​Lean transitioned from manufacturing to healthcare through the vision of two pioneering women: Sister Monica Heeran and Joanne Poggetti.
 
Sister Monica Heeran, the CEO of PeaceHealth, had heard me speak in Chicago at a Juran Institute symposium on managing for quality in research and development. She asked for more information, because she wanted to improve PeaceHealth’s not-for-profit healthcare system in the Pacific Northwest. Probably the first US healthcare CEO to embrace Lean, she signed a two-year contract with Poggetti and me to lead a Lean implementation.
 
Back then implementing Lean in healthcare was a dream

​Before Sister Monica signed the contract, I asked Joanne Poggetti, then president of Poggetti & Associates, what she thought. Without hesitation, Poggetti said yes, Lean could be done in healthcare. She had first-hand experience of inefficiencies and mistakes in healthcare. She had the vision to see how Lean could eliminate those mistakes.
 
So in 1996, before it was fashionable, Sister Heeran had the courage to implement Lean in her hospital system. Poggetti took Sister Heeran and her CEO’s to Japan. Sister Heeran was the first healthcare CEO in the world to see Toyota in action in Japan.

Poggetti and Sister Heeran came back and implemented learnings. Early results were outstanding.
 

• Lead times for billing cut from 28 to 3 days.
• Home Health services redesigned in a few weeks
  
• Saving $600k almost immediately

​Sister Heeran later retired and Lean didn’t continue at PeaceHealth. But the ground was broken for Lean in healthcare. Now, hundreds of healthcare organizations have seen the transformational impact of Lean, all thanks to Joanne Poggetti’s vision and Sister Monica Heeran’s courage.
 
Later after joining Boeing, Poggetti became a protégé of Dr. Deming & traveled with him.
 
The best part? I was lucky enough to marry Joanne and we’ve continue the work she started.

​I arrived at Boeing in 1978, at a time when the aerospace industry was doing well, and I brought with me some perspectives I had developed during my service in the US Army, including two tours in Vietnam. With the Army, I had conducted my own research into waste—specifically, waste in war—and I soon discovered that many of the same concepts applied to the corporate realm. Not long after I started my Boeing career, the company began examining—and attempting to apply—the “total quality” teachings of Dr. W. Edwards Deming and Dr. Joseph Juran, which had played such an important role in making Japanese industry competitive.

​Boeing leaders were making speeches about our 60 percent market share, our number-one position in the world, and the fact that rival Airbus could never catch us. When I looked at our performance metrics, however, I found the figures mediocre. I believed that, to move Boeing to the next level of performance, we needed to go to Japan to study world-class companies and then create a new vision for Boeing.
 
I walked the halls telling anyone who would listen that just because we had 60 percent market share for commercial airliners didn’t mean we had world-class metrics. It was a tough sell.

​Eventually, Bruce Gissing listened. In early 1990, with Gissing’s insistence and leadership, a team of Boeing executives who were involved in the quality effort embarked on our first study mission to Japan. The trip itself lasted two weeks, and to put it mildly, participants’ eyes were opened. As one manager commented, “Thank God Toyota is not in the aerospace industry.”
 
Training for 100,000 employees and managers was completed in 24 months—a rate unheard of in a corporation the size of Boeing. From 1994 to 1996, defects in production were reduced 35 percent, and customer complaints dropped accordingly. Where applied, Lean reduced the typical floor space required for operations by 50 percent and cut the amount of inventory kept on hand by 30 to 70 percent (Boeing Company 1997).

Going outside Boeing, I recruited organizational development consultant Joanne Poggetti, who worked with Boeing statisticians and candidates representing all the company’s major functional organizations for an intensive, two-year learn/do experience. Everyone was sent to off-site seminars conducted personally by Dr. Deming, Dr. Juran, and Bill Conway of Conway Quality.
When the team members came back, Joanne had the assignment to design and launch 18 quality improvement courses and seminars that would be attended by more than 34,000 employees.
 
So, I wasn’t looking for business in healthcare when it came to me on that flight to Atlanta in the fall of 2000. But fate was already playing its hand. My wife, Joanne Poggetti, who had worked with Dr. W. Edwards Deming, had started her own consulting firm while I was still with Boeing. In 1996, she had signed a contract with a healthcare system and started them on the road to Lean, with consultation support from me, after the system’s CEO heard me speak. That October, Poggetti became the first person to take a group of healthcare CEOs to Japan to attend Shingijutsu’s gemba kaizen at Hitachi.
 
My years guiding Lean implementations in healthcare had begun, almost without me realizing it, just as a few leading healthcare organizations became ready for transformative change.
 
In 2000, Mike Rona, then president of Virginia Mason Medical Center, sat next to me on a plane. We started talking. I said, “Mike you have to see this pitch about Lean that I’m going to present to the Minister of Health in Spain.’ Rona listened patiently. When we got off the plane I handed him my first book, “A World Class Production System,” recently published by Boeing. He didn’t forget our conversation. He shared the information and the book with his boss, CEO Gary Kaplan. As a result, JBA spent 6 years helping Virginia Mason get started with Lean. VMMC is now an acknowledged world leader in healthcare.

Since then, I’ve helped other healthcare organizations, most recently the province of Saskatchewan in Canada. 

​Through my work with healthcare organizations, I’ve been able to apply my Lean learnings to a cause I’m passionate about: ending preventable deaths. My goal is to help organizations put systems in place that eliminate medical errors. Fewer errors means higher quality care, lower costs, and zero preventable deaths.