GA 152 | TWI, Kata, and Respect for People with Skip Steward and Brandon Brown

You're listening to episode 152 with Skip Stewart and Brandon Brown.

Welcome to the Gemba Academy Podcast, the show that's focused on helping individuals and companies achieve breakthrough results using the same continuous improvement principles leveraged by companies such as Toyota Del Monte and the U.S. department of Defense. And now, here's your host, Ron Pereira.

Hey there. This is Ron Pereira with Gemba Academy, and I'd like to welcome you to another edition of the Gemba Academy Podcast. As always, thank you so much for taking time out of your day and your week to listen to the show and for watching our Lean and Six Sigma training videos over at Gembacademy.com, we definitely appreciate each and every one of you. Now, last week we attended the TWI Summit and the Katakan Summit in San Diego, California. It's put on by the good people over at Lean Frontiers, and as always, it was an incredible event. I think there was around 300 people in total kind of mingling between the two sessions. It was really cool as you could go listen to a talk on Toyota Kata and then you could turn around and go listen to a talk on twi. And there were so many really, really good sessions. Mike Rother gave an incredible keynote, really, to both groups, and our friend Steve Bennerman from ATC Trailers gave probably one of my favorite talks. There were so many. I don't want to say one was better than the other, but Steve is. We featured Steve in ACC trailers a few years ago on a Gemba Academy Live episode. And, and after watching Steve, I sat back and I looked at my colleague Steve Kane, and I said, you know, one day I'd like to be half the leader that man is. He was just so incredible. The way that they practice all aspects of Lean, in particular respect for people over at ATC Trailers was truly moving. And then Skip Steward, who is going to be on the show here today along with Brandon Brown, gave a really, really good keynote address to the Kata conference attendees where he kind of covered the that his hospital system, namely Baptist Memorial Healthcare, is practicing. And they're really into really all aspects of Lean, but in particular they are heavy into Toyota Kata and twi, namely job instruction, job relations, and job methods. And so they're doing some really, really good work. And Brandon Brown is a Kata coach and he's been on the podcast before. We'll link to his episode over in the show notes, so be sure to check that. But Brandon gave a really moving talk on the topic of Toyota Kata. And in fact, towards the end of his talk. He did something that was pretty powerful. He actually, we were recording it, of course, the video, and he kind of stopped, got off the stage, walked over kind of towards the cameras and he started speaking to the cameras and he was speaking to the nurses that have truly changed his life. And I don't want to spoil his secret because Brandon kind of talks about that here in today's episode. So I want you to definitely check that out. Now show notes for this particular episode can be found over@gembapodcast.com just look for episode 152. Again gembapodcast.com and look for episode 152. Okay, enough from me. Let's get to the show.

All right, so we are here in sunny San Diego, California at the Katakan and TWI Summit. So I'm here with Skip Stewart and Brandon Brown. So gentlemen, thank you. So the. Well, the conference actually just ended and it's been a great, great two days. I heard you yesterday and I heard you today and not just saying it because I'm sitting in front of you, but you both really did a great job. So thank you for sharing your stories and thank you for taking time to come chat with us here on the. We're making a video and a podcast.

So.

So let's just kind of start maybe with you. We're going to get into quotes and the normal podcast stuff, but I think it's important to maybe level set the folks with who you guys are and what you do in your day jobs.

So my name is Skip Stewart. I'm the Chief Improvement officer for Baptist Memorial Healthcare, which is one of the largest non for profit healthcare systems in the United States with hospitals in Tennessee, Mississippi and Arkansas. And we're headquartered out of Memphis, Tennessee.

Okay, good.

And I'm the owner of Continuous Coaching Commitment. We do several things within the realm of cada, twi as well as John Maxwell leadership Training. I'm also an associate with the W3 group, so we do some Kata deployments within that organization as well. So that's the arena that I've pretty much been working in the last five.

Years and longtime listeners probably feel like name sounds familiar and it's because you've been on the podcast before. I can't remember which number it was, but. But yeah, we'll dig that out and put it in the show notes. So. Well, you guys have both listened to the show and you know, we kind of like to begin in the end at the start with our guests sharing a quote or two of something that possibly Inspires them. So, not that I don't know, you didn't really prepare for this, but do you guys have any off the top of your head?

One that always comes to my mind is a quote that a friend of mine, Mr. Yoshino, that was the manager John Shook at Nummi, has told me more than once is always make sure your people have the ability to succeed in the permission to fail.

