations, Nemours Children’s Health System and Herman Miller. Each of these organizations have been on a lean journey for quite some time and are very mature in their thinking. When traveling back home I began to think about what makes mature organizations successful. Continue reading →

How Do You Know Your Problem Solving Is Driving Improvement If You Are Not Measuring It?

Posted on by Kim Barnas

Tape Measures on Brown Wooden Background

As I visit healthcare organizations around North America, people come forward sharing concerns that they are hitting a wall, even within the management system. Often what I hear is that they have implemented stat sheets and huddles, but not all of them have implemented a performance review process. The management system is just that—a system!  The goal is to develop people to solve problems and improve performance.  How do you know if your problem solving is driving improvement if you are not measuring it?  Continue reading →