In Their Natural Environment
I scheduled a meeting this week and a room for our meeting. During the course of our conversation, we began to discuss process and other items related to the their work. Gratefully, I had enough awareness to stop the conversation and we, as a team, walked out to the Gemba and continued our discussion there.
Staring at Acoustic Ceiling Tiles

There is a Design Thinking opportunity to Emergency Room care. In my previous post, I discussed the time involved in waiting to receive care -queueing properties of ER care. What I didn’t discuss is the feeling and experience of the patient during care. That’s the topic for this post today.
Emergency Room (ER) Wait Times
The Emergency Room plays a vital role in patient care and plays an important role in communities and society. According to the CDC, there were 119.2 million visits to the Emergency Room in 2007 1. Indeed, the demand for emergency room care is great.
Lean Thinking and the Amazon Kindle
I receive emails from recruiters – frequently. So, as a favor to them, I am posting a job for your interest: the hiring company is Amazon.com.
Below is one job description and contact information, but if you go to the Amazon.com website, there are over 50 open positions looking for people with experience in Lean Thinking and Six Sigma.
Kanban Family Job Chart
I’ve tried this a few times, but I think this time, with the help of the kids and my sweet wife, we’ve got it right for our family.
The Opportunity
We have a big family – we’ve adopted a bunch and we’re very thankful for our chance to be parents. We’ve got great kids.
Extraordinary Response
Often, our best moments are during times of trial. Indeed, what we remember most and what is most inspiring are not the scores of naysayers that exclaim “it’s dark, it’s dark” to describe the gloom that is all around us, but the humble, smug, and steady person that lights a candle so that others can see.
Complacency, Urgency, and Change
John Kotter makes a good case that urgency is the key ingredient in any organizational transformation. Conversely, the lower the urgency, the higher the likelihood that the firm will collapse or fail or not transform in a way that will enable it to win in a changing marketplace. Kotter does something else that is interesting: he defines True Sense of Urgency, Complacency, and False Sense of Urgency. This was very instructive.
Shining Metal Pointing Direction
Hoshin Kanri is a management tool used at Toyota to align business strategy and mobilize the entire organization toward the business strategy. Hoshin Kanri means “Shining Metal, Pointing Direction” or “Directional Needle”. In other words, Hoshin Kanri is a North Star or a Compass.
Homogeneous Innovation
Things are all too familiar. That’s good and bad.
It’s good if the service or product meets my basic needs and is memory-neutral: that is, the interaction results in neither good memory or bad memory. It just is and I don’t care.
It’s not good if I come away from the experience thinking “I could have received that same service or product at 50 other places, with no material difference.”
Dichotomous Thinking at IDEO No More
Recently, Tim Brown, the CEO at IDEO came to a realization that Design Thinking can coexist with Six Sigma and Lean. For a while, his stance was really of black-and-white thinking: it’s either Design Thinking or Lean Thinking. This position is akin to a student who believes that if he doesn’t earn an “A” in a class, he believes he failed. Clearly, not healthy.