What's that mean to you?

Well, it means that we're giving people the permission to be creative, to experiment their way forward. There's no fear in that. But we're also. We have a responsibility to prepare them. And there's a lot that goes into preparing someone. It's not just about sending them through a training class and checking a box and having them sign a competency document.

Yeah, yeah, yeah.

But you. So a quote that I use, kind of not being afraid to fail. I've always liked the Teddy Roosevelt quote. I actually brought it up on my phone. I'm not going to read the whole thing, but most people are familiar with it. It starts out, it's not the critic who counts. It's not the man who points out how the strong man stumbles or where the doer of deeds could have done them better. And then it ends with who at best knows in the end, the triumph of high achievement. And at worst, if he fails, at least he fails daring greatly, so that his place will never be with those cold, timid souls that never know victory or defeat. I think that speaks to kind of what Skip was saying there. And it really goes in line with what we're trying to teach with Encada. Don't be afraid to fail. Don't be afraid to experiment. You're going to fail what you're learning from that and then move on from there.

Yeah, he was the first kata thinker, maybe out there, right? Maybe just kind of give everybody a high level overview of the journey at Baptist Memorial and kind of how it started, maybe, and just kind of just tell us a story.

So the Baptist management system has been in existence for around, oh, we'll call it maybe a little under three years, because I've been there three and a half years at this point. And we determined initially that we needed standards. And so we introduced twi, both job instructions, job relations and job methods, predominantly at first job instructions. So that journey has come a long way with a wonderful relationship with the TWI Institute out of Syracuse, New York. And to date we have 45 certified train the trainers. But more important than trainers, we have active practitioners that can break down really difficult jobs in healthcare and help create a standard behavior. You know, everyone wants to talk about standard work and that's fine. Nice words on a piece of paper, nice little pictures. But how do we create a standard behavior? And I would make the argument that TWI job instructions helps do that. We also have job relations going on in two of our hospitals and we're experimenting with job methods in another hospital. And so that has been a major, important, what I would call a subsystem within our management system.

All three J programs.

All three, that's right. And so some of them are obviously at a farther down in its evolutional path than others, but it's had a huge, huge impact. So that we have everyone doing a particular task. What's important is that has played a big part in our CADA efforts. So our CADA is the main ingredient within our management system. And where TWI fits is when you're trying to understand, when you're trying to move from your current condition to your target condition and you're trying to understand where you're at, many times you discover that everyone is doing a task completely different and that variation with everyone doing that task is causing errors and mistakes. And so then someone will come along with a hypothesis and they'll say, if everyone had a similar behavior in how they completed this task, that would help move us towards the target condition. Now, I don't want to imply that it's the only countermeasure, it's not a magic wand, but it sure is powerful to help move towards that target condition, both ji, JR and jm. And so another piece of that that Brandon's been so helpful on is we've even flipped it on its head and we've said, when we think about like JR or ji, how can we use KATA to help deploy it? By simply starting off asking the question, what do we want to achieve with it and by what date? And then, Brandon, you can probably speak a little more to that.

And before you do, just as I never want to assume anything, on the podcast, we have listeners with all varying degrees of experience and knowledge, give a quick 30 second synopsis of just what Toyota Kata is all about and then maybe follow on.

So Toyota Cotta is starting at really at a strategic level within the organization and defining the challenge. What challenge? One year, two year, three year challenge. Are you trying to achieve something that really gets up into your throat, you know, kind of makes you uncertain, you don't know how to get there. From there, you back up and grasp your current condition. All this is usually around a storyboard, where a learner and a coach are in front of a storyboard as well as a second coach, and they've defined a current condition. And then two weeks out, four weeks out. Where do we want to be closer to this challenge? What portion of the challenge? How much do we want to bite off of the elephant, so to speak? The elephant is the challenge. The target condition might be just the back leg of the elephant. And then we do PDCAs around obstacles we identify that are closing that gap between the current condition and the target condition. So each one of those bites, each one of those pdcas are eating the elephant one bite at a time. The power behind kata is if we can rapidly do these pdcas, or if we can chew the elephant really fast, the faster we're going to be able to get to that challenge.

Yeah, got it. Okay, so I guess how has that then played in with what Skip was talking about?

So one of the things that Skip came to me and said was, you know, we don't want to train job instruction, or we don't want to train with job relations just to be training. We want to be strategic about it. We want to link it to our strategic A3s.

