GA 243 | How to Strive to Thrive with Michael Lombard

Why am I coaching them if I don't think it's important, you know, not only for their development, but for what we're trying to accomplish. And so I like to actually reaffirm that. I think it puts it, it inspires me. And I think if you're an inspired coach, you know, and you got good technique, you can be a very, like, transformative coach.

When we first started this podcast back in 2014, finding guests was not always easy. So I often found myself just reaching out to friends that I knew within a le community. And one of those folks is my longtime friend, Michael Lombard. Now, I've known Michael for many, many years. And we were, I think we had done three episodes and so we were up to episode number four. And so I reached out to Michael, said, hey man, can you come on and talk about something? And I wasn't even really sure what the heck I was doing back then. And, well, obviously still learning what I'm doing even today. But Michael was kind enough to come on back in May 8, 2014, and we spent some time talking about Toyota Kata, was one of the first people to really go out and become really outspoken about the power of Toyota Kata. And so today what we've done is we kind of caught up on all the things that have been happening in Michael's life since 2014. And he's been busy having children and changing careers a few different times. And so Michael today is a managing director at Kaiser Permanente in the East Bay area out in California. And so during the episode, what we do is we kind of talk about what he's done leading up to that role. In fact, we spent quite a bit of time talking about a two year assignment he had turning around a hospital. He was the CEO of this hospital. And so we really talk about what he did, like how he approached that. And Michael had never been a CEO of a company before, and so he's really stepping in and learning as he went. But as you'll hear, he took a very kind of scientific thinking approach, imagine that, to solving the issues there. And it was a fantastic success story that he's going to tell you all about now. We then transition into his new role at Kaiser Permanente and talk about how they're applying Toyota Kata with physicians and really everyone there at the organization. And he's going to spend some time talking about what they call strive to thrive, which is a really cool way to think about continuous improvement. So show notes for this episode can be found over@gembapodcast.com just look for episode 243 again, gembapodcast.com and look for episode 2, 4, 3. Okay, enough for me. Let's get to the show. All right, Michael, welcome back to the show. How's it going, my man?

I'm good. Glad to be here, man. Can't believe it. We were looking online. We were just talking. I was the fourth.

Yeah.

Number four episode ever in the illustrious Gemba Academy podcast history. Yeah.

This one. I don't even know where we're at. 260 something.

That's what triggered. When I saw that you had gone past like the. The 200 episode. Yeah. I was like, my goodness, that's amazing. That's quite an accomplishment. Yeah.

Well, we had, we've not. I don't. I had double checked this, but I don't think we've ever missed a week.

That's incredible.

I think we had one week like early on where we had like an itunes problem. Like the episode was there, but itunes was messed up or something and. But yeah, we've this, you know, you're a machine, man.

I had like. Because I was trying to find my episode, which was the fourth one.

Yeah.

I had to keep scrolling back and back and back and I had to keep going. I'm like, where in the heck.

Yeah.

How many is he's done? But it kind of goes along with my quote, you know? Yeah. It's easier to act your way to a new way of thinking than it is to think your way to a new way of acting.

Right.

And when you get into the. Those habit building routines.

Yeah.

It just becomes a reflex. It's just impressive how. How you can produce under those circumstances. So kudos, man.

Thank you. Thank you. Well, I love doing it, you know, it's. And this has been especially fun, so. Hey. Well, episode number four, people need to go back. We'll link to it in the show notes.

Old school.

That's old school. You see your og, man, we came a long way since then, man. I mean we had a lot of fun, a lot of learning, but catch everybody up. Michael, what's been up since 2014 with your life?

Well, you know, became a father, have two kids now. That's awesome. Isabella's four already.

Wow.

You know, going on 14.

Yeah.

And then little MJ, he's two, about three. Yeah. And yeah, it's just been life changing.

Sleeping now kind of. Right.

They're finally sleeping and they're. They're healthy as can be and they're. They're awesome. And so that's been life Changing, of course, and kind of taught me the virtue of patience, which I think is important with lean leadership. Yeah. And so, yeah, that's been pretty transformative. And I've continued my journey in healthcare.

Yeah.

And trying to learn as much as I can and help, Help people, basically.

So walk us through your, your, your healthcare journey so far. Like, what have you done along the way and what are you doing these days?

So I guess I started about. I guess it was about nine years ago. Eight. Nine years ago in healthcare, working at Children's Medical center in Dallas as a project manager and then went to Texas Health Resources as a operational excellence director for a while. And then for the past four years, until till recently, I've been working for a company called Cornerstone Healthcare Group, based out of Dallas. And the last role I had there was a kind of a stretch assignment. It was to go to a hospital in southwest Louisiana and be the CEO. And it was kind of a. We didn't, we thought it was going to be kind of a closure. You know, we thought maybe the hospital was going to have to shut down. And we ended up kind of turning it around. You know, it took about two years. But that was the last role I had before my current role, which is. Brought me out to California to work for Kaiser Permanente as a managing director for the East Bay, which is a, the area that includes Oakland, and, and just overseeing our lean transformation. Some other stuff, supply chain reports into me and some of the technical Medicare operations stuff that we do reports into me. So kind of an odd portfolio, but mostly it's lean management.

