Practicing Lean cover page

Practicing Lean

Practicing Lean

Learning How to Learn How to get Better, Better

If we keep practicing, we might get good at it eventually. We all have a starting point in our personal "Lean journeys." Looking back at our first year of work in Lean or continuous improvement methodologies, we probably weren't very good at it. What are our reflections and lessons learned? What can we share with those who are just starting today? This book is a compilation of those stories.

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About the Book

As of 6/2/16, about $750 has been raised so far for the Louise H. Batz Patient Safety Foundation. The book can now also be purchased through the Amazon Kindle Store

Doctors don't "implement medicine," they practice medicine.

Lawyers don't "implement cases," they practice law.

Shouldn't Lean facilitators, consultants, managers, and the like, also "practice Lean?" 

When most of us start with Lean, the practices and principles are new. We might struggle to make change happen. I know I did. Our initial clumsy efforts hopefully turn into proficiency and mastery over time. We shift from "doing Lean" to "being Lean" and teaching others how to be Lean.

This book is a collection of honest and unvarnished first hand stories about learning, failing, and getting better at leading Lean transformation efforts. What mistakes have been made? What are the lessons learned? How do we "Plan, Do, Study, Adjust" our way to more effective Lean transformation models?

Proceeds from the book will be donated to the non-profit Louise H. Batz Patient Safety Foundation. Disclosure: Mark Graban is on the board of the Batz Foundation.

We have a diverse set of contributors so far, and future participants ideally continue come from various industries - manufacturing, healthcare, software, startups, etc. If you are interested in potentially being a contributor, adding a chapter or story to this book, please fill out this web form.

Podcast About the Book:

Listen to Ron Pereira interview Mark Graban about the book as part of the Gemba Academy Podcast.

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Table of Contents

  • Welcome to the Book!
  • Chapter One - Mark Graban
    • Identifying Problems is only the First Step in Improvement
    • Inexperience and Ignorance or Incorrect Knowledge?
    • Lean Means Always Learning
    • If We Keep Practicing Lean, We’ll Get Good At It
    • Is it Lame to Call Situations L.A.M.E.?
    • Let’s Reflect
  • Chapter Two - Mark Graban
    • See One, Do Some, Teach a Bunch
    • My Early Days in Manufacturing at General Motors
    • Some of My Early Mistakes and Lessons in Manufacturing
    • Early Mistakes in Healthcare
  • Chapter Three - Nick Ruhmann
    • Timing is Everything
    • Starting Out with Six Sigma
    • Bucking the Trend
    • Leaning Out of Six Sigma
  • Chapter Four - Michael Lombard
    • Into the Learning Zone of Parenting
    • 2006-2010: Discovering Lean, Practicing L.A.M.E.
    • 2010-2012: Getting Clinical with Lean
    • 2012-2015: Practice Makes Permanent
  • Chapter Five - Paul Akers
    • Every Day is a Massive Revelation
    • If I Had Only Learned This Earlier
    • Lean Thinking – It Never Ends!
  • Chapter Six - Jamie Parker
    • Bike Ramps: Crashing and Burning
    • Diving in Head First… in the Shallow End
    • The Hammer or the Screw Driver
    • Standards for Standards’ Sake
    • A Five Letter Word
    • West is Best
    • Beliefs Drives Behavior
    • The Tortoise and the Hare
  • Chapter Seven - Harry Kenworthy
    • My First Job - Trial by Fire
    • Learning on the Next Job
    • Connecting with a Great Mentor
    • Really Learning about Union Relations
    • Learning about Accountability and Getting Stuff Done
    • My Experiences with Dr. Deming
    • If I Only Knew Then What I Know Now
  • Chapter Eight - Bob Rush
    • Everyone is an Expert
    • I’m Now the Old Guy
    • My Firefighting Got in the Way of Progress
    • Lean Without Respect Isn’t Lean and Will Fail
    • Learning From an Expensive Mistake
    • The Gleam in Her Eye
    • Lean Champions
    • My First Kaizen Event
    • How Did I Get Here?
  • Chapter Nine - Samuel Selay
    • Learning Continuous Improvement: Reflections on Practicing CI in the Marine Corps
    • Cultural Roadblocks to Deploying Continuous Improvement
    • Lessons Learned from Japan
    • Practicing Continuous Improvement
    • Problem Solving Process
  • Chapter Ten - David Haigh
    • Lean From The Source
    • Isn’t Lean Just a Bunch of Tools?
    • Financial Waste Isn’t Always Muda
    • You Can Use Lean to Grow
    • Don’t Forget Your Lean Value Proposition
  • Chapter Eleven – Joseph Swartz
    • Go To the Coalface
    • We Didn’t Have Insurance
    • Touch and Feel the Output
    • Pride Cometh Before the Fall
    • Oops, I Shouldn’t Have Said That
  • Chapter Twelve – Cameron Stark
    • Looking for Lean
    • Clinical Audit
    • Service Planning
    • National Collaborative
    • Knowledge Transfer Partnership
    • Finding Lean: Virginia Mason, Tees, Esk and Wear Valley, and NETS
    • What Now?
    • Turning Process Gains in to Improvement Gains
    • Embedding Improvement
  • Chapter Thirteen - Harvey Leach
    • “I don’t know anything much about Lean!”
    • An Industry in Turmoil
    • An Introduction to Some Different Thinking
    • Reflections
  • Chapter Fourteen – Andy Sheppard
    • Learning from Others
    • Technical Insight
    • Change Management
    • Leadership
  • Chapter Fifteen – Mike Leigh
    • A very lucky guy
    • Lesson 1: Leadership and culture is trump
    • Lesson 2: Be believable
    • Lesson 3: Promote the journey – the results will come
    • Lesson 4: Promote the philosophy – not the tools
    • Final Thoughts
  • Chapter Sixteen – Jamie Flinchbaugh
    • What’s wrong with your pull system?
    • The Boss
    • The pivot and the lesson
    • The solution
    • The learning
    • What’s next?
  • Thanks for Reading the Book!