Why are we doing it?

Why are we doing it? What metrics are we trying to move? What relations are we trying to improve with the employees? How are we trying to make it better at Baptist? And we looked at a lot of different ways that we could deploy the J methods. One of the first ones we started was job relations at one of the NEA hospitals there in Jonesboro. And we took a learner and a coach, and we had a storyboard, and we said, what are the process characteristics and what are the process metrics and the outcome metrics we're trying to achieve? Two of the main things they were trying to achieve, along with, you know, reducing the number of small problems that end up escalating into bigger problems, were written warnings and involuntary terminations. And so we tied those two metrics to the things, the activities that were going on, and each day the learner and coach would meet. There was also trainings involved. How do we plan out the trainings? Who all do we need to train in this, in job relations? And they would just work each day to a small pool of the obstacles that they would be working on to try and advance closer to this target condition of lowering these particular metrics. Another one was the job instructions. And so we started the same method, but we decided that we Wanted to do it a little differently. We wanted to. Since job instructions across all of these processes within Baptist was so vast, we didn't want one or two people to shoulder the burden of having to do that. So we used the shepherding concept or a group of leaders, some executives, some at the director, some at the manager level, to put a storyboard together and use KATA to deploy the job instructions. Part of their responsibility was to, as job instruction breakdowns came in, was to look at them and say, are these written in a way that we can teach them effectively and efficiently? Are they related to some specific strategic metrics? And in particular the shepherding group for Twiji at the Memphis Hospital, the cno, one of the leaders there, Michelle Smith, who was wanting to try and tie this to their overall strategy of reducing catheterized associated urinary tract infections or Cauti's clafschine bloodline infections, as well as hand hygiene, just overall and fall prevention. Those were some four key areas that she wanted to try and improve using the job instruction methods. And so the shepherding group got together and they first started to put together sessions where they would decide what's our trainer ratio to actual staff ratio that we need for the different nursing floors versus the other non clinical areas and the lab and other areas. So those were some metrics that they were trying to achieve as well as seeing what the validation of some of these job instruction methods were. So they meet once a day for five days while they're there, and then coach and learner have this KATA session around the obstacles that are keeping them from being able to get to this training ratio that they want to be at and ultimately tie each floor to their individual goals on those four quality measures.

Now, something you touched on today in your talk, Brandon was falling, right. And you didn't get into any details. And that's fine. I don't know what you can. Don't say anything that you're not supposed to say, but I'm curious. Pull the curtain back a little bit. Like how did you approach that? Like reducing patients falling? Like, what does that look like? Because I have no clue.

So it started out on I think one mainly of a step down units. When you come out of an ICU situation or you come down from a surgery or situation, maybe it's even an elderly patient and they're on a floor. There are certain fall precautions that nurses take and more to make sure that the bed alarms are set and functioning correctly. The tether alarms, there's some other 4P rounding which 4P is going in every hour and asking both from a, from a nursing standpoint as well as from a leader standard routing standpoint. You know, pain position. We say potty and we say possessions are all these things within your reach so that you don't have to get up and that we can be here to get those in the right position. So we wrote job instructions around those four Ps and how we standardize going into the room and making sure that all those are in place, the bed alarms going in and making sure that there's compliance that the bed alarms are set. They even took it as far as to create a patient family contract for fall prevention. In other words, if your mother, grandmother were in the hospital after a surgery or, or an extended period of time, they put a falls contract together that it's not necessarily a legal document, but it's just an understanding that we don't want your mother to set up in bed to have to reach for water or cell phone and possibly fall out of the room if you're happening to be on a cell phone making a call somewhere. We want you to be able to feel the freedom to call the nurses for us to be in there to help in that situation. Or we, we don't want you to assist your mother to go to the bathroom. We know you're perfectly capable but we want to do that. It's our responsibility to make sure that she safely gets to the restroom and back. And so compliance with that and being able to come to a patient family and nurse agreement as to how we want to care for your patient. They took it that far as creating these false contracts and partnering with the, the families there.

Skip Alexa. What kind of. In your talk yesterday you spent quite a bit of time kind of sharing some of the successes and some of the challenges. So maybe we can maybe talk a little bit about that.