Yeah. So I want, I definitely want to dive deep into your Kaiser role there. But let's go back to your previous role as CEO. What did that look like? What was the problem and how did you approach it?

Well, I was reflecting on this, driving down today, and when I went down there two years ago or so, the hospital had. The CEO had resigned, most of the leadership team had left. They all went over to the other hospital, which was the competitor in the market. Okay. And so there was basically, there's no leadership team. And they didn't know if they were even gonna keep the hospital open. It was, I think that it was probably within a month or two of being closed down for good.

Okay.

That was the situation. Wow. And it was really beds. And it's a small specialty hospital, 30 beds.

Okay.

And it's part of a hundred bed campus. So we kind of have one section of the campus. Okay. And it was just in dire straits. And, you know, a lot of Shenanigans going on in Cajun country, you know, and. And it was. It was kind of. Well, it really wasn't funny, but it was actually just so bad that it was comical.

Wow.

You know, and it was really just a stretch assignment for me to learn and to get some experience as a hospital administrator. But there were no expectations. And so what was your approach? You know, I was fresh off of, you know, I've been teaching, really going deep into the improvement kata. Coaching kata. Spreading it across 18 hospitals within this company. Cornerstone for years leading up to this. So it was like I was getting a ton of reps. Yeah. So by that point, I was kind of ready. You know, Mike Rother talks about, you know, take the training wheels off. Yeah. You know, you need to make it your own. That's kind of what I did. I didn't go down there and introduce any formal methodology. It was more of just like, hey, let's identify the problem to be solved and let's get to work on, you know, aligning the organization. Let's get to work on improving our processes and developing our people and enabling them. Kind of the three, you know, areas that I always fall back on is like, how are we doing in those three categories? That kind of the approach that I took and, you know, it was very complex. For example, like, the alignment piece, at first, there was no, like, ocean planning or strategy deployment. It was like, can we keep the doors open? Yeah, that's. That's what we're going to align around for now.

Yeah.

And that, you know, in order to do that, we had to rebuild a leadership team. So that was like the first target. And then after that, we had a bunch of really technical regulatory issues that we had to work our way through that also threatened to shut the doors. So that was like the next target. So the first little bit alignment was kind of easy because it was like, it's do or die.

Yeah.

You know, there's not a. It's not hard to build consensus to.

Hey, we have to improve the burning platform. Was.

It was there. It was like, yeah, yeah. Flaming barge of Burning platform. So, you know, but eventually it became more complex. It was like, okay, now can we. Can we actually make budget? You know, God forbid we actually make budget a couple months. And we did that. We achieved that for a whole year. And then it was like, can we actually secure our future? And basically that meant in that market, because of the dynamics there, it meant, can we strike up a joint venture with one of our big referrals? So one of our Big customers. And I checked in, I've been out, I've been gone from for about nine months. But I checked in with my successor. Yeah. And they just closed the deal on the joint venture just like a month or two ago. And so the future is bright location. But you can see how it started off. The alignment piece was just let's stay open.

Yeah.

And then let's hit budget and then let's.

Yeah.

Move forward. So that was the alignment piece. Nice. And then as far as like, you know, my there that most passionate about when it comes to a lean management system, whatever is enabling your people, developing your people and you know, which is why I'm probably such a big fan of improvement kata coaching, kata method. But we didn't, like I said, we didn't introduce as a formal thing but we did introduce some things like visual management and huddling to be able to. So that everybody had a way to speak up and a way to surface issues and a way to tackle them using visual management. So that was kind of like probably the number one tool that I relied upon when I was down There was a big old visual management board that took up a whole wall in a conference room.

Nice.

And everybody had their segment of the board and their segment of the board had. Here are my, you know, two KPIs on a run, chart tracking and here's my daily flow of patients that I'm managing. And then here are the improvement. My A3s or whatever. Yeah. And so everybody had their board and that was like I use that as a, as a development tool for my people.

Were there any employees that were there at the very beginning of the, of the crisis that stuck with you all the way through?

Oh, everybody.

Oh really?

Yeah. Once the, once the coup d' etat had occurred and the whole prior regime kind of left the remainders which you know, out of a, let's say a 12 person leadership team, there was maybe three. Three that remained and then we added the other.

But then there was nurses and oh.

Yeah, a lot of them were looking for jobs and, and we were able to retain most of them, you know, through grid partnership with hr.

Yeah.

