We had some webcam problems through our webinar host, unfortunately, so there is no video this time... just the audio.
KaiNexus CEO and co-founder Greg Jacobson joins host Mark Graban for the eleventh episode of the Ask Us Anything series, the recurring session built around questions from webinar attendees. The questions this time hit a few of the most persistent tensions in continuous improvement work. Why do hard-won changes drift back to the old way? Does Lean really require everyone to be in the same room, even when budgets and geography make that impossible? And what is the most effective way to control and reduce costs, especially when traditional cost-cutting tends to undercut the very engagement an organization needs?
Here is what the episode covers and the thinking behind each answer.
An attendee asked for inventive ways for senior management to make their support for continuous improvement visible. Mark started by raising the bar on the word "support." He hears leaders say they support improvement constantly, and his question back is always what that means in practice. A one-time statement is not support. Support is leaders going to where the work happens, listening to people on the front lines about what they are struggling with, hearing their ideas, and acting as servant leaders rather than answer-givers. Those behaviors are not inventive; they are foundational.
Greg's inventive angle came from Jim Collins's "Good to Great." Set a BHAG, a big hairy audacious goal, that is not stale or boring or purely financial, and that, if achieved, would actually move the organization forward. He shared the KaiNexus example for that year. At the start of the year there were just over 12,000 improvements completed across the customer base since the platform's first release. The BHAG was to reach 25,000 by year-end. They hit just over 26,000. Greg had committed that if they cleared the goal he would let the company shave his head, and so they did. The point is not the head shave. It is that a goal with stakes attached, public, specific, and big enough to feel real, pulls leadership attention onto the work in a way that an abstract statement of support never does.
A long-standing question came up: how do you sustain improvement activities and prevent slipping back to old habits? Mark has heard this in healthcare for more than a decade, and he challenged the framing. What gets called backsliding is often a change that was never fully adopted in the first place. That is one of the weaknesses of the rapid improvement event model. The event team designs a new process, tests it during the week, and hands it over the wall to the people who do the work every day, who were not involved in developing it and were not trained in it. The event team returns 30 or 60 days later, sees the old behavior, and calls it backsliding. Sometimes the more accurate description is that the change never landed.
The lesson is to stop blaming people. Ask why the change either was not adopted in the first place or reverted. Greg agreed, and added that even where the change did stick, sustaining it is hard work. If continuous improvement were easy, every organization would already be doing it well. He named the strongest hedge against drift in one line: lead with why, and include everyone. Do those two things and you can do everything else less well and still backslide less.
An attendee named Margo wrote in after a one-week Lean certification course where she was told repeatedly that quality improvement must be done with everyone from the team in the room, with no exceptions. Her teams had been improving successfully through virtual collaboration and were told that was not Lean. With government cutbacks on travel and staffing, she did not have the resources to bring everyone in physically, and now some team members were refusing to participate unless they could travel. What did the hosts think about virtual improvement teams?
Mark started with a guardrail against absolutes. "Always" and "never" usually betray weak thinking, including inside the Lean community. When he worked in manufacturing, large kaizens could plan a planned line shutdown and bring everyone together with inventory to buffer the downtime. Healthcare cannot do that. Patients keep arriving. You have to be creative, pull some people away to work on something for a stretch while gathering input from as many others as you can. "Include everyone" does not require physical co-location. It requires that people contribute and feel heard, which can happen in many ways.
Greg's pushback was sharper. Nothing in his reading or in any serious Lean leader's writing requires every person to participate in person, every time. Telling distributed, complex organizations they are not doing Lean unless they bring everyone into one room creates an artificial barrier that produces only one outcome: they will not improve, because the barrier is impossible to meet. Even within KaiNexus's customer base at the time, dozens of organizations were running some of the strongest Lean management systems in the industry, connecting in huddles, face to face, and asynchronously through the platform, often all in the same week. There is no possible way to convene every single person who touches a process for an event. The question is how to design participation, not whether to demand presence.
Mark closed the segment back at balance. The other extreme, letting two people dictate standard work for a 50-person department, is also wrong. You get representatives, take a first pass, test it, and gather five minutes of input from each person on the team. Include everyone, respect everyone, get input from everyone, without requiring full dedication from everyone.
Greg added two more reasons against the everyone-in-the-room rule. First, the best place to discover waste and identify improvement is the gemba, while the work is happening. Why delay the improvement cycle waiting for a calendar to align when the observation is right there? Second, improvement happens through countless small interactions, and culture is built in them. He used the Spurs as the analogy. The system is not Coach Popovich constantly talking. It is senior players talking to junior players, even players running timeouts. Improvement disseminates the same way, fluid, distributed, anyone coaching anyone, more like catchball than a formal meeting structure.
An attendee asked about effective cost control and cost reduction mechanisms. Mark separated Lean and Kaizen from traditional cost-cutting deliberately. In healthcare especially, "cost-cutting" has usually meant reducing labor, and when people are already stretched, that route damages quality, morale, and patient safety. The Lean playbook is different. Ask employees for their ideas, not just on cost reduction but on making their work easier and serving customers better, and commit not to lay people off in the name of cost reduction. Done this way, improvement produces cost reduction without breaking the people doing the work. It also tends to surface revenue ideas, which often address financial problems more effectively than cuts.
Greg's contribution was a frame he uses with customers. Lean takes waste out of a system, and as that happens, quality improves and cost falls together, which only feels counterintuitive until you understand what value means. The more practical question is when to ask for cost-saving ideas and when not to. If the very first thing an organization says to frontline staff is "give us cost-cutting ideas," engagement collapses. Lead instead with "tell me what frustrates you, and let's start solving those problems." Engagement runs much higher, and cost impact follows on its own. Across the KaiNexus customer base he cited a useful pattern: roughly one and a half percent of all completed improvements are worth more than $10,000, and about half a percent are worth more than $100,000. Those large-impact improvements are not the result of asking for them. They come out of a healthy improvement program because somebody saw a problem worth solving.
Mark gave the rule a name. The book "Obliquity" by John Kay argues that complex goals are often best reached indirectly, and cost reduction is a textbook case. You usually get more of it by not chasing it. He added the necessary exception, drawn from a story in "Healthcare Kaizen." A hospital CEO in Indiana who had already built trust, a no-layoff commitment, and a strong improvement culture stood up in front of the organization and said, in effect, we have to reduce costs by seven million dollars this year, we are all going to pull together, and we are going to improve quality at the same time. They hit the goal. He shaved his head. The lesson is not that head-shaving is required. It is that an organization with that level of trust can ask directly for what would have failed if asked at the start, before the trust existed.
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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