So yeah, both within our entire management system, whether it be, you know, yesterday I talked a lot about strategic deployment and how that is gets deployed down, how it's connected to twi, how kata is kind of the engine that the lubrication I called it that makes all the gears turn. You know, we've just had. We've been very blessed. We've seen tremendous improvement both clinical and non clinical. We've seen significant amounts of money hit the bottom line as a result of reduction in denials. We have seen patient care improved with some areas 75% reduction in falls, 50% reduction in what we call left without being seen. That's in people will come into an ed. And many times if they don't get seen fast enough, they'll get up and walk out the door. We don't want that to happen. Those patients need help, right? Or maybe the time it takes a patient to go through a process, we've seen that reduced by half and so on and so on. But what's amazing is seeing the evolution of the people's thinking that they're given that permission to fail, you know, to experiment, to be creative. And we've just seen an overall huge improvement both in patient care as well as financial metrics, both in clinical and non clinical area. Because Kata is really content neutral is one thing. It is meaning I can use it in any industry. The other thing is it's very fractal. So I can be having a conversation with a CEO or I can be having a conversation with a frontline worker, or I can be having a conversation with my son about his goals and ambition. I can still use the same thinking pattern.

Yeah. Yeah. You shared a pretty powerful story today. Not to put you on the spot again here, but it literally brought the room to a standstill and there were some. It was pretty touching. So. And it was related to your, you know, something pretty personal to you. So if you're comfortable sharing that, I'd love to hear it.

The work that we had started on the fall, Scott, as I mentioned, started six months prior to right now with one floor, a step down unit and a director of med surgical by the name of Jackie Barton. And what I learned from that was, was exactly what I just spoke about is that they do 4P rounding to make sure that the patients don't get up, that they set bed alarms, that they make sure that they're on, that they're on the fall bands and they have a band on their arm and there's a sign out of the door. I never noticed any of that stuff before I had the opportunity to work with Baptist. So they became my teachers as I'm trying to teach Kata to them. And what they've been able to do now that she's expanded it across, across all five med surg floors is within the first four weeks or the first two target conditions, the falls rates have dropped 48%. And that's 39 patients they project that won't fall under the care across these four, five floors. And what that meant to me specifically is how they taught me to be aware of that is my mother whose health is degrading a little bit. And we're starting to see early signs of Parkinson's Parkinson's disease and some things like that was about two years ago in the middle of the summer in July. She had fallen coming back from a neighbor's apartment. And literally in the middle of the afternoon at 2 in the afternoon, I get a call from my sister that my mom's fallen. She was not able to get up. She's out on the asphalt and she's at the emergency room with first and second degree burns on her arm. She was there 45 minutes the next fast forward another year and so we're starting to talk to mom about long term care and what we're able to, what we can do and what we can provide. She fell as my sister was taking her to the grocery store and fell and broke her elbow. I got a call on that and we went to the hospital, it's a non Baptist hospital in the town where she's at. And the first thing that we went into the room was to start to. My sister and I start to talk about after we found out she was okay, that what are we going to do long term? You know, I'm gone. I do coaching and I'm gone. My wife works full time. If we move her to our home, we just transport the fall from her apartment to our living room. My sister has three kids under six and so she's not able to do it as well. But we're starting to have that conversation. I just happened to look at the side rail and I see the word bed alarm and I see that there's no lights on. And so I asked my mom, can you show me your left arm? Because it was the right arm that was injured and she had no fall band on her arm. And I told my sister, they said they were going to discharge her this afternoon. And she said, yeah. I said let's ask a few questions. So I stepped out of the room and looked and there's no fall prevention sign. So that when they had the nurse shift to shift, bedside report that's reviewed that this patient is at a fall risk, none of that was at this hospital. And so I just pushed the call button and I said, has my mother been assessed for fall risk? Well, no sir, we didn't know that she needed to be assessed for fall risk. I said, she came in through your ED with a fall, she has a broken arm and that's the reason she's here. I'd like the bed alarm set, the tether alarm set, the band put on. So I start going through all the things that the Baptist nurses had actually taught Me. And they were instantly down there. I told that story to those nurses on this Master Fallscott about, you know, what that means to these 39 patients. And what I told them and what I mentioned earlier today was that they'll never hear what I'm about to say because I've lived it and experienced it. They'll never hear the families of those 39 patients say, 30. Thank you for not letting my mother fall. Thank you for not letting my father, my grandfather, my brother, my uncle. Thank you for following your job instruction, for making sure the bed alarms were set, for all the things, all the steps and measures. Thank you for taking care of my family member. They'll never hear that from those 39 patients, but I wanted them to hear it from me.