And once we, once we settled down after that first month, you know, we didn't lose a single leader the whole time I was there. It was a miracle. You know, I was really thankful because there's no way you can make progress.

Yeah.

You got stability with your leadership team. And there was, you know, people that have been there for, you know, 25 years, they were bought in.

Yeah.

They did not want to see that place shut down. And they're the ones that had the gumption to make it happen.

So looking back on it now, if you. If you could go back and have a conversation with yourself now, knowing what you know now, would you have done anything different?

Oh, yeah.

You think you.

Oh, yeah.

I mean, we always learn.

And it's easy because I was a rookie CEO, so it's like, expect that you're going to make a bunch of mistakes. And we did. Fortunately, none were like, you know, grievous mistakes.

Yeah.

But there was, like, I spoke about this at. When I did my keynote at Katacon last year in Atlanta. Title. My presentation was when the Training wheels come off.

Yeah.

And I kind of did a little rope a dope. I kind of led the audience down a path where we're talking about, hey, we turned around this hospital, it was all great. And then at the end, I kind of gave him a surprise ending, which was. But here's why it went wrong. And it was the fact that, you know, as I'm using kind of the scientific mindset that I kind of developed by practicing kata for thousand plus coaching cycles, kind of just started using it to make stuff happen down in that market, forging, you know, joint ventures and whatnot. And it was really. We were testing every step along the way. Yeah. But the people that I was working with, they hadn't been really formally trained in that method. And so for them, for some of them, it was very stressful. And, you know, it made life tough on them because there was so much experimentation happening around them and they just didn't. They didn't know how to frame it. Like, they didn't have the context to think scientifically.

Yeah.

And so if I were to go back and do it again, I would have introduced more formal, a deliberate practice of kata as opposed to just de facto practice. Like, yeah, we're practicing, we're doing it, but I'm not calling it anything.

Yeah.

I would have given a little bit more education, a little bit more time to kind of like, adapt. Because I think for some people, they really struggle with embracing that uncertainty that comes from rapid experimentation.

Yeah.

So that was a big kind of aha moment for me. Like, yeah, I would have done that differently.

Yeah, yeah, yeah. Got it, got it, got it. Well, great job though.

It was fun. It was very stressful. I've got all these gray hairs in my beard now that I did not have before I went down there.

Yeah.

I also have a deep appreciation for gumbo now.

Okay.

Because when you're in Lake Charles, Louisiana, and they have an annual hospital gumbo cook off. Yeah. Like basically every department makes their own gumbo. And it's like unique and distinct. There's 20 different, you know, five gallon pots of gumbo lined up and you have to sample them all. Yeah, that's the, that's the culture down there.

Okay.

And it's delightful. But instead of chili cook off, it's exactly. Although I did introduce Texas chili. Okay. Market.

Nice.

And we had a chili cook off right before I left.

There you go.

And I think, you know, true Louisiana political fashion. I think they rigged the voting and.

Okay.

I ended up losing.

That's all right.

All right.

So let's talk a little bit about what you're up to these days. Michael, tell what's your role looking like these days at Kaiser Permanente?

Yeah, so in my role there, I've worked. Kaiser's kind of this big behemoth of a healthcare system. And in each service area, it's kind of you have two organizations. You have Permanente Medical Group, which is all the doctors, and then you have the hospital and health plan side. It's a really great actual model. The way that they do it, it's all one stop shopping. You know, if you're a member, you kind of prepay for your care. Your money flows into the health plan, the health plan distributes it to the medical group and the medical, the doctors are the ones that make the decisions on what's going to be done. Right. For the patient. And then, and then they work in collaboration with the hospital and then the outpatient centers as needed. And so I work on both sides, which is a, which is a fun thing. You know, you get to almost work with two cultures. You know, although there's a lot of similarity and there's a lot of unity, but you get to see the different leadership styles. Yeah. And it's like a nice. It's like you have two petri dishes, you know, and you're experimenting with things and you can try things. But anyway, so that's the way Kaiser set up and I'm manage their, what we call patient Care Improvement system. It's our version of a lean management system. Okay. And that's the. Yeah, that's the majority of my portfolio. And you know, we were talking earlier, there's a few other departments and stuff, operational departments that report into me, but it's predominantly focused on, you know, aligning the organization and process improvement and developing people.

Yeah. So what's the, what's Kaiser's journey With scientific thinking. Toyota Kata.

