Frequently Asked Questions
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Kaizen is a Japanese word that means “change for the better,” often in the context of the phrase “continuous improvement.” While many of the ideas were taught by an American, Dr. W. Edwards Deming, to the Japanese after World War II, the ideas (and the word “Kaizen”) came back to the West in the past two decades thanks to the work of Masaaki Imai and Norman Bodek.
While it’s a good practice to not bombard people with too many Japanese words in the context of Lean or other improvement approaches, we think the word Kaizen is easily adopted and it has an unique meaning and approach that we honor by using the word. Some organizations, however, will use these principles under the banner of an “Idea Program” without calling it Kaizen.
The word Kaizen has become commonly associated with the terms “Kaizen Event” or “Kaizen Blitz.” We think those terms are a bit of a misnomer because improvement doesn’t have to be part of a formal project or event. These events are sometimes known as Rapid Improvement Events (RIE) or Rapid Process Improvement Workshops (RPIW). Events can be very helpful and our book describes how the formal events complement the small, daily continuous improvements that we think are the heart of Kaizen. We think low-cost, low-risk improvements that are identified and completely local in a workgroup are the heart of Kaizen.
Yes! While the word “kaizen” is Japanese, many of the principles are universal. We have examples in our book from across the United States, as well as England and The Netherlands. The Kaizen principles are built around the human desire to do the best quality work and to have their voices be heard. Success with Kaizen has more to do with an organization’s culture than any national culture. For what it’s worth for healthcare professionals, Toyota has been very successful with their Kaizen process in countries around the world, including the United States and Canada.
Successful Kaizen initiatives don’t make “Return on Investment (ROI)” as the primary objective. Healthcare professionals are more likely to get engaged with Kaizen when they are allowed to focus on things that often don’t have an easily measurable ROI, such as improvements to quality and service to patients. Kaizen also focuses on small problems and easy improvements that make the workplace less frustrating and more rewarding for staff. While organizations like Franciscan St. Francis Health System (where co-author Joe Swartz works) don’t ask staff to calculate an ROI for each and every Kaizen improvement, they do estimate the cost or revenue impact of those with a significant impact. In 2010, they estimated a financial impact of over $3 million, which they feel is a conservative estimate. They also have improvements in quality, patient safety, waiting times, patient satisfaction, and staff engagement, some of which can be quantified.
Lean healthcare is based on “Lean manufacturing” or the Toyota Production System. Toyota’s business philosophy, The Toyota Way, has two pillars: “continuous improvement” and “respect for people,” so Kaizen is at the core of what Lean organizations do. The word Kaizen is often translated as meaning “continuous improvement” and the Kaizen approach is one that treats everybody with respect. Part of that respect is the recognition that all employees, regardless of their education level or pay grade, can participate in the continuous improvement of their own work. Some of the recognized leaders in Lean healthcare, such as ThedaCare
and Virginia Mason Medical Center
, have included Kaizen practices in their Lean program and culture, as we describe in the book.
We believe everybody wants to participate in patient-centered improvements. The best way to engage people is to ask them to participate in Kaizen. Senior leaders and front-line managers can set an expectation for continuous improvement by asking people to identify problems and propose countermeasures or solutions. Leaders should allow people to work on problems or opportunities that matter for them and their patients. Beyond just asking, leaders need to be supportive and collaborate with staff members in their improvement work. Our book outlines key behaviors for leaders at all levels, as well as models for engaging and enrolling others in change.