KaiNexus CEO and co-founder Greg Jacobson joins host Mark Graban for the fourteenth episode of the Ask Us Anything series, the recurring session built around questions from webinar attendees. The questions this time cluster around the awkward middle stretch of a Lean rollout. Training is done. Some people are bought in, others are not. Leaders want to see results before they commit more resources. Standards are uneven across sites. The work to be done in that middle stretch is not flashy, and it is where most programs either build momentum or quietly stall.
Here is what the episode covers and the thinking behind each answer.
Two related questions opened the episode. One asked what to do after initial Kaizen training has been delivered to employees and managers. Another asked about leadership requirements in healthcare. Mark combined them because the short answer is the same. Lead. Engage people. Figure out what it takes to put the training into practice. Knowing the concepts is not the same as practicing them, and the practice is where the value lives.
Greg's point was that the way to start is the way to keep going. Get small wins quickly, day one or day ten thousand. There is nothing magical about it. Find small, low-cost, low-risk opportunities and act on them, and the culture builds from there. Mark added that this takes leadership effort over time, not just one push. Leaders have to believe their employees have ideas, make it safe for those ideas to surface, and help people take action. Don't overcomplicate it. "What frustrates you at work?" is enough to start a conversation. Study the process. Try a small experiment. Keep the early steps simple.
A question asked for proven strategies to get staff to suggest projects. Mark challenged the word "projects" first. Projects are big, team-based, and complex. After training, the more useful starting point is small improvements people can act on within ten feet of where they work. Not every improvement should be a just-do-it, but starting there builds the habit faster than starting with chartered events. Greg made the same point with a personal example. He started engaging emergency department residents in Kaizen by asking, simply, what frustrated them at work. Everyone can think of something from their last shift. If leadership creates an inviting environment, the early problem is rarely getting initial suggestions. The more interesting problem is what to do with the initial flood. In the first month of a new program, ideas come in fast; the curve settles into something steadier after that.
Mark pushed back gently on a phrase that hides inside the question. "How do we get staff to participate?" can carry an implication that the problem is the staff. The more productive question is why they are not participating. He pointed to Bruce Hamilton's advice from GBMP: when a suggestion box system fails, don't blame the workers, look at the system. And he cited Ethan Burris's research in HBR, which found that "futility" is often as common a reason for not speaking up as fear. People do not stay quiet only because they are afraid. They stay quiet because they do not believe anything will change. Both barriers are leadership's responsibility to address.
Greg closed the segment with a useful analogy. He and his wife adopted a rescue dog that had been through a boot camp, and what made the training stick was the six sessions afterward, where the humans learned to handle the dog. Front-line workers are obviously not dogs, but the structural point holds. "How do you get people to do something" is usually answered by changing what the leaders do, not by changing what the people do.
Another attendee asked what tips work when most participants resist the tools that formalize change. How can champions bring the doubters along? Greg's answer had two parts. First, talk in the resistor's language, in the goals that matter to them, in the work they are trying to make easier. Many of the best implementations happen when people do not even realize they are doing improvement science. Second, sometimes some people need to get off the bus. Good to Great makes that case, and Greg acknowledged it sits at the opposite end of the spectrum from the first half of his answer.
Mark argued for patience on the second point. Some organizations that do this well find that perhaps seven percent of an organization may eventually need to exit, but the leader's first obligation is to coach people up the curve. People who look like resistors have often been damaged by the environment they have been working in. Cynicism built up over years can look like resistance to change. Change the environment, give them a chance, and many of them come along. Some have been worn down too far, and a fresh start somewhere else is better for everyone. Leaders also need to ask how they created "dead wood" in the first place. Peter Scholtes's old line was that you hired live trees. The question is what the organization did to them.
The most important reframe came from work Mark had been studying called motivational interviewing. One of its core lessons is that resistance is a normal step in the change process, not a pathology. It comes from doubt, from lack of confidence, from lack of knowledge, from the fact that something has not been tested yet. Once you stop treating resistance as an abnormality, the leadership response shifts. Listen more than you talk. Help people articulate their own motivation. Look for alignment with the organization's purpose. Most of the change happens there.
A question asked what should be included in continuous improvement policies and procedures to assure effectiveness and sustainability. Mark started with policy around leadership behaviors, and what the organizations that do this well make explicit: the expectations of leaders at every level, the daily and weekly practices that go with each role. That kind of clarity is a form of policy whether or not it is labeled as one.
Greg framed it as creating a standard. Picture an organization with three locations all doing improvement differently. When leadership changes at the strongest of the three, suddenly one of the weaker locations cannot draw on the others for help, because the work is not legible across sites. A standard does not mean cookie cutter. It means the people in three locations can sit in on each other's huddles, A3s, or idea boards and within a couple of minutes understand what is happening. Without that, no momentum builds across the organization, and lessons stay trapped where they were learned.
Greg added an observation from KaiNexus implementations. The discovery process at the start often surfaces things customers did not know about themselves. Eight different A3 templates living in eight pockets of the organization, for example. The discomfort of that discovery is part of the value. The methodology of doing an A3 is what matters; the precise layout of the template is a secondary concern. Picking one and standardizing is usually a clearer win than people expect.
A nonprofit attendee asked how to learn Lean when the organization does not have the budget for training and certification. Mark recommended books as the cheapest, deepest investment available, with Imai's "Kaizen" as a particular starting point. Greg first encountered Kaizen by reading Imai's book on his own, with no expert at his side, and he noted that used copies sell for a few dollars on Amazon. Mark added his own books, "Lean Hospitals" and "Healthcare Kaizen," along with Karen Martin's free content at ksmartin.com and the affordable training library at Gemba Academy. The KaiNexus blog publishes several posts a week, and there is a substantial archive of free webinars to draw on. There is no shortage of high-quality material on the open internet. The harder discipline is reading enough of it to know which of it to trust, which is where well-grounded books like "The Toyota Way" or "Gemba Kaizen" come in as a baseline to compare new ideas against.
The last question came from an ER physician, Don, asking how to demonstrate the benefit of process improvement and KaiNexus to hospital administrators in a way they will actually hear. Greg took it as a question about selling up. No hospital is uninterested in better ED flow. So make sure everyone can see the current state of flow, then show the change. Door-to-doctor time, door-to-disposition, disposition-to-departure. As those numbers move, leaders ask how. The answer is the story behind them. We engaged a hundred staff, implemented several hundred improvements directly related to flow over a year, and here are the handful nobody expected to matter that actually moved the dial. Most leaders respond to outcomes first and ask about methodology second. Don't lead with the methodology.
Mark added the pilot path for organizations that do not yet have budget for an enterprise rollout. Run a small test of change, do it well enough to produce noticeable results, and let those results carry the case for scaling. Sometimes the spark works, and senior leaders ask to learn more about the approach. Sometimes it does not catch, and the next round needs a different strategy. Most KaiNexus customers start at smaller scale — a hundred people, twenty, three hundred, some share of the whole organization — and the platform is designed to surface impact clearly enough that the scale-up case writes itself. Few organizations come to continuous improvement because someone told them about the principles. Most come because they saw another organization doing something well and worked backward.
Ask Us Anything is a recurring series of short sessions answering questions from KaiNexus webinar attendees. It is hosted by Mark Graban, VP of Improvement and Innovation Services at KaiNexus, with Greg Jacobson, the company's CEO and co-founder.
See every episode in the series on the Ask Us Anything main page. Earlier episodes are also available on the KaiNexus YouTube channel and in the KaiNexus podcast archive.
See KaiNexus in action and see how KaiNexus helps organizations capture ideas, coach improvement, and connect daily work to strategy.
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