Monthly Archives: January 2012

December 9, 2014

Transform yourself into a change leader

by Lean Fox

For the past few decades I’ve been consulting with hospitals, clinics and physician practices to improve the patient experience. During this time period I’ve seen many projects succeed and unfortunately a few projects fall short of their projected goals. Those initiatives that lose steam or derail usually have poor leadership engagement. So here are my tips to help individuals overseeing any change management or continuous improvement project move beyond the tasks of management and be effective leaders.

First, one must acknowledge the difference between leadership and management. John Kotter explains that management is a set of well-known processes, like planning, budgeting and problem-solving. This is a complex task, but it’s not leadership. Leadership is associated with taking an organization into the future. Leadership is about vision, about people buying in, about empowerment and, most of all, about producing and sustaining change!

So let’s start with vision. The changing landscape of healthcare requires thinking differently so:

  • Be creative in your problem solving methods
  • Seek new knowledge
  • Question everything by asking why
  • Look beyond the traditional metrics of today
  • Identify what is over-valued and under-valued at your organization


But how do you get people to buy in? You must be open to what the individual and team requires. At times you will lead from the front, from within, and from the rear. One leads from the front by establishing the vision for the team and providing direction to the team to accomplish project tasks. Then, during the team’s execution of the task or project, it is important to lead from inside by monitoring  the effort. Listen, watch, and assess to help the team make timely and effective course corrections when necessary.  Finally, lead from the rear by allowing strong members of the team to exhibit their own leadership skills while taking time to work with those individuals who may be struggling as team members. Performing leadership from each of these positions will enhance trust in the leader.

Albert Einstein observed, “The significant problems we face cannot be solved at the same level of thinking we were at when we created them.” If you’re a manager eager to transform yourself into a change leader, continuously challenge yourself to think differently and be flexible to the needs of your team so you can adjust what type of leadership the situation calls. Best of luck on your journey!

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October 30, 2013

How Lean changed my perspective on work: blog by RPN, Jolene Hathaway

by Lean Fox

With upcoming changes to the physical layout at Chatham-Kent Health Alliance Women’s & Children’s Unit , there was a need to streamline product/supplies and maximizing the use of space. Mr. Sperl lead the unit-based team through a 5S project that included a one-day walk through and 3-day event to Sort, Straighten, Shine, and Standardize.  Our guest blogger talks about her experience and eagerness for the last S, “Sustain.”

Jolene Hathaway headshot
Blog written by Jolene Hathaway, Registered Practical Nurse, Women & Children’s Health Chatham Kent Health Alliance

What I liked and learned:

I loved the process of cleaning and filter product that were expired, or not needed to be stocked on our shelves due to lack of use. Some items had great expiry dates and some items haven’t been used in years. This process was amazing to witness. It’s incredible the amount of product that was taking up space on our shelves.

What I have done since:

I have tried to educate fellow staff in what “Lean” is all about. I’ve also tried to educate them on the importance of keeping up with the Lean project in the future. I’ve explained that this is a team effort and the more we keep up on the Lean project the more tidy and neat our floor will be and we will continue to save money.

How has the Lean changed my perspective on work:

I’ve realized how much staff and I look past items that become “just another picture on the wall”. After being in the same place day after day, clutter, pictures, charts, etc no longer stand out. We forget they are there. We could have had posters expired from 5 years ago and no one ever notices until a new eye comes along. It’s funny how our brains work.  I was amazed at the amount of waste and unnecessary wall space that was taken up, as well as the distractive clutter in many places.

If I could change one thing, I would recommend a short explanation of the lean program to the fellow staff members. This project was sometimes bashed or not taken well by other employees. I did try my hardest to explain the process with the pros and benefits of the program. Although I feel a short power point with before and after photos’ or some sort of teaching to the other staff members would have benefited others to join in on the Lean program.  I think once others are properly educated on what “Lean” is all about and the greatness of it, then the change would be accepted more.