Yeah. You know, I started introducing it about six months ago. Okay. And it kind of. It kind of took off kind of organically. We on the medical group side, it's a very. It's a very kind of collegial environment. It's not a big top down structural kind of culture. And so instead of doing like the standard approach to introducing kata, which would be you form, you know, an advanced team and you start developing your initial cadre of coaches and then you kind of multiply from there. We said, why don't we just do kind of more of an organic approach? Just kind of. Let's train all of our physician chiefs, that's like the head physicians for each department. You know, let's train them up and let's see what they do with it, you know, because they're a bunch of really high achieving, smart, dedicated folks. Let's just see what they do. And I was kind of wasn't exactly enthusiastic about that approach because it just wasn't what I was used to. Okay. But I went with it, you know, because I was new and I didn't really fully understand the culture, but I trusted the people that I was collaborating with. And it really yielded some nice unanticipated applications of kata that I never even considered. For example, one of our docs who's over our adult and family Dalton Family medicine practice is a big. It's like our primary care department. And so it's a major kind of department. And the head of that, he just started using it with his patients, actually coaching a patient as if the patient was a learner, because you can come up with the best care plan, but if they don't adhere to it for.

Whatever reason, was a challenge to be well.

Well, if you think about. So this led to. Once we heard that he was using. Caught it directly with patients to help them strive through their own psychosocial issues that were preventing them from being well.

Yeah.

Then we started thinking about what's the, you know, what does it really mean to be well? Because Kaiser has this campaign, it's called Thrive. That's like their main marketing focus. It's called Thrive. And the idea means we want our members to thrive. We want them to have well being, we want them to be healthy. But we started talking about, well, what does that really mean? Is there something more even than just not being sick? Is our. Is our job as a health system to just help you not be sick, or is it to help you what, be happy? Or is it to do like, be Able to do meaningful things to enable you. So because Kaiser is, like, pretty far ahead on a lot of the. The areas that healthcare struggles with, they've accomplished things that have created a nice, stable foundation.

Okay.

They can start to have these types of conversations and say, you know, what do we want to be in the future? Is it just to keep people from getting sick or is it to help enable them to do meaningful things, you know, to learn and to grow and, you know, you can actually have those kind of conversations at the senior levels.

Yeah.

In a company like that because of the. Just the foundational stability that they have.

Yeah.

So when we run these little experiments, like using KATA with a patient, it's like we're kind of studying that.

Yeah.

And saying, could that be, you know, a bigger thing?

Yeah.

And, you know, like I mentioned thrive. That's the marketing thing for Kaiser.

Yeah.

Well, KATA is kind of a striving model. So we said, let's just call it Strive to Thrive. Can we all. So, doctors, can we strive? Can employees strive? Can leaders strive? Can our community, our patients and our members strive? And can it develop those good striving skills? And can that lead to maybe better mental resiliency? You know, we've seen that happen. When you do KATA with your folks.

Yeah.

Inside the organization. Yeah. You see them develop a nice resiliency. Right.

Yeah.

Why couldn't a patient do that? You know, and so the strive to Thrive kind of applies to all of our people, not just our employees, if that makes sense.

So how's that working with that doc and his. A patient?

Yeah.

I mean, it's just got a big storyboard up on the wall or what?

Or it's more informal than that. Okay. It's more of like in the flow.

Of their appointments, just how they're having conversations.

Yeah. Yeah. It's like a training was off kind of version of it. It's just kind of setting target conditions.

You know, based on next time I'm going to see you in a week.

Blood sugar to be at a certain level.

Yeah.

And you have all these obstacles. You've got, you know, the way you normally cook.

Yeah.

Full of, you know.

Yeah.

Carbs or whatever.

Yeah.

You know, and maybe there's medication that you can't afford or maybe, you know, there could be a hundred different psychosocial determinants.

Yeah.

That might be kind of obstacle. Obstacles to your meeting your target. And so doctors often get very. They tell me they often get very frustrated and they kind of lose a lot of joy in their practice because it's like, I come up with this great care plan. I know it'll work. It's. It's not really that complicated. It's like you're pre diabetic. We know kind of what you got to do to not be diabetic.

Yeah.

And. But nobody does it. And so it's like. Feels like my work isn't meaningful.

Yeah.

That's what they're telling me. And they're saying, but now when I'm now thinking of it as a coach, not as the designer of their care plan specifically, but rather I'm helping coach them to a care plan, help them strive through their challenges, is adding some more kind of joy, meaning back to their practice, which is a really, a really cool thing to see because when you're in, I mean, in Kaiser, we have so many members and you just see so many patients and it can become very much of a. Just a repetitive thing.

Yeah.

But now this is adding some more human element back into their practice.

Nice school. Nice.

Yeah.

Now what about just from like a continuous improvement perspective, how. What's your. Are you using Improvement Coaching kata for that?

Oh, yeah, yeah. So we've, we've started to develop advanced teams now. For example, we have a group of doctors that are what we call communication consultants. They help doctors improve their communication skills with patients so that the experience can be better for the patient. And we're training them up as an advanced team so that they, when they go to kind of help a doctor improve their, their patient satisfaction experience, they can use the same techniques. That's one example where what's an advanced.

