The most common reason organizations give for not improving more is also the least examined: we don't have time. In this session, Mark Graban and Greg Jacobson, MD, push back on that assumption directly. The honest version of "I don't have time" is almost always "I'm choosing not to make time for this" -- and once you frame it that way, the conversation changes.
Mark and Greg work through why the busyness trap exists, how leaders break it, and how habit science explains why some organizations build improvement into daily work while others keep treating it as a special project that never quite happens.
Every survey response Mark has ever collected after a workshop or webinar lists the same barrier to improvement: time. Staff don't have time. Managers don't have time. We don't have time to do this.
The trap underneath that response looks like this. We're too busy to improve. Because we don't improve, waste and frustration accumulate. That makes us busier. Repeat.
The organizations that escape the trap don't start with extra time on their hands. None of the great continuous improvement organizations began with an empty hour blocked off every day. They started by recognizing that some portion of their busyness was waste, and that working on that waste was an investment that paid back in time -- not a withdrawal from a fixed account.
That reframe matters. Improvement work isn't an expense. It's an investment that compounds, and the early returns fund the next round.
When improvement isn't happening, leaders need to know which version of the problem they're dealing with.
Can't means people don't know how. They haven't been trained, coached, or supported. They don't feel confident running a small experiment, so they avoid it. The fix is teaching and coaching.
Don't means people know how but aren't doing it. The cue isn't there, the routine feels heavy, or the reward never shows up. The fix is making the practice easier and more visible.
Won't means there's an active choice not to participate -- usually rooted in a belief like "my employees don't have ideas worth spending time on." This is rarer, and it's a leadership behavior issue almost every time.
All three are addressable. Each requires a different leadership response. Lumping them together as "they don't have time" hides what's actually going on.
A common question from leaders trying to start: how much time per week, realistically?
Greg and Mark land on a low number. A 15-minute daily huddle is enough to get going. The huddle itself isn't where deep problem-solving or implementation happens -- it's a cue. Maybe another 15 to 30 minutes a day across the team for the actual improvement work, especially in the early weeks.
Mark tells the story of asking a manager at Franciscan St. Francis Health in Indianapolis -- an endoscopy unit running hundreds of frontline kaizens a year -- how much time her team spent on improvement. Her answer was essentially: how much time do you spend breathing? Once it's habitual, the question stops making sense. But getting there requires a deliberate starting point: 15 minutes, every day, with a real cue and a real routine.
The same manager described carving out time during staff meetings that already existed and running short "kaizen blitzes" over lunch -- not the week-long event version, just 30 minutes where people surfaced ideas they'd been carrying around in their heads. Small, repeated, low-friction.
A different lens from a tour at Toyota's San Antonio plant. A frontline worker fielded the question every visitor eventually asks: you talk about kaizen, but everyone's busy building trucks -- when do you actually do it?
Her answer: if she had an idea and there was no time during the shift, she'd talk to her supervisor, who would generally approve overtime to stay and work on it.
That answer cuts hard against the reflex in most healthcare and service environments, which is to send people home the moment the workload dips and treat overtime as the enemy. Toyota's calculation is different. The overtime is cheap relative to the value of the improvement, and refusing to fund improvement work guarantees the cycle keeps repeating. If your CI program is already in KaiNexus, the ROI math on this is straightforward -- the impact of improvements is tracked, and "should we approve 30 minutes of overtime to implement this?" stops being a debate.
Mark and Greg lean on Charles Duhigg's The Power of Habit to explain what's happening when continuous improvement starts to stick. Every habit has three parts: a cue, a routine, and a reward. Strip out any one of them and the habit doesn't form.
For improvement work, the daily huddle is the cue. The routine is small enough not to overwhelm -- surface a problem, log an idea, work on something already in progress. The reward is the visible result: walking into work and seeing the change you suggested actually in place. That's an intrinsic reward and it's faster, cheaper, and more durable than any external recognition program.
This is why suggestion box systems fail. The cycle is too slow. You drop an idea in, hear nothing for weeks, and the habit never forms because the reward never arrives. Greg's point: it's not that suggestion boxes are bad in concept, it's that the feedback loop is broken. Whatever replaces them -- digital or otherwise -- has to close that loop fast.
It's also why some teams report "huddles aren't helpful" and quit. If nothing improves as a result of the huddle, there's no reward, the loop breaks, and the team is right to abandon the practice. The fix isn't to enforce attendance. The fix is to make the huddle actually produce improvements.
A practical wrinkle Greg and Mark talk through: daily huddles aren't always the right cadence. One hospital they reference moved from daily to three times a week because they didn't have enough progress between huddles to make daily check-ins meaningful. That's the right kind of adjustment -- match the cadence to the actual rhythm of the work, then protect the time you've committed to.
Greg makes a physics point that's worth keeping. Starting continuous improvement is harder than continuing it. Static friction is always greater than kinetic friction. The first week, the first month, the first six weeks take significantly more energy than year three of a mature program.
This explains a pattern leaders see and misread constantly. Early effort feels disproportionate to early results, so leaders conclude the program isn't working and pull back -- right before the kinetic phase would have kicked in. The right response is the opposite: protect the practice through the static phase, knowing the energy required will drop once the box starts moving.
A few specific moves that came up in the conversation. None of them require a budget.
No-meeting zones. ThedaCare protected 8-10 a.m. every day as a zone with no formal scheduled conference room meetings. That time goes to gemba walks, huddle boards, and improvement work. The cue is the time on the calendar. The routine is improvement. The reward is visible progress.