This Lean product has been a wonderful experience for me and I am so glad to be a part of Lean5S.

Download the case study that includes pictures from the project


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October 22, 2013

Practical Lean Management Workshop on Nov. 7th

by Lean Fox

Join us in Novi, MI on November 7th for a dynamic, action-oriented Practical Lean Management for Healthcare Workshop led by instructors who have implemented Lean in over 25 healthcare facilities. You will leave with a clear understanding of key process improvement tools to navigate the Affordable Care Act and EMR demands for lower costs and improved patient and administrative work flow.

Learn more and register

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July 29, 2013

A great celebration of our new Book!

by Lean Fox

We were thrilled to see many of our friends and colleagues join us on July 18th at the Garden City Hospital lobby to celebrate the publication of Practical Lean Six Sigma for Healthcare-Using the A3 and Lean Thinking to Improve Operational Performance in Hospitals, Clinics and Physician Group Practices.

Garden City Hospital President/CEO Gary Ley introduced the authors and spoke highly of the process improvement work that Todd Sperl has facilitated in the emergency room and surgery department. Todd thanked Mr. Ley for opening up Garden City Hospital to host the event. Todd acknowledged his wife and Lean Fox Solutions business partner Andrea Sperl for her support, art direction and event planning. He thanked co-authors-Rob Ptacek for his attention to detail, co-author and business partner Jayant (Jay) Trewn for his calming influence and publisher Don Tapping from MCS Media/TheLeanStore for all the time they spent working on the book in Chelsea, MI.

Todd explained how he wished he had a book like this when he started his Lean journey in healthcare about ten years ago because it brings everything together to introduce change management philosophy by bridging the gap between the technical Six Sigma and Lean which focuses on removing waste in processes. What sets this book apart is the idea of project management/walking through a process and examples from hospitals, physician offices and clinics. He explained that the book was designed as a convenient, quick reference, and, most importantly, a step-by-step implementation guide. Authors Todd Sperl and Jayant (Jay) Trewn were in attendance signing books. Rob Ptacek was unable to attend.

Everyone enjoyed the Hors d’oevres, fruit and cookies compliments of Lean Fox Solutions-a value added provider of Lean and Change Management experts. Names were drawn throughout the event for Lean Fox Solutions hats, Max’s Granola (, and an Eastern Market Walking & Tasting Tour ( Wayne Mattern, Director Surgical Services won the raffle for golfing with the authors at the Garden City Hospital outing. Gifts for all those in attendance included The A3 Pocket Handbook for Kaizen Events ( and LiveSmart All Natural Energy Bars .

Many thanks to our friends and Lean advocates from St. John Health, Garden City Hospital, Oculys Health Informatics, Canterbury-on-the-Lake, Integrations, ROI Strategic Business Solutions, Blue Cross Blue Shield of Michigan and Davita who came out despite the heat to celebrate with us! For pictures of the event, visit the Lean Fox Solutions Facebook page.

How to purchase the book
The book is available in spiral bound and Kindle format at and for bulk orders, contact The Lean Store at 734-475-4301. If you are interested in a free one-hour Lean seminar at your organization, contact or call 248-417-2349.

poster rev

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July 1, 2013

New handbook on process improvement for healthcare offers tools for navigating Affordable Care Act demands

by Lean Fox

Chelsea, Mich.- July 1, 2013 – Three Lean experts are offering healthcare professionals across the nation a helpful guide to process improvement under healthcare reform.  Their book,  Practical Lean Six Sigma for Healthcare: Using the A3 and Lean Thinking to Improve Operational Performance in Hospitals, Clinics and Physician Group Practices, offers tools and outlines the steps necessary to reduce waste and improve efficiencies in healthcare companies.

According to authors Todd Sperl, Rob Ptacek and Jayant Trewn, “If you build a culture of continuous improvement, your health organization will adapt better to change and uncertainty.”