Team just for folks that maybe don't know what we're talking about.

So it's the, the group of folks that you kind of go deep with.

Yeah.

And you really develop them. You get them a lot of reps so that they can have some level of proficiency with the Puma Kata Coaching Kata method. And then once they're, you know, pretty proficient as a learner, they can start practicing the coaching kata and then they can become pretty proficient at that. And at that point they can start grooming the next wave of coaches so that you can spread. It's kind of, you know, Improvement Kata Coaching Kata method is kind of designed to be a spreadable method. You know, there's other, you know, maybe more sophisticated improvement techniques. You know, if you want to get into, you know, doing, you know, a three problem solving in a very, very like, powerful, sophisticated manner. But it's not necessarily designed to be spreadable. Something that's designed to get rapid reps. Yeah. Kata is all about. Yeah. Tons of reps. So you can get practice and kind of rewire your neural pathways, you know, and so that's why you develop the advanced team is not for them to be the greatest, most, you know, advanced problem solvers in the world, but to be able to get to a level of proficiency that they can then spread it.

Yeah.

And that's a little bit of a fundamental difference. Yeah. With kata, we consider it at Kaiser East Bay very squarely in the kind of enabling people and developing people category. More so than just like process improvement.

Okay.

You know, but although you get that as well.

Sure, sure. Yeah. I. The way I've been. I liken to scientific thinking is. Or Toyota. I. I'm using the analogy, and it's not perfect analogy, but I believe it's the horse, you know, and the horse is. Is walking towards this ideal state, you know, challenge, whatever you want to call it, where they. So they got a. They got a heading and they're pulling his huge cart, and the cart's full of things. Maybe our tools, maybe our methodologies, whatever it might be. And the horse eventually comes against an obstacle, something is in the way. No. Horse can't get around it, so he needs something out of the cart to get through it. So, you know, in Gamba Academy is an example, we have 1500 videos. So people are like, which one do I start with? Hell, I don't know. You know, I mean, what obstacle do you have in front of you right now? Right. And that will dictate the tool. Right.

Having that. Having that meta skill of knowing kind of what tool tends to kind of.

Yeah.

Useful in what situation.

Yeah.

Is really powerful, you know.

Yeah.

Especially when there's so many tools out there to choose. Exactly. Become tool of the day or whatever. Right, right. Except when you're doing it just in time in response to a specific issue. That's powerful.

Yeah. You know, so what I want to talk about now is you've been practicing kata for a long, long time, Michael, One of the leaders of this movement, I would say, you know, there's this. I was actually talking to. To a person recently, and they were saying something to the extent of that, you know, they don't want to get bogged down in the tools, you know, and they started rattling off 5s, you know, seven ways. Toyota Kata. And I'm like. And I'm like, yeah, it's not a tool, you know, it's a way of thinking. Right. And so I think we've got to Do a better job within the, within this lean movement of ours. And kata practitioners of explaining that it's not a tool. Right. It's a way of deliberately practicing, you know, of learning. And I would even say we should stop trying to solve so many problems. Instead try to learn, learn faster. And the faster we learn, the problems will be knocked down.

Yeah.

But it's not about solving the problem. It's about learning.

Right. When you, when you get so much, so many reps and so much practice that you kind of learn how to learn.

Yeah.

And you improve how you improve.

Yeah.

Then, you know, you've got that meta skill.

It changed your life.

It's just, it's just like, okay, now whatever's in front of me, I can deal with.

Yeah.

You know, whether it's a hospital in Louisiana that's about to close down or whether it's a patient in front of a doctor that's got some psychosocial issues. Yeah. You know, it's just the, this tenacious mindset and these reflexes.

Or my 16 year old daughter who's stressed out because she's struggling in chemistry. Right. And so. All right, let's break it down, babe. You know, and you know, next thing you know, she's. She's chipping away one obstacle and she's doing it. And next thing you know, grades come up, she's believing in herself.

You know, it's amazing how that, that snowball effect starts to happen, you know?

Yeah.

On the topic specifically of the, you know, the tools and the misinterpretation of where kata fits in. You know, I used to try to have a lot of these intellectual conversations and try to talk my way into, like, let me try to explain the difference between a, you know, a tool and a meta habit, you know, and like, and it would never leave anywhere, like. No, everybody just has their understanding.

We say meta. They're like, what meta mean? Yeah.

So it's pointless to have it like, it's. Again, it's back to acting your way to a new way of thinking. Yeah. So what I love to do is just, I don't even really tell them that we're doing it. I just start doing it with them. And so I'm working on this A3, trying to improve, you know, reduce defects in my department or whatever. And it's like, oh, cool, let me see your A3. Okay, so you're, you're on the left side. So your target is probably to get this left side done in the next, what, two weeks? Is that about right?

Yeah. Okay, cool.

