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, Franciscan’s 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 organization’s 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 difﬁcult 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. You’re 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,
asDague adds, “You have to just keep beating the drum. Sometimes
you may feel like you’re in a stadium all by yourself, but you’ve got to
just persevere with the program. It has to have a return as you go along.
But, you’ve 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
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