That's pretty powerful, you know. And it just goes to show that I think the more the we all practice lean, continuous improvement, whatever you want to call it, we realize that it is so much more than profit and loss. Right. It's about people in the end.

Right.

And changing people's lives. And what a story.

What a story.

And so bravo to those nurses, you know, that you have so. Well, maybe let's wrap this part up with maybe some advice. Skip that. You know, someone's watching this or listening to this, and perhaps they're in a senior leadership position similar to yours. It doesn't necessarily have to be healthcare, just an organization. And they are getting started with their journey. Speak to that person. What advice do you have for them?

You know, I get that question actually quite often. Where to start. Right. And if it's an open slate, you know, kind of an open canvas like that, I always, I encourage them to start with KATA because KATA is not about the board. KATA is not a methodology. KATA is not a project. It's a thinking pattern. And so I can have a thinking pattern with me and you right now. And I don't need a board. And so that thinking pattern is going to then influence at all level within an organization. Now, are there other parts that I would start to add to that, that management system? Yeah, TWI and KATA in my opinion is a marriage made in heaven. So they tend to go together very well and helps create a standard behavior with job instructions. Job relations, if you'll look at job relations, it looks very similar to the improvement KATA model, but it's how to deal with human problems. Job methods really looks at the pattern of work within a loop of a value stream. So those would be some areas that I would strongly recommend. At some point you're going to have to get to what's known as strategic deployment. So we've had a wonderful relationship with Pascal Dennis and his team and it kind of creates the framework for everything to live in. But within that framework, we got to have good thinking. And I come right back to that Kata is, is that it's a thinking model for us. And so I caught a lot with folks and they don't even know that I'm doing it because I was having a conversation with my son and he was telling me about his goals. Well, that's a challenge. I asked him where he was relative to that goal. That's the current condition. Then we talked about where could he be at in a month and he articulated that that's a target condition. I said, well, what obstacles are in your way, son of being able to accomplish that and which one are we going to focus on first? He told me that, he said, and then I asked him, when can I come back and learn what has happened with you running an experiment on that obstacle? So he didn't know that his dad was practicing kata, but that's what we were doing. So that would be some recommendations I'd make.

Love it. What about you? Anything different?

One of the things I would say if they're going to get started with kata, there's a lot of information on Mike Rother's website. There's a guide.

First of all, the book, right?

Toyota Connor, step one, read the book. Mike has a YouTube channel. Baptist is soon to be putting together a YouTube channel of things going on in healthcare around Kata. Just get started. A lot of people think and at this conference we had a lot of questions about how do I, how do I, what's my strategy? How do I get leadership on board to get started yesterday from a corporate, corporate situation, how do I deploy this model? I think the best thing that you can do if you attend a workshop or you, you get the five question card is just get started. Yeah. Put a storyboard up there. Use the free tools that Mike has on his website. Get a learner and a coach, as he said you've got. Every organization has a challenge, has a goal, has a challenge they're trying to reach. Make that your challenge statement. Now, how much of that can I get done in the the next two weeks and what's my current condition related to that? And start asking the questions. Because really what Mike's put together is really what he's called at this conference, a starter kata. In other words, it's something to get started with the basics. My son Plays the violin. And the first four lessons we paid for were to play the open and closed notes on the violin all the way up the octave and all the way down. That's a starter kata. He still does that. I can go to. To any opera or orchestra or any concert, and they're down there going through the octaves, and they're warming up and playing up and making sure they have the proper form and proper technique. And that's really what a kata is. It's a starter kata. To get started, asking these questions to help you advance toward your challenge by meeting target conditions and overcoming obstacles. So you don't need a huge strategy to get the experience and get exposure. You've got to get past the awkwardness of acting your way to this new way of thinking first. And I think that's just the main point is to get started. Then you can always bring the leadership in and say, hey, ask me these questions, and let's start talking about how I'm progressing toward my goals.

Yeah, beautiful. Well, love it. Could talk to you guys all day, but I gotta. I want to definitely get into the reflection section because I know we've gone through various parts of it, but changed some questions up, I think, since last time you answered. So we'll just kind of tag team this one. So the first question that we always ask folks is, you know, we spend a lot of time in Lean talking about those two pillars, continuous improvement and respect for people. And continuous, supreme, obviously, is the tools, the things that we can do and touch and see. But respect for people is often a little bit harder to define. So I'm curious, between the two of you, what does respect for people mean to you?