Well, what are obstacles, you know, would you have to get through to get the left side of that A three done? Well, this fishbone diagram, I'm not exactly sure how to really do that or who I need. Okay, what's an experiment that you could do to maybe. Oh, I can go watch a Gimb Academy video.

I was hoping you were gonna say boom. Boom.

Yeah. You're gonna pull out the good whiskey later, right?

Yeah, yeah, yeah.

So that's, you know, while. While other. While I would have, you know, three, four years ago, I would have spent hours trying to convince this person that kata plays well with a 3s. And there's not. They're not in competition for each other. Yeah. Trying to. And having people argue. No, let's just not do kata. Let's just do a three. I'm like, cool, let's do a three. Let me help you real quick. And we're gonna do this coaching tech. Yeah. And they don't even know it. Before they know it, they've got a few reps. Yeah. And then they're starting to see, huh, there's something that happens.

There's a rhythm.

Yeah. Like this rhythm. Now we're dancing. And this routine, even, it's almost like a practice, like we're practicing a routine. Yeah, yeah. What is it? And that's, you know, that's the point I've gotten to. Maybe it's just lessons learned from the past.

Yeah, yeah. No, I love it. I mean, we, you know, we still have a, you know, kind of a traditional green belt, black belt program for folks that want to learn to make, and we coach them now using coaching kata. All right, so where do you want to be? Oh, you got to do an MSA measurement system analysis.

Cool, cool, cool.

All right, so what are. What's. What's. What's in your way? Well, you know, which one of those you want to go after first? That one. Okay, cool. What do you want to try? You know, what do you think's gonna happen? When can we find out what we've learned next?

You know, and it's beautiful.

It's just this rhythm, and we're moving through the DMAIC process with a coaching cattle.

And it feels natural.

It is. It's totally natural.

What I love, though, is when you get to. Okay, so you get. You get past that point. And they're like, okay, I get it. Now. There's, like, this meta thing that I really like. Well, how can we do more of this kata stuff? And I say, well, what a target Be for that.

Yeah.

Can we get to, you know, one repetition a day?

Yeah.

Okay. How do we currently do that? You know, what is our current approach? Are we blocking any time to do coaching? Yeah. So we're walking through, we're caught out of the kata, and then the head explodes, and then you have to kind of regroup. Exactly.

You know, the hardest part. I've been meaning to ask you. I wanted to have you on for last year or so. You know, the hardest part of practicing kata to me and teaching others and even just doing it ourselves at Gemba Academy, is target conditions.

So tough. They're so tough.

What are your. What are your. What. What have you learned along the way to. To help with setting good target conditions?

Yeah, I mean, it's all what you do prior to trying to set the target condition, you know, so. And that could come in. There's a couple different ways to interpret that. So one, how much practice do you get before, you know, so the more you practice, the better you're gonna get at it. So that's a blanket state. Sure. But more specifically, it's like, you know, as you're doing the understanding the direction part of kata, and then you're doing the grasp the current condition part, then setting a target becomes essentially the. The art or the talent, I guess, of holding two things in your mind simultaneously.

Yeah.

You know, where are we headed overall and where are we at today? And using insights from both of those to find this. Like this. This where. Where the. The Venn diagram overlaps. Yeah. You know, between what makes sense for where we're headed in the future and what would be based on the reality of today. So you're holding these two, you know, just thinking about the overall direction. I'm using my hands here.

Yeah.

Anybody can see me on the. On the podcast. But when you're thinking overall direction off in the distance, you're thinking. You're using the strategic part of your mind.

Yeah.

You know, and sometimes the creative part of your mind and. Or should be always.

Yeah.

We actually. We don't call it, like, a direction or a challenge or a hoshin. We call it just what would awesome be? Let's talk about awesome. And then we work our way back from that to find, you know, like, oceans, like, challenges or whatever. But we start with just, like, creative. Like, let your mind roam, like. Yeah. What would the ideal situate. You know, what would awesome look like?

Yeah.

So you're holding that creative, strategic, big pie in the sky kind of mentality, and at the same time, then you're doing the. Grasp the current condition, where you're doing a very analytical, like, objective reality check. Really, how are things done today and what kind of results does that produce today? And, you know, what are some of the factors at play today? So there's a very analytical mindset, and then you're holding this creative big picture kind of mindset, and at the same time, and you're holding those two things at once. That's a tough thing to do. Yeah, that's totally different. Right? Those two mindsets.

Yeah.

And so you're trying to hold them at intention, you know, at the same time, and then trying to snatch out of that. Out of that ether, like the. Where these two bodies are orbiting each other, trying to find that. That gravity that kind of connects. Stepping stone, like, that's it. That's okay. I got. I think that's it. Yeah. And then, of course, it's, you know, an experiment to see if you even selected the right target. So that's a different type of. Of experiment that occurs at a higher level than. Than the little experiments that you're doing to get to your target.

