Lean in Healthcare – Interview with Mark Graban

illustration - hospital on fire

(Mark Graban is an internationally-recognized expert in the field of “Lean Healthcare,” as a consultant, author, keynote speaker, and blogger. I reached out to him to chat about his approach to applying Lean in hospitals and healthcare organizations. You can find him on Twitter or LinkedIn.)

Q: Lean has a long history in healthcare. What are some of the current trends and understanding of “lean” in hospitals and healthcare?

A: Some of the earliest experiments with Lean methods in healthcare were in Seattle in the late 1990s. Two of the longest-running examples of the adoption of Lean in healthcare include ThedaCare, a health system in Wisconsin, and Virginia Mason Medical Center, in Seattle, which have been using Lean as an improvement model and a management system for 12 or 13 years now. Those organizations, along with some others, have really embraced Lean as a new culture, modeling themselves after Toyota in some ways, while maintaining, of course, the special values and purpose of a hospital.

Even with those shining examples, however, far too many health systems have a limited view of Lean, thinking of it as just an improvement methodology or as a set of tools or projects. The best Lean success comes from adopting Lean as a culture and a management system... yet, we’re still hoping to see more of that in healthcare. It’s unfortunately easier for people to adopt a few new tools to use in their existing, and often dysfunctional, organizational cultures.


illustration - honeymoon period

Lean in Larger Organizations – Interview with Jay Badenhope

Jay Badenhope (Senior Product Manager of JustAnswer) leads product teams that experiment and build things to solve meaningful customer problems.  I reached out to him to chat about his approach to implementing lean startup in large- and mid-size companies. You can find him on Twitter or LinkedIn)

Q: What is the difference between running lean in a very large vs. a mid-sized company? How have you adapted?

A: In my experience, there is a difference but it’s not night and day. I’ve led lean product teams at Intuit and JustAnswer. Both companies have established products and business models for making money from selling those products. To paraphrase Steve Blank, a company is responsible for executing on a proven business model, unlike a startup that is seeking to establish a new business model. I’ve led product teams that were responsible for testing ideas for new business models within these two profitable companies. The main difference I’ve seen is that larger companies tend to be more conservative in supporting the existing business model and smaller companies may be hungrier to try new things.

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illustration - fishbowl leads

Fishbowl Leads

(This is a guest post by Sean Murphy, who coaches early stage technology firms. You can find Sean on Twitter, LinkedIn or on his blog.)

You are back from a tradeshow and have 400 business cards in a large pile on the table. Booth visitors had dropped them in a fish bowl you set out to request more information and win a chance at a cool device. Now the work begins - finding the good ones in the pile.

Out of the 400 cards there may be 20 or 40 who are really interested in your product. You have to find them in the pile before too much time has passed and they are on to their next problem. The good news is that a few will remember you and follow up (and a few who didn't hear who won the drawing may also call if you picked an especially valuable or hard to find device).  Most of your follow up efforts, whether by phone or E-mail or postcard or prayer will go unanswered. This is true even for early adopters who are interested but also very busy. You will need to try a few times in different ways.

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B2B goals and objectives

Untangling B2B Sales Goals

Setting goals is something startups love to do.

We set aggressive revenue goals, customer acquisition goals, investment goals...

...but walk into a sales call?

Often it seems the only goal is to come out with a feeling of self-congratulation.

"It's going great! They really liked our pitch!"

When it comes to B2B sales, our ability to set concrete goals is lacking. Even when we make a concrete sales funnel, we often have a vague step called "Follow up" or "Get buy in."

This is a fundamentally bad practice.

(Shameless plug: I've been working with Sean K Murphy on combining some of our ideas on B2B sales and will be giving a first workshop on Jan 29: From Customer Interviews to Enterprise Sales)

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Prioritization of sales prospects

4 Categories of B2B Customers

(This is a guest post by Kenny Nguyen, who has spent the last six years helping B2B companies with marketing and sales. He describes himself as a guy who "doesn't like sales, but you have to sell if you're going to help people." You can find Kenny on Twitter.)

It’s hard to keep tab of sales when we’re talking to one potential customer after another. B2B startups founders - with limited sales experience, myself included - have trouble with qualifying leads.

Every customer we talk to ends up being qualified customers somehow, someway.

As a consequence, focus ends up being diluted across way too many leads at the same time. B2B founders could benefit from having a fast and effective qualification process. There are great tools out there to help manage pipelines, ask questions, flowcharts, and analyze potential sales top-down, but there isn’t much available to help qualify potential customers in a no-nonsense manner.

To cut to the chase, you can download the cheat sheet here:

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Qualitative vs. Quantitative

Stupid debates: Qualitative vs. Quantitative

When I was studying marketing I had an arms length list of research techniques like conjoint analysis, surveys, and focus groups. After I read Four Steps to the Epiphany, there was only one: Get out of the building and talk to customers!

At LUXr, Janice Fraser introduced me to a whole new host of tools to gain insight such as hallway usability testing, contextual inquiry, and mental models.

Add this to lean startup standards like smoke tests and it's a pretty overwhelming.

Should we run a Pocket Test with Picnic in the Graveyard to follow up? Should we do a Wizard of Oz or a concierge approach? Would you like a lemon twist with that?

So what type of experiment should you run? And when?

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flux capacitor - a back to the future moment

Reuniting Product Management and Lean UX

(This is a guest post by Rich Mironov, who coaches product executive and product management/owner teams. He wrote The Art of Product Management. You can find Rich on Twitter, LinkedIn or on his blog.)

I was at a recent Lean Startup Circle talk about the future of product management. It was a "back to the future" moment for me, hearing about the need for the strong strategic product management that predates Lean and Agile. A return to first principles, but with more build-measure-learn.

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