With the Affordable Care Act, payment structures are changing, and more people will have access to health coverage.  Physicians and healthcare organizations will need to adapt to higher demand and new reimbursement models.  Sperl says, “the successful implementation of Lean Thinking and Six Sigma will help provide quality care for more patients with no or minimal staff increases, because it reduces waste and variation in all types of healthcare processes.”

Ptacek says, “This is the first book that provides a common sense approach to problem solving in healthcare by bridging the gap between a highly quantitative analysis of the Six Sigma process that requires extensive training, and Lean Thinking-a more simplified approach to continuous improvement.” Trewn adds, “This book was written so that no matter where you are in your process improvement journey, it can assist in your efforts to improve the patient care experience.”

The Affordable Care Act is estimated to extend coverage to 16 million more people by 2014 reports  And according to , on average Medicaid only reimburses doctors 56% of the market rate for medical procedures.  Dr. Ernest Yoder, Dean College of Medicine, Central Michigan University, says the book is, “ a must-have for healthcare professionals seeking a useful, clear-cut handbook for process improvement methods and tools, complete with case studies and examples.”

Published by MCS Media, Inc., the book is now available at and for $17.95.

About the Authors

Todd Sperl, MS, is owner and managing partner of Lean Fox Solutions, a value added provider of Lean and change management experts that help healthcare organizations improve the patient experience while providing a positive return on investment. Todd is adjunct instructor of Healthcare Management at Oakland University.

Rob Ptacek, MM, is president and CEO of Competitive Edge Training and Consulting, a firm specializing in leader and organizational development and Lean Enterprise transformations. Rob is an adjunct instructor of Management Principles, Total Quality Management (TQM), and Lean Champion Certification.

Jayant Trewn, PhD, is a Lean coach and advisor at Lean Fox Solutions and adjunct professor of Quality Engineering at Lawrence Tech University. He has over a decade of experience building healthcare & service delivery process improvement programs based on Lean, Six Sigma and PDCA concepts.

Practical Lean Six Sigma for Healthcare-back of book

Practical Lean Six Sigma for Healthcare

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January 18, 2013

Value Stream Mapping for Healthcare available as an Apple iBook

by Lean Fox

Value Stream Mapping for Healthcare by Todd Sperl and Rob Ptacek is now available for download on your iPad with iBooks or on your computer with iTunes.

Learn the basic five steps to creating a value stream map, as well as when and where to use a value stream or process map, and when a hybrid approach might be used. The examples detailed in this book will provide that context. No two value stream or process maps are the same. The five steps will assist you in determining what type of map would most likely be of value given your requirements and needs.

It can be purchased for $9.99 at this link:

Value Stream Mapping for healthcare itunes

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December 6, 2012

The First Lean Healthcare App is Now Available in Apple’s App Store

by Lean Fox

Chelsea, Michigan-December 6, 2012-The first iPad app for Lean Healthcare has now been released in Apple’s App Store. “Practical Lean for Healthcare” is the brainchild of Todd Sperl and Don Tapping, two Lean experts who previously collaborated on Lean healthcare books. The app was created to help front-line associates, quality managers, service line directors and C-Level Executives understand the principles and tools of Lean Management for Healthcare. These highly successful tools of Lean will assist healthcare organizations with improving the patient care experience and the main performance indicators of financial, regulatory, patient safety and quality, and resources (capital and people).

According to Don Tapping, MCS Media owner and Lean author, “The amount of information out there on Lean in healthcare can be overwhelming so our goal was to create the best information and deliver it in a compelling format through the use of video, audio and case studies.  This first app is an introduction to Lean.  Lean and its problem solving counterpart, Six Sigma, offer the healthcare community the opportunity to obtain long term, sustainable results, which is why, we plan to release additional apps in the Practical Lean Sensei for Healthcare series.”