So here's another tactical kata question for you. So you're. So when you, when you're, let's say you're, you're well into a regular routine with a learner, you've had many different coaching sessions and, and they have a previous step that they were. They're coming to report on kind of thing. When you ask the question on the card, you know, what's your current. What's your target condition? You know, so they can say, okay, what's your current condition? So when you ask the current condition, do you. When do you. How often do you go back to the. Because it. You're really asking, what's the current condition of that target condition? Right. How often do you go back and what's the current condition as it relates to the challenge? Like, you know what I'm saying? Because there's going to be two different things.

You mean the. Okay, so let me just clarify. We're not talking about the current condition originally when we first started, right? You're not talking about that?

No.

Yeah. You're talking about how, like, are we 25% on the way to our target? Are we 100% out of the way? Have we, have we met our target yet? Yeah.

Let's say, for example, let's say the challenge is, I want to run a marathon. I want to run 26.2 miles. What's your beginning? What's the current condition? I can't even run a mile without throwing up. Okay, cool. What's your target condition? Where you want to be in two weeks? Well, I want to be able to run a mile without walking.

Yeah.

Okay, cool. List out some obstacles.

Blah, blah, blah.

Okay. So we're working our way towards that mileage and come back for our third coaching session. Hey, what's your target condition? I want to run a mile without walking. What's your current. Where are you at now? So they're gonna. They're gonna talk about that, but now we're not worried about 26.2 anymore. You know, we're worried about that target condition. I guess what the. Sometimes the question comes in is, how often do you track? Where are we at on the 26.2 miles? You know what I'm saying? I like to.

I like to start off a coaching cycle by. As the coach, I'll kind of. I like to kind of lead them into the right frame of mind and the right vibe, you know, to have a good, productive coaching cycle. So I like to kind of kick things off by, you know, let's. Let's reaffirm our vision of where we're headed overall.

Yeah.

And I. And I like to actually do that myself as a. You know, I probably should have them articulate that back to me, but I actually like to do it myself as a way of showing, like, my commitment to their journey, because, you know, why am I coaching them if I don't think it's important? Yeah. Not only for their development, but for what we're trying to accomplish.

Yeah.

And so I like to actually reaffirm that. I think it puts it. It inspires me.

Yeah.

And I think if you're an inspired coach, you know, and you got good technique, you can be a very, like, transformative coach.

Yeah.

If you're just kind of going through the motions, you don't really care.

Right.

Still be a good coach with good technique. But, yeah, I like to kind of make sure that I'm committed and. And verbally indicating that. So I'll say, all right, man. So, Ron, you're working on this awesome thing, man. You're gonna run a marathon. Like, that is. So few people do. That is so awesome. Yeah. Like, so I'm trying to do the emotional intelligence thing so we can connect and.

Yeah.

You know, get. The atmosphere is conducive to good coaching.

You know, set to learn our D's.

Right.

Twi.

Yeah. And just like. And get excited. Let's just get excited. Because running the marathon, it's cool thing.

Yeah.

You know, let's get excited about that. So I like to do that. And that's always like a good starting point.

Yeah.

And then it's okay with that awesome challenge of mine. Let's jump into these five questions. You know what I love is you start to see at the medical center people, we have little badge buddies that have the five questions card on and people will say, hey, I just need to practice, I need to get some reps. Do you mind if I use these questions with you? Is it just a way to kind of like have a conversation somebody into doing it with them? Yeah, because there's like, you know, in the past, you know, just, you know, well intentioned. But effective coaching can be like, well, what are you doing to fix this problem? And then they're automatically triggered in a negative way. They're kind of in an away posture at that point. You know, you can like physically see people kind of withdraw, lean back almost. And so as a counter to that, people would just be humble and say, I just need to practice my coaching kata. I need to ask these questions. Questions, do you mind if I just do them with you real quick? So then you jump into the questions and then you get, you know, then it's pretty straightforward. But there's that part where you, you were mentioning when you get to the. It says after you've answered the second question, what is the current condition? It says flip the card over and reflect on the last experiment. It amazes me to this day how often people just struggle with that act of flipping the card over and reflecting on the last experiment. Like the first, I would say five to 10 coaching cycles. I do with somebody I know that every time they're going to not understand like why to reflect on the experiment or how to do it. It's just like this physically awkward thing for them to do. Yeah. So I like to, you know, what's.

Crossing your arms the other way, man? Yeah, exactly.

It is even like, even at like a physical level, like just the flipping over of that car just like throws them off.

Yeah.

You know, and so I've experimented with different formats of the card, but I don't really, at the end of the day, I don't think it's the tool that's the issue. I think it's just mindset that, you know, that has to be formed.

Yeah.

