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KaiNexus Blog

Everything Continuous Improvement


Maggie Millard

As the Director of Marketing, Maggie educates the continuous improvement community, KaiNexus customers, executives, managers, and staff in just about every industry you can think of about improvement principles and KaiNexus' continuous improvement software. Her desire to improve the American healthcare system combined with a love of spreading knowledge to the far reaches of the internet inspires her work with KaiNexus every day. Maggie graduated from the College of William and Mary in 2010 with a BA in History. She spends her free time hanging out with her sweet, sticky, stinky new baby and two displaced dogs in the mountains of Virginia.
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Recent Posts

Insights into Tech and Healthcare from Last Night at General Assembly Austin

Posted by Maggie Millard

Aug 16, 2017 1:37:47 PM

Last night, our CEO and Co-Founder Dr. Greg Jacobson was invited to host a panel at the General Assembly Tech and Healthcare event in Austin Texas. This event hosted “thought-leaders in health care to explore new intersections between their field and technology. Together, we discuss how they’ve been impacted by the rise of tech, ways they’ve adapted and innovated along the way, and what they expect to see in the future.”

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Ideas for Spreading Improvement from Our Lady of the Lake Hospital

Posted by Maggie Millard

Jul 31, 2017 10:46:48 AM

Here at KaiNexus, we often get a peek into some of the truly remarkable improvement initiatives and work that organizations undertake to create positive change for their customers and employees. Recently, KaiNexus Vice-President of Improvement & Innovation Services, Mark Graban, spoke with Lindsey Booty and LeaAnne Teague from Our Lady of the Lake hospital in Baton Rouge, Louisiana.

Both Booty and Teague work in the Lean Management Office of Our Lady of the Lake, which is an 800-bed teaching hospital that began using Lean and CAP [Change Acceleration Process] methodology about three years ago.

Listen to the Interview
and Subscribe to the Podcast:

“CAP is change acceleration, we learned it from our GE counterparts when they were here with us in a consulting role, and it helps to ensure that you have the “people” portion of improvement considered. It goes through creating a shared need with your peers and with your team members, making sure that they’re properly bought into the change, ensuring that systems and structures around the organization are set up to make sure that the changes are sustained throughout improvement. It really helps us to get aligned with the “people” side of improvement that’s often left out when you just look at quality solutions,” Booty said.

“Three years ago was around the time that people really began to talk about highly reliable organizations, and to be highly reliable you needed this very robust process improvement platform,” Teague said. “Our leadership really looked at that, took the challenge, and said it’s through Lean methodology and it’s through change acceleration that we want to begin to make our mark.”

A big part of Our Lady of the Lake’s improvement efforts centered around Lean boot camps they hold bi-annually. However, in 2017 a new electronic medical records (EMR) system was installed at Our Lady of the Lake, which represented separate improvement work that needed to be completed.

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Enhancing the Power of Idea Boards with Improvement Software

Posted by Maggie Millard

Jul 28, 2017 11:54:30 AM

Idea boards have been used for quite some time now as a way to engage staff in continuous improvement. They're an excellent improvement on a suggestion box system, since the boxes have (on average) just a 2% implementation rate. Idea boards are used in companies around the world in every industry, with varying levels of results.

In this post, we'll look at the value idea boards bring to the table, and how to improve upon them with the use of new technology.

What are some benefits of idea boards?

  1. Inspiring Engagement

    When you have a board filled with opportunities for improvement submitted by your front line staff, the result organizations want is increased engagement in the improvement culture and enthusiasm for getting involved. Seeing those ideas - and the effort going into implementing them - inspires people to come with their own ideas, and it makes improvement part of the daily conversation.

  2. Sharing Ideas

    Humans are wired to improve. We want to do things to improve the goods and services we provide to our customers and patients, and we want to make our own jobs better, safer, and more efficient. Idea boards extend the usefulness of each improvement we make by sharing them with other people in our work area. Say, for example, that you determine it would be more efficient to store supplies in a new location. Rather than just moving them in your own work space, you can share the idea on an idea board and thus bring it to the attention of everyone else in the area. In this way, your own incremental improvement has a much larger impact on the organization.
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Strength in Numbers: Improving from the Bottom-Up [Webinar Preview]

Posted by Maggie Millard

Jul 26, 2017 11:18:51 AM

I was so excited to do this podcast interview with Mark Graban about tomorrow's webinar, I just had to share it with you all here on the blog, too.

On this episode of the KaiNexus Podcast, Mark Graban, founder of LeanBlog.org and the VP of Innovation and Improvement Services here at KaiNexus, gave us a preview of tomorrow's webinar titled Strength in Numbers: Improving from the bottom up.

Strength in Numbers: 
Improving from the Bottom-Up

July 27 from 1:00 - 2:00 ET

Register Now

In this webinar, you'll learn:

  • Where your best ideas for improvement come from
  • Why bottom-up improvement is a critical component of an improvement culture
  • The ROI of engaging everyone in improvement
  • How to engage more staff in improvement
  • How to keep up with all of those new ideas


Listen to the Interview and Subscribe to the Podcast:


If you've been keeping up with KaiNexus, you know that this is a topic near and dear to our hearts. Our continuous improvement platform was originally created to facilitate bottom-up improvement, spreading into top-down improvement and strategy deployment over the years to support more comprehensive improvement cultures.

Bottom-up improvement refers to ideas from front line staff about how they can improve their work. These improvements save money and generate revenue, save time, improve customer and patient satisfaction and safety, and make the company a better, safer place to work.

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From the Model A to the Model 3: The Opportunity Cost of Failing to Improve

Posted by Maggie Millard

Jul 19, 2017 9:41:14 AM

The definition of opportunity cost is "a benefit that a person could have received, but gave up, to take another course of action. Stated differently, an opportunity cost represents an alternative given up when a decision is made. This cost is, therefore, most relevant for two mutually exclusive events."

Think about this in the context of opting to implement continuous improvement software. That decision is pretty clear-cut; either you implement the software, or you don't.

While people understand the concept of opportunity cost when it comes to, say, investing, applying that concept to improvement seems to be a bit more elusive.

In this post, I'd like to take a look at the opportunity cost of NOT implementing improvement software.

Typically, when we're trying to get an organization to calculate the cost of each idea they fail to capture and implement, they get stumped right off the bat because they don't know the value of their ideas and have no way to measure the numbers that are getting lost along the way.

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How Lean Coaching is Different for Bottom-Up Improvement

Posted by Maggie Millard

Jul 