Well, I think that's a big subject, right? You know, there's a whole book written on it, you know, and so I think kata is absolutely respectful, because how much more respectful can it be to allow you to think on your own? We have been raised in a culture and a society where we've all grown up giving instructions, telling people what to do. We've actually conditioned many young folks to wait until their next order or commandment is given. But when I'm coaching you correctly, using kata or any kind of coaching approach, then I'm asking you questions because I want to know what you think. I want to know what your perspectives are, because you're closer to the work than I am. And so I think that's incredibly respectful.

To go along with. What Skip is saying about respect for people is, you know, giving them permission to fail, giving them Permission to the freedom to experiment, the non command and control. I think for years what we have been afraid to say, which kata brings right out to the forefront, is we're expected to come to the session or come to the meeting or come to our boss, and that's what we're being paid for, right? The answers. We're supposed to have the answers and we're supposed to have the data. We don't have all of the solutions, if we'll admit it. And the three most feared words that most people don't want to say is I don't know, we don't want to tell our boss, I don't know. Well, in the Toyota culture or in the culture where we're talking about respect for people, they embrace that. In fact, when you're to the point of that knowledge threshold as we, as we call it within cada, you're saying, I don't know, I've got a little bit of information, I've got some data, but I don't have the answers. We celebrate, but that's not the end of it. Now what's your next step? What are you going to do? What's your plan to try and find out either more information or try and experiment to run in the target condition so that you can know more about the process. So I think respect for people is allowing them to have the freedom to say, I don't know what the answer is, but I've got a method, I've got a thinking pattern that will help me be able to get to that answer.

Start with you this time. What's the best advice you've ever received?

I think the best advice very young in my career, I was 27, I was in an engineering field and the engineering manager there was moving on to another plant. And so he had asked me to put in for that position. So this is my first experience, experience at being a manager. I'd been a project engineer, mechanical engineer before that. So I had a range of engineers from younger than me, 24, 25 years old, just right out of college, to some engineers that were 55, 60, 62 years old. And the first thing that he told me was that you're going to have to lead a broad range of people and you're not going to have all of the answers and you're going to have to coach and, and tailor your style, your management style to a wide variety, 40 years of different experience levels. The one thing that he told me was that you're going to have to lead and you're going to have to learn at the same time. And he said, don't ever stop learning while you're leading. You're going to learn from both the engineers and the those that are older than you, and you're going to learn from the ones that are younger than you. And you're going to have to adapt your management style to fit that whole range of those 40 years of experience. So I think that's probably the best advice anybody gave me as far as stepping into management. Really into the flames right there at 27 years old. Nice.

Got it.

I would say something as simple and as profound as be quick to listen and slow to speak.

That's hard.

Very hard. Very hard.

I guess that's why they say God gave us, what, two ears and one mouth, right?

You know, most of us tend to listen so that we can reply versus listen to understand. One of Brandon's greatest qualities that I'm always telling him is Brandon's very comfortable with silence. And. And a lot of times people don't know how to take that, but that's because he is showing them the highest level of respect because he's trying to listen, to truly understand, to empathize and sympathize with that person, to understand. Anyone can listen, to reply. Right. You don't have to go very far to hear people talking over each other. But if we can learn to be quick to listen and slow to speak, I think it'll help us.

What are you most proud of on this journey of continuous improvement that you've been on?

The relationships. Because we have wonderful human beings, wonderful nurses, wonderful technicians, wonderful leaders that we're giving them the power to improve their own world. It's not about Skip. At the end of the day, I'm just a cheerleader and you can just give me some pom poms, right? But they're the real ones doing the real work. I know we live in a world where we want to have different colored belts and we want to be experts. That's not what we want to do. We want to allow the real people that do the real work to improve their own work. And so I would say the relationship with some wonderful, wonderful people. Baptist Memorial Healthcare is just an amazing, caring organization.

Sounds like it can't wait to come visit. What about you? What are you most proud of?