A goal that names the time. Dr. Marwan AlBakri at Henry Ford set an explicit target with his team: 20 minutes a day for improvement, and nobody gets criticized for taking that time. The number isn't sacred. The act of naming it is.
A running list of opportunities for improvement. When 20 minutes opens up unexpectedly, you don't want to spend 18 of them deciding what to work on. Mature KaiNexus customers maintain an active list of OFIs so any pocket of time can be put to use immediately.
Use slow seasons deliberately. A hospital lab Mark works with is slammed with virology testing in winter. They accumulate ideas during the busy season and implement them during the slower months -- which then makes the next peak season less stressful. Not ideal, but better than not improving.
Audit your meetings. If a meeting is one-way communication, it's a memo. If you're attending without contributing, send a delegate or read the notes. Challenge the default 60-minute meeting block -- most should be 30 or 15.
Personal time management. Greg recommends "The Secret Weapon" video series for combining Getting Things Done principles with task management and inbox zero. The point isn't the specific system; it's that personal time discipline frees capacity for the important-but-not-urgent work, which is where improvement lives. Stephen Covey's distinction between urgent and important is the right framing.
Switching from logic to emotion changes what people are willing to make time for. Switch by Chip and Dan Heath calls this painting the postcard -- describing what a better future actually looks like in concrete terms. A workday with less frustration. Going home on time. Patients not waiting. A team that gets credit when an idea works.
Most CI sales pitches inside organizations skip this step and lead straight to methodology. People don't make time for methodology. They make time for outcomes that matter to them.
A question that came up during Q&A and is worth its own section: what do you do when frontline staff are eager but leadership won't support the time?
Two paths. The first is to demonstrate before asking. Find pockets of available time -- the 10 minutes at the start of a shift, the lull after the morning rush -- and implement small improvements that prove the model. Then bring measurable results back to leadership and make the case for protected time. Static friction is real; sometimes you have to break it from below.
The second is to reframe the conversation in terms leadership cares about. Not "we want to do more lean" but "we have a strategic priority that currently has 10 people working on it. We have 5,000 people who could be contributing to it." That's a different conversation. The KaiNexus webinar on the ROI of continuous improvement walks through how to build that case in detail.
A few specific things the platform does that matter for this topic. KaiNexus gives leaders visibility into where improvement is happening and where it's stalled, so the question of whether the time is being used well stops being a guess. It tracks impact in financial and non-financial terms, which makes the case for protected improvement time concrete instead of theoretical. It maintains the active list of opportunities for improvement that lets teams put unexpected pockets of time to immediate use. And it spreads improvements across departments and facilities, so the time invested at one site pays off across the organization.
If your improvement program is generating ideas but losing them, or generating results but failing to make those results visible, that's the problem the platform is built to solve.
Mark Graban is Senior Advisor at KaiNexus and a recognized voice in Lean management and continuous improvement. He is the author of Lean Hospitals, Healthcare Kaizen, and The Mistakes That Make Us, and host of the Lean Blog Interviews podcast. He has worked with healthcare systems, manufacturers, and service organizations to build cultures grounded in respect for people, scientific problem solving, and learning from mistakes.
Greg Jacobson, MD is co-founder and CEO of KaiNexus and a practicing emergency physician. After being introduced to kaizen principles early in his medical career, Greg founded KaiNexus to help organizations scale continuous improvement, increase visibility, and make improvement part of daily work rather than an occasional initiative.
Why do organizations say they don't have time for continuous improvement?
The honest version is usually that they're choosing not to prioritize it. Time isn't typically the constraint -- priority is. The cycle reinforces itself because not improving creates more waste, which creates more busyness, which feels like even less time. The teams that escape the cycle treat improvement as an investment that pays back in reclaimed time, not as overhead.
How much time per day or per week is needed to start a continuous improvement program?
A 15-minute daily huddle plus 15 to 30 minutes for actual improvement work across the team is enough to get traction in the first weeks. The early effort feels disproportionate because static friction is higher than kinetic friction -- starting takes more energy than continuing. After the first six to eight weeks, the time required drops sharply.
How do you make continuous improvement a habit rather than a special project?
Build the habit loop deliberately. The cue is a recurring time on the calendar -- typically a daily huddle or a no-meeting zone. The routine is small and low-friction enough to do consistently. The reward is fast and visible -- the change you suggested is actually in place. Slow feedback breaks the loop, which is why suggestion boxes generally fail and why daily cycles outperform monthly ones.
Why do daily huddles fail in some organizations?
Almost always because nothing actually improves between huddles. The cue and the routine are present, but the reward isn't. The fix isn't to enforce attendance; it's to make the huddle produce visible improvements so the loop closes and the habit can form. If progress between huddles is too thin to support a daily cadence, dropping to three times a week is a reasonable adjustment.
What can frontline staff do if leadership won't protect time for improvement?
Demonstrate before asking. Find small pockets of available time, run a few small improvements, and bring measurable results back to leadership. Then make the case in terms of strategic outcomes leadership already cares about, not in terms of methodology. The KaiNexus webinar on the ROI of continuous improvement covers the framing in more detail.
How does Toyota think about overtime for improvement work?
Differently from most healthcare and service environments. At Toyota's San Antonio plant, supervisors generally approve overtime when an employee has an improvement idea and no time to implement it during the shift. The reasoning is that the cost of overtime is small relative to the value of the improvement, and refusing to fund improvement guarantees the busyness cycle continues.
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