Todd Sperl, owner of Lean Fox Solutions and Lean Healthcare lecturer says, “I find when my clients and students hear about real-life examples, they get really motivated to be a change-agent in their own organization. I am excited to deliver, concise, actionable information in an app format.  I’m constantly looking for ways to use to technology to enhance our lives, which is why the Lean Healthcare Assessment was such an important element to include in this app. By applying your customized Assessment results to the Improvement Guide, users can begin their journey of introducing Lean at their hospital, clinic or physician group practice.”

About MCS Media, Inc.
MCS Media, Inc. is a publishing company based in Chelsea Michigan founded by Lean expert and best-selling author, Don Tapping. MCS Media is the parent company of The Lean Store which offers books written by Don and his colleagues as well as Lean Six Sigma Implementation Aids and Workshops. For more information, visit
About Lean Fox Solutions
Based in Huntington Woods, Lean Fox Solutions is a value added provider of Lean and Change Management experts that help healthcare organizations improve the patient experience across the continuum of care, while providing a positive return on investment. The organization was founded by Todd Sperl in 2008. For more information, visit

App Details
Preview at:
Price: $3.99
Requirements: Compatible with iPad. Requires iOS 5.0 or later.
Categories: Business and Medical

Press contact:
Andrea Sperl
Lean Fox Solutions
Cell: 248-417-2349


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January 17, 2012

5-S with Lean Fox at Chatham-Kent Health Alliance

by Lean Fox

Recently I was on site at Chatham-Kent Health Alliance in Ontario, Canada to facilitate a 5-S project in the Surgical Services area.  The 5-S process or Sort, Straighten, Sweep, Standardize and Sustain is a tool from the Lean Six Sigma Methodology.  This video demonstrates how the 5-S process helped Chatham-Kent create three additional bays for patient care and save money by pinpointing excess supply and streamlining ordering strategies.   This is a great example of a successful implementation because of passionate staff who were involved in the process of change which starts with the support and enthusiasm from key leadership: CFO, Sarah Padfield; Program Director, Eleanor Groh; and OR Manager, Janice Wilmott.   

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October 20, 2011

The Value of Understanding Your Process

by Lean Fox

process mapping-swim lane

I am always surprised how much you can learn by mapping the work flows you manage. Over the past several weeks I have been spending time with various Healthcare Leaders mapping their processes as they prepare to introduce an electronic medical record (EMR) to their organization. For this engagement we decided to map the patient experience using swim lane maps. A swim lane map or diagram is a good tool to map a process flow and identify potential problem areas that need to be corrected.

A map of your process can be useful in several ways. First, it clarifies each team member’s role and responsibilities, including direct patient interaction and behind-the-scenes activities. This answers questions such as “Who is responsible for walking the patient back to a bed?” or “Who should call patients with their test results?”

Second, it helps reveal problem areas and targets for improvements. This is critical when you are implementing an EMR. To ensure a smooth (well smoother than expected) deployment you need to first understand your current state – warts and all, before moving to the future state. For example, this mapping approach shows visually where hand-offs occur in the process. This is where lack of coordination and communication can cause process problems. When we started documenting the lane changes, I heard, “wait that doesn’t happen during our shift. We do it differently.” Or another response heard often was, “why do you ask those questions again during discharge? We ask those questions when the patient first arrives. We have to ask again, because not all the correct information is being collected at the beginning.” Missed data, wrong data, rework and delays in the process become painfully clear when laid out in a swim lane map.

Our healthcare clients have come to truly appreciate the process of mapping the patient experience using the swim lane. The map is a great change management tool as well. It clearly illustrates that providing patient care is a team effort, thus creating a shared need and vision for change!

If you would like additional information about this approach, please drop me a note.


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June 3, 2011

Innovative ideas in healthcare

by Lean Fox

I recently read an article that idenitifed 5 innovative items from automotive that almost didn’t happen, e.g., seatbelts, airbags, catalytic converters, etc. These are now expected, standard items, but recent history tells us that the industry fought their introduction. What innovative idea will healthcare look back on and think why didn’t we do that sooner?! EMRs? ACOs? Lean Thinking?