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About the Editor

About the Contributors


Bob Rush

Bob Rush currently is a Lean Manufacturing Group Leader for Tesla Motors in Fremont, CA. Bob has over 35 years of operations experience and has had over 25 years of Lean practice. His experience is in companies ranging from start ups to Fortune 100 companies, and title levels that ranged from shipping clerk to VP of operations. In addition to Tesla, some of the companies he has worked with, and for, include Hewlett Packard, JDS Uniphase, and Idex Corporation. His journey includes 10 years of consulting experience, where he had only himself to blame if things didn’t work out. His Lean journey started with World Class Manufacturing, which led to Lean manufacturing, where he was fortunate enough to learn kaizen events from the Shingijutsu Consulting group. He continues to work with a love of kaizen as a way of life and has led more than 500 kaizen events over the course of his practice of Lean. He has been trained that respect for people is the most critical pillar of Lean and he shows it with all people that he works with.

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Cameron Stark

Born in Glasgow, Scotland, Cameron Stark graduated in medicine from the University of Glasgow in 1985. After working as a junior doctor in medical and surgical posts, he spent four years working in Psychiatry in the West of Scotland. Stark then trained in Public Health Medicine and has been an NHS Consultant since 1996, first in Ayrshire and then in the Highlands. He has professional qualifications in Psychiatry and Public Health and postgraduate degrees in Risk, Crisis and Disaster Management (University of Leicester) and in Public Health (University of Glasgow). 

With research interests in public health, mental health and quality improvement, Stark has published over 50 papers in peer-reviewed journals. He has written four previous book chapters, co-edited three academic books and co-authored a recent book on the psychology of soccer coaching. 

He trained as a Lean Leader with Tees, Esk and Wear Valley NHS Foundation Trust, and now coaches staff who are learning about Lean in NHS Highland. Stark is responsible for the quality assurance of Lean training materials used in NHS Highland and works with their Kaizen Promotion Office manager to arrange events and develop training. 

Away from work, Stark is married with three children, and lives in Inverness, Scotland. 

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David Haigh

David works at Johnson & Johnson Canada, the largest consumer healthcare company in Canada, and part of the Johnson & Johnson family of companies.

David started his career in the telecommunications sector, working at Research In Motion, and has worked in Lean and Six Sigma in the telecommunications, construction, automotive, consumer packaged goods, and healthcare sectors in Canada and globally since 2003. 

David has a BASc in Mechanical Engineering from the University of Waterloo, an MBA from Wilfrid Laurier University, and his Lean Six Sigma Master Black Belt certificate from Villanova University.

David and his wife Cindy currently reside in Toronto, Ontario, Canada with their son. He can be found on Twitter @Leanlearnlead and LinkedIn.

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Harry Kenworthy

Harry Kenworthy has authored articles on Total Quality in Quality Progress and Purchasing magazines and several articles in Government Finance Review: "Getting Started with Lean", "A Guide to Starting the Lean Journey", and "Blending Agile and Lean Thinking for More Efficient IT Development." He worked previously in several manufacturing organizations, serving as process engineer, general foreman, operations manager, division manager, group vice president, and lastly as vice president of manufacturing. Harry has worked in industries including copper & brass rolling, tube and bar mills; printed circuit boards; custom plastic molding; and his last tenure was 26 years at Rogers Corporation which served a variety of markets and technologies. He was responsible for the Rogers worldwide Lean Six Sigma effort and left to devote full time to his consulting firm in 2004. His consulting organization, QPIC, LLC, focuses on clients implementing Lean Management Systems in over 20 states with state government agencies, counties, cities, and large K-12 school systems. Harry has a B.S. in Materials Engineering from Rensselaer Polytechnic Institute (RPI), and a M.B.A in Finance from Syracuse University. Harry and his wife Elaine reside in Connecticut. This chapter is excerpted from his upcoming book: "Lean Government Now - We Can Do This!"

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Harvey Leach

Harvey Leach is a Principal Consultant with The Consultancy Company based near Oxford, England where he works with around 30 colleagues to help clients "Make Strategy Happen" by applying his experiences of Lean thinking, change management and leadership development to help them solve problems and grow their internal capability to identify and implement improvements.