You know, I've got a slogan, I guess, or quote, so to speak, that's on my website, on the back of my cards. Focus on the people and the numbers will come. You focus on the numbers, the people will go. So that's what I've tried, tried to do. When Skip contacted me about come in and help us with kata. Help us learn this thinking pattern is build those relationships first. Because, you know, coming from a manufacturing background, a mechanical engineering degree, and I'm talking to a nurse in the healthcare setting first. I've got to understand where she's at or he's at, either way. And I've got to be able to relate to them as a person. Sometimes I struggle. Actually, some of our sessions because we'll go through the coaching cycle and I'm ready to bring a point out and go into a teaching mode. And the first thing they're asking is, how's your mom doing? How's she getting along? How's your wife doing? My wife's a breast cancer survivor, so they're asking me about that. If they didn't truly have that relationship with me, they wouldn't ask those type of questions. And so I have to stop sometime and pause and say, you got to focus on the people, Brandon. You got to do exactly what your motto says. And so I have to stop, take a timeout. And we cover that. We cover that. They'll text me a lot of times. They'll send me instant message or something from LinkedIn related to how they did on falls today or something like that. And I don't get that from a lot of other clients. That's a unique culture to Baptist and I think it speaks to what he's talking about as far as developing those relationships first.

Yeah, yeah. Kind of a geeky question now. You guys reading any good books or read any good books over this last year? Doesn't have to be about lean leadership, people behavior.

A couple books for myself is I am reading the newest book from Jeffrey Leiker and Karen Ross on the Toyota way to service excellence. Really good book.

But she's cool, isn't she?

Oh, it is, yeah. So really great book that. And then that's probably. I would say that's probably the main book that I've spent time reading.

Mine's going to be a non Lean, non gemba related particular book. But I've been reading the book of James over and over again and specifically with my boys.

Verse one.

Man, I'm feeling really bad now.

Yeah, I'm over here reading lean.

I quoted. I quoted. Where do you work? I actually quoted from James. He's reading it.

But every morning to connect with the families. Mean nights as I spend away as we go through the first five devotion that my wife's going through. And we'll go through that. They're in the book of judges right now. But me personally, I'm reading. I'm reading the book of James. And it's just basically how you speak, how you talk to people, controlling your emotions, self control, all of those things that you learn from that disciple are just so applicable in all stages of life and everything. So. So that's for me, just one of the personal things that I've been doing.

Love it. So final words of wisdom, maybe from either one of you or both of you, and then tell people how they can connect with you.

You can connect. You know, my name's Skip Steward with a D. Like being a good steward of your funds. I'm on link.

You go read James tonight too, aren't you?

That's right, I am. Get way out of here.

I'm going.

But I'm on LinkedIn and I'm on Twitter. You can. I'm pretty easy to find on that. And I would just say be willing to admit that, as Brandon said, you don't know, and that's okay. There's nothing wrong with that. And then move forward.

Personal relationships, as we've talked about, I hate to go back to the same thing, but, you know, focusing on the people first, you've got to build that relationship with any new client, with any new entity or group that you're working with. As I go into a new hospital, the first thing I want to do is I want to meet with the CNO and I want to build a relationship with her and her administrative assistant, because they're the ones that are going to be able to make or break as far as success. So I want to build that relationship first. And then as I go to each particular area of the I'm working with, I want to build that relationship with them. And so I'm always trying to bring in anything personal, whether it's related, as I mentioned, to my wife's condition or to my mom's condition or anything like that. So I could at least have. And even my mom, she was a nurse assistant for 15 years. And so when I start to talk about that, they can start to say, okay, this person really understands, at least from the standpoint of what a nurse goes through, through during their day. They may not know the technical part of how to put an IV in or anything like that. But building that personal relationship, I think in any situation is probably your best, your best asset.

And where can you be found?

You can find me my personal webpage for the company is continuouscoachingcommitment.com you can find me on LinkedIn. Brandon Brown C. Brandon Brown is my Twitter handle. So I tweet a lot of things out on that. Okay, so any of those, any of.

Those areas and we'll link everything up on the show. Notes I don't know what the number is of this episode. I'm sitting here in San Diego, but we'll put it in the intro or something like that. But gentlemen, thank you so much.

What a week. It's been. Great.

I look forward to future collaboration.

Give everybody a little heads up.

I think we're going to head off to, to this amazing hospital system and check out what they got with our camera guys and, and we'll see. Tell a story.

Fantastic.

Awesome. Thank you.

All right, thanks for listening to the Gemba Academy podcast. Now it's time to take a free, no strings attached, fully functional test drive of Gemba Academy's School of Lean and Six Sigma over at GembaCademy.com gain immediate access to more than 500 Lean and Six Sigma training videos free of charge at GembaCademy.Com.

Sa.