KaiNexus CEO and co-founder Greg Jacobson joins host Mark Graban for the nineteenth episode of the Ask Us Anything series, the recurring session built around questions from webinar attendees. The questions in this batch sit close to each other in a useful way. What does leadership actually have to do, day in and day out, to make a continuous improvement culture stick? What do you do when ideas pile up in a backlog and never get worked? And what about the methods that seem like they should help, public scoreboards, walls of shame, individual rankings, that quietly produce the opposite of the result they were meant to drive?
Here is what the episode covers and the thinking behind each answer.
An attendee named Mark asked a clean question: so much is written about Lean and Six Sigma tools, but if changing to a continuous improvement culture starts with leadership, what actions and behaviors do leaders at the top and the middle have to take alongside the systems and tools? Mark Graban opened with the Toyota frame, where leaders talk in terms of technical methods, managerial methods, philosophy, and culture, and named the one behavior he would pick first: leading by example. Toyota leaders inherit a culture that runs on this. Leaders attempting a transformation usually inherit decades of habits that run on the opposite. So culture change has to start at the top, and modeling cascades from there. Two specific behaviors are non-negotiable. Stop blaming individuals for systemic problems, because without psychological safety nobody surfaces what is actually going wrong. Stop jumping to solutions, because the ironic move that produces an improvement culture is sometimes spending more time understanding the problem before acting.
Greg's contribution was a long-arc observation. The worst thing a leader can do is bring continuous improvement up once and never return to it. Leaders have to keep talking about it, in town halls, in face-to-face meetings, in email, in whatever channel runs the organization. They also have to communicate why this is happening, what the organization hopes to accomplish, before staff will engage. And then comes the hard part, the part that takes twelve to twenty-four months for many leaders to feel comfortable with. They have to walk in with open ears, closed mouths, humility, and visible respect for the people doing the work. That posture feels vulnerable. It is read by the people who matter as strength.
Mark added the structural piece. The tools, Kanban, TPM, 5S, all of them, are countermeasures to specific organizational problems. Lean itself is a countermeasure to a business problem. When someone says "our goal this year is to implement Lean," the right next question is "in service of what?" That problem-to-countermeasure connection is itself a leadership behavior, because it models how the rest of the organization should be thinking. The word countermeasure also matters, because "solution" sounds definitive in a way that improvement rarely is. Greg used the medical version of the same point. A physician does not approach every patient the same way; the diagnostic framework is constant, but the tools applied depend on what the patient came in with. PDSA is the framework, and the tools are deployed where they fit.
An attendee named Becca asked the right kind of practical question: when continuous improvement ideas sit in a backlog, how do you bring awareness to them without making every employee log into a software system to view the backlog? Mark used the question to push on a deeper assumption. Backlogs are not inevitable. He sees them on huddle boards too, sticky notes piling up, PICK charts with low-effort high-impact items sitting for months. People learn to treat the backlog as the natural state of the work. The better question is why. Why is there a backlog? Often the answer is that the same two people are doing all the implementation. The fix is to widen who works on improvements, not to accept the bottleneck.
Greg agreed and named the leadership obligation underneath it. If the volume of ideas outweighs the capacity to act on them, that is a capacity problem the leader has to solve. There is real ROI in solving it. Some of the unaddressed ideas would save money tomorrow if acted on. And the deeper return is that if leaders ignore ideas, people stop submitting them. A backlog left to grow is a participation problem in waiting.
On the practical mechanics, Greg walked through how he uses status discipline in KaiNexus to keep work moving. New status should never sit for more than seven days, ideally less than 48 hours. From there an idea should either move to Planned (we're going to do this, with a timing commitment), straight to Active (yes, let's start now), straight to Complete (we did it before the next huddle), or Deferred with a review date so it surfaces again later. He runs the same discipline on KaiNexus's own product ideas: he reviews new items weekly, and people know it. The point is not the specific statuses. It is the cadence. Five or ten minutes spent triaging a handful of items beats two hours spent later trying to dig out from a wall of unaddressed ideas.
An attendee asked about common safety leadership principles, vision, accountability, engagement, leading by example, and what those behaviors look like in practice. Mark's first answer was the precondition for any of them: leaders have to create an environment where it is safe to speak up. Safe to point out risks. Safe to report a near miss. Safe to admit a mistake. Without that, every other safety principle is theater. He has worked with organizations that talked about professional safety while making it clear that disagreeing with the wrong person was not safe.
He went after a specific word too. "We have to hold people accountable" often translates, in practice, to "we're going to punish people." That posture drives the opposite of what an organization claims to want. People get better at hiding problems, not at preventing them. The reframe is accountability for and to, not accountability as a euphemism for blame.
Both hosts pointed to Paul O'Neill as the example. O'Neill walked into Alcoa, an organization with cultural dysfunction and tanking financial metrics, and refused to lead with either. He led with safety, the one thing everyone in the building could agree on. The financial outcomes followed. Greg shared a smaller version of the same instinct from a customer meeting the prior week, where a manufacturing leader, asked about his organization's principles, named safety first without hesitation. That is what a safety culture sounds like.
Greg added the diagnostic move worth holding onto in healthcare specifically. Sometimes the punishment is not direct. Sometimes it is process. If reporting a near miss is so onerous that people quietly skip it, the system is punishing reporting by design. A lot of safety opportunity is lost there.
Mark used the leftover time to follow up on a related practice he had been thinking about: a "wall of shame" approach to driving improvement, where adherence rates by name are posted publicly, hand hygiene compliance for example, with red and green markers. His gut reaction was that he disliked it, and his reasoning was that shame is not a useful starting point for improvement.
Greg admitted there is a gut-level pull to the idea. If you call out the people doing badly, surely they'll do better. The problem is that the moment you do, you start gaming the system. Everything points the wrong direction. People figure out how to get green without actually improving the underlying behavior. He pulled it back to Pink's "Drive" again, the same pattern: extrinsic incentives work, but their side effects undermine the result. The better path is the same one used elsewhere in the conversation. Keep the data. Use it to start a one-on-one conversation. "Greg's hand hygiene compliance is 20%, let's understand why, oh, it's because of X, Y, and Z, now we have a system problem to solve." That moves the work forward. The board does not.
There is a useful intermediate path: showing each person where they fall in the distribution, de-identified, so people can see whether they are in the top quartile, the middle, or the bottom without anyone else seeing their data. That preserves the calibration value of comparison without triggering the gaming behavior that shame produces.
Mark raised a related practice: monthly awards for top performers on a metric. He hesitated for the same reason. Once people are competing for the award, the metric becomes the work, and the underlying behavior becomes incidental. He would rather measure the outcome that actually matters, the infection rate downstream of hand hygiene compliance, than incentivize the intermediate measure. The recap also has a small punch line: the person who submitted the wall-of-shame question wrote in to say their organization had been doing this for five years, and the hospital-acquired infection rate had not meaningfully improved.
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.
.svg)
Copyright © 2026
Privacy Policy