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April 6, 2011

MMGMA Spring Conference and Coach Carr

by Lean Fox

Coach Lloyd Carr and Todd SperlAs a consultant it is always good to attend conferences and workshops. They allow me the opportunity to listen and learn, as well as get a pulse on what others are doing to improve the patient experience. At the recent Michigan Medical Group Management Association (MMGMA) Spring Conference along with excellent speakers presenting on relevant and timely topics (e.g., ACO, PCMH, and BCBSM PGIP), the keynote speaker was Coach Lloyd Carr, University of Michigan Football Coach (retired).  

I’ll be honest. When I got the MMGMA email announcing that Coach Carr was the keynote speaker I had mixed emotions. While not a Michigan alum I thought he was a great coach and was excited to hear him speak in person; however, I wondered, “what does Coach Carr know about healthcare?” It turns out a lot!  During his appearance, Coach Carr talked about leadership, tradition, and the pursuit of excellence.

These are topics relevant to any industry whether you’re running a major football program, COO of a hospital or managing a high volume physician practice. Carr told a story of a champion bull rider he met while coaching a bowl game. He asked this young man how are you so successful? The bull rider said, “I remind myself everyday that the bull doesn’t give a damn about what I did yesterday.” I find this story very relevant to healthcare. Care givers need to remember that each patient is different and they could care less about what you did the day before. While the job is the same to you every day, the experience is new to that patient who is counting on your expertise.    

Coach Carr also emphasized that as leaders, you need to communicate your expectations to your team (or staff), your priorities, what you need from them and always let them know how they are doing. Great advice since healthcare workers are always busy and these core items tend to get neglected.

Prior to his talk, as he waited quietly in the back of the room, Coach Carr shook hands with several MMGMA members, me being one of them. Carr looked at my shirt, grinned and said, “Lean Fox…I could use your help to lose weight.” We both chuckled and he moved on to the next person. Maybe he sensed how nervous I was to shake his hand. He could have easily brushed me off, but he went the extra mile to make that brief moment memorable for me (and him). I truly enjoyed getting the chance to meet Lloyd Carr.

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March 6, 2011

Electronic Medical Records & Electronic Health Records

by Lean Fox

Recently I have noticed that many in the media and healthcare industry (myself included) use the terms electronic medical record (EMR) and electronic health record (EHR) interchangeably. However, these terms describe completely different concepts, so what the heck is the difference? Off to Wikipedia we go…no not this time. Don’t worry I’m not going to go all techno geeky on you. All you need to remember is this, an EMR is a more silo’d record of a single diagnosis; while the EHR provides a more comprehensive view of the patient’s health and history by pulling information from several systems or multiple EMRs. EMRs will never reach their full potential without interoperable EHRs in place. It’s important to understand the differences, and to reduce confusion in the market.

Lean thinking can assist you in the selection, implementation, and adoption of an EMR/EHR for physician practice, service line and/or hospital.  Before selecting and deploying an EMR/EHR, you really need to assess the current process flow first to understand how your team works and uses data. Too often we introduce software solutions to get us out of a paper mess and simply end up with an electronic mess that is less flexible. Prior to selecting an EMR/EHR, we recommend that our clients:


  • Map out the current state to identify the waste in the process.
  • Agree on what waste needs to be first.
  • Create a stop, start, continue document that outlines what the team is going to stop doing, what they are going to start doing differently and what will stay the same moving forward.


All of this helps shape the vision for change and prepares the staff, physicians and others for the deployment of an EMR/EHR. Physician practices, service lines and hospitals should only engage a software solution where it adds value. Your organization has specific characteristics and behaviors that make your business unique.  You need to fully understand them before committing to an expensive software system that won’t or can’t adapt to your organization. Here is an interesting story from Fast Co Design on an EHR deployment.


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