Prior to joining The Consultancy Company, Harvey spent 27 years with Rover Group and BMW Group, where he gained an impressive reputation for implementing improved ways of working in every team he managed, covering areas as diverse as Product Development, New Product Introduction, Production Planning & Control and Production Strategy. Alongside this, he acted as a trainer for a number of internal programmes to grow the organisation's Lean capability – Total Quality Improvement, Leading Management and Coaching for Performance.

Over the last 11 years, Harvey has applied and developed the skills he acquired to support clients in a range of industrial and public sector organisations, covering both operational and administrative areas. In addition to leading and facilitating improvement programmes for clients, he has developed and delivered a range of highly acclaimed public and bespoke training programmes.

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Jamie Parker

Jamie Parker practices Lean and is passionate about learning and sharing Lean leadership. She has 15 years' experience in operations management / leadership across retail, service, and manufacturing environments. Jamie serves as an internal coach to her organization's operations managers across the country while supervising P&L and operations management responsibilities for six commercial print plants. Jamie expresses passion for helping leaders break the habits of traditional management approaches to create environments primed for team member fulfillment.

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Joe Swartz

Joseph E. Swartz is the Administrative Director of Business Transformation for Franciscan Alliance, a group of 14 hospitals in Indiana and Illinois. He has been leading continuous improvement efforts for more than 20 years, including 10 years in healthcare. 

Joe is co-author of the book Seeing David in the Stone: Finding and Seizing Great Opportunities. Joe has also co-authored the book, Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements, with Mark Graban, which was awarded the 2014 Shingo Research and Professional Publication award.  He also co-authored The Executive Guide to Healthcare Kaizen (Productivity Press).

Joe consulted from 1993 to 2005, working in automotive engineering, semiconductor manufacturing, industrial product manufacturing, pharmaceutical manufacturing, and aerospace assembly. 

Joe studied Electrical Engineering at Cleveland State University as well as Management at Purdue University, where he graduated as a Krannert Scholar for academic excellence in their masters program.  He lives in Indianapolis, Indiana with his three children.

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Michael Lombard

Michael Lombard, MBA, PMP, is a seasoned leader in Lean Healthcare, currently serving as the Senior Director of Operational Excellence at Cornerstone Healthcare Group in Dallas, TX. He has a track record of helping hospitals and other care providers radically improve performance through continuous improvement. His specialty is enabling leaders, from the front-lines down to the c-suite, to develop strong Lean Management habits through proven coaching techniques. Above all, Michael is a lifelong learner, always looking to apply lessons learned at work and at home as a father and husband.

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Nick Ruhmann

Nick Ruhmann is an ongoing student of "lean thinking", the Toyota Production System, and certified Six Sigma Master Black Belt currently leading the enterprise wide deployment of an Operational Excellence culture at National Flood Services, a leading flood insurance solutions provider and division of Aon plc. From 2010 to 2012, he worked in medical device industry for BD Medical, leading Continuous Improvement within their Diabetes Care division, but spent the bulk of his career with Tenneco Inc, a major Tier I automotive supplier to nearly every OEM including Toyota. During that time, Nick’s career has offered a diverse background, including both functional and leadership positions across Research & Development, Product Engineering, Process Excellence, Operations, Process Engineering, Quality, and Supply chain.

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Paul Akers

Paul Akers describes himself as an "entrepreneur, business owner, author, speaker and Lean maniac." Paul is founder and president of FastCap, based in Ferndale, WA. FastCap is an international product development company founded in 1997 with over 2000 distributors worldwide. A prolific inventor, Paul holds US and international patents. His company, FastCap, launches approximately 20 new innovative products per year and has won business of the year in 1999 and 2010. Paul and his wife, Leanne, have built FastCap from their garage into a multi-million dollar company in 13 years. In 2011, Paul wrote his first book about Lean Manufacturing, "2 Second Lean." In 2015, Paul published his latest book, "Lean Health," which you can download as a free PDF. Find info about the books at . Read his full bio online (PDF) -

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Samuel Selay

Samuel Selay is the Continuous Improvement Manager within his organization in the Marine Corps at Camp Pendleton. He has worked in the field of supply chain and logistics for the past 12 years. For the last 6 years, he has managed his organization’s Continuous Process Improvement/Lean Six Sigma (LSS) Program. During this timeframe, he has facilitated/mentored 28 completed LSS projects or kaizen events. Additionally, he mapped and standardized 36 processes, conducted 90 process audits, and implemented his organization's Quality Management System, resulting in a 20% reduction in shipping defects. 

Along with project leadership, he has instructed and certified 481 employees as LSS Yellow Belts and 121 employees as LSS Green Belts. He is a certified Lean Six Sigma Black Belt from the University of San Diego, a certified Logistics Technician (CLT) from the Manufacturing Skills Standards Council, and a certified ISO 9001:2008 Internal Auditor from the World Wide Quality Network. He holds a BS in Management Studies from the University of Maryland University College and a MBA in Management and Strategy from Western Governors University. 

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