It's interesting how that always target conditions because you're trying to hold these two things constant like where are we headed and where are we at? And making a decision based on both of those mindsets. That's tough.

Yeah.

And then that part about reflecting on the last experiment, it's like people so uneasy about that.

Yeah.

I like to kind of try to hone my skills in those two areas whenever I can. Yeah, I love it as a coach.

I love it. What's next for. For Michael Lombard and Kaiser Permanente?

Yeah, I mean, I'm really loving it there. You know, Kaiser's very much a leader in quality in the healthcare industry. They're pretty revolutionary, actually, the way that they've modeled their company, their business model, and. And I see this kind of strive to thrive concept as having a lot of. A lot of room for growth.

Yeah.

I think, you know, we've seen multiple anecdotal examples of how it can be used directly with patients, and now we want to put more research into that and kind of prove it out. And fortunately, you know, being in the Bay Area, we've got wonderful resources, you know, UC Berkeley right in our backyard, and they have the Clear Institute, the Center for a Lean Engagement in Research and healthcare.

Okay.

And Dr. Steven Shortell is a friend. And we're, you know, looking at how can we, you know, quantify the impact of strive to thrive using KATA with patients. Yeah. Trying to put some more formality behind that. So I see that as somewhere that we're gonna be headed and just continuing to evolve our management system, which is. We're about three, four years into lean transformation. I've only been there for nine months, and for the first three years or so, it was your traditional infancy of lean, where you're doing a lot of tools, you know, and we're starting to kind of start to understand like the Shingo model a little bit more and kind of unwind from the tool based architecture and go to more of the principle based architecture, which is, you know, comes down to ideal behaviors, which come down to habits and reflexes. So here we go with KATA again. It's like, how can we help you set a target to develop a new habit of reflex for doing whatever catch ball as part of your strategy deployment.

Yeah.

Or doing coaching as part of your people development. Yeah. Or doing, you know, pulling the andon cord as part of your continuous daily improvement? Yeah. It's like, that's a reflex too. Well, let's set a target. How can we get our folks to have to feel perfectly safe pulling that and on cord?

Yeah.

You know, so I see us progressing toward a, you know, behavior and habit based, principle based architecture. That's really where my focus is right now and, and I think, you know, we're just getting started, so. A lot of room for growth. Yeah.

Well, we'll have you back on.

And another.

Let's not wait, you know, four years. Four years, you know, five years.

I forgot to ask you, man, how I know you got. How many kids do you have now? Seven. Yeah, I tried to, you know, start trying to catch up with you. Just no way to do it, man. Got too much of a lead on me. I think we're done at two.

Well, that's all right.

But they are a handful and I'm sure seven's a handful.

Yeah. Well, it's interesting when you have that many kids, you know, the older ones end up being like, little. My oldest two are girls. Thank the good Lord. You know, they're super, super helpful and mature, you know, and.

When's the last time you had good Texas barbecue?

Oh, man, a couple weeks ago maybe.

That's not bad. Yeah, it's been a while for me. I haven't lived in, you know, in Texas for about, I guess two years now.

Yeah.

And. But I did last weekend, went into San Francisco for this pop up barbecue event with an Oakland based barbecue guy.

Yeah.

Matt Horn. And it was awesome. It was Texas style barbecue. He actually went to Texas to the Gimba. Yeah. And studied how they make barbecue. Yeah. And absorbed it all and brought it back to the bay. So now we got Texas barbecue in the bay. I'm stoked.

Nice, nice, nice. So good. Hey, so how can folks connect with you, Michael? What's the best way.

Oh, man, it's been a while since I've even thought about that. LinkedIn. Yeah, I'm on LinkedIn. Michael Lombard. I'm Twitter. It's at Mike Lombard. I don't really do. I used to do a lot of blogging and.

Yeah.

And YouTube videos and stuff. But it's. It's been probably four years. Yeah. Done any of that kind of.

Of stuff.

You know, just with, with kids and with these types of roles that I have, it's like there's not a minute to breathe.

I hear you.

But. Yeah, I guess probably on LinkedIn and Twitter and. Yeah, that's cool.

All right, brother. Well, hey, man. Well, we got to get ready to go to this Gimba Academy cocktail party. Not to rub it in listeners ears that they wouldn't be able to go.

Because it's already passed. Why aren't you here, listeners?

Yeah, yeah, yeah. Some of them are. Some of them are.

We'll see you later then.

Yeah, that's kind of weird. It's like, you know. Yeah, I know. Future, you're blowing my mind. Thanks, brother.

Thanks, Ron.

Be good. Thanks for listening to the Gemba Academy podcast. Now we invite you to take a no strings attached, fully functional Test drive of Gembaacademy.com gain immediate access to more than a thousand Lean and Six Sigma learning resources, all free of charge at Gembaacademy.com.