Chapter 10
Kaizen Programs
You have to manage a system. The system doesn’t manage itself.
W. Edwards Deming, Ph.D.
Many of the Kaizen methods shared to this point can be implemented locally
at a department level, as did the laboratory at Childrens Medical Center Dallas.
Other organizations, like Franciscan, have moved beyond local efforts to develop
and maintain an organization-wide Kaizen program. This chapter shares what
Franciscan and other successful organizations have done to create a program-
matic approach to Kaizen. This includes creating a central Kaizen Promotion
Office, considering the use of incentives and contests, and documenting and
sharing Kaizens electronically. We will also outline some expected timelines and
costs associated with a Kaizen program.
Getting Started
The upfront costs can be as small as providing some initial kickoff training.
Asmentioned earlier in the book, Franciscans leaders brought in Norm Bodek
for a day of training and workshops. If you bring in a well-known consultant or
a trainer from a local community college, the costs and fees can vary widely. You
can try to create your own kickoff training, but the expertise brought by consul-
tants can be invaluable, especially when you are bringing something new to the
organization. Yet the expertise level also varies widely, and does not necessarily
correlate with the cost, so shop wisely.
A timeline for an organization-wide Kaizen program includes planning,
kickoff, growing, and maturing the program. At Franciscan, leaders planned for
a month prior to the official kickoff in April of 2007. The kickoff event lasted
272 ◾  Healthcare Kaizen
for one day. In the two months after kickoff, they provided the initial “how to”
training and developed an internal website with blank Kaizen Reports, instruc-
tions, and resources. Then, starting with month three, they conducted training on
Lean topics on a monthly basis for the first year, as detailed in Chapter 11. In the
second and third year, Franciscans leadership brought additional training to spe-
cific departments that were struggling with Kaizen. A successful Kaizen program
does not just happen—it needs to be designed, implemented, and executed well.
When Will You See Results?
Leaders often ask how fast they can expect to see results after launching a
Kaizen program. The good news is that Kaizen delivers small, but real and
tangible, results immediately. You will start seeing small results as soon as the
Kaizens begin to roll in. At Franciscan, the first Kaizen was completed and
turned in the very first day after the kickoff event, with dozens more being done
in the first month. Each Kaizen provides benefits, even if they are as simple as
saving two seconds of time.
It is important to understand that the greatest benefits of Kaizen are seen when
the organizations culture is changed. The time required to change a culture is
measured not in weeks or months, but in years or even a decade, depending
on how aggressively and skillfully Kaizen is introduced and embraced. At some
point, Kaizen will permeate the organization so fully that the effects cross over
into every improvement activity, making it somewhat difcult to separate out the
effect of Kaizens from Lean Six Sigma and other improvement approaches that are
taking place simultaneously.
James Dague, CEO of IU Health Goshen Hospital, recalls, “The first
three years of this program are very tough because everybody’s waiting
for it to go away. Youre not going to take all the negatives that got you
to this point, where you need an improvement program, and wash it
out of your organization in one year.” Leaders need to have patience,
asDague adds, “You have to just keep beating the drum. Sometimes
you may feel like youre in a stadium all by yourself, but youve got to
just persevere with the program. It has to have a return as you go along.
But, youve got to establish that this is not a project of the month or a
temporary thing, but this is the way we’re going to run our culture from
now on.
Since the time Franciscan started their Kaizen program, it has spread through
the organization each year, leading to some visible changes in the culture. For
example, four years ago employees tended to regularly voice their frustrations in
a loud and adamant way to administration regularly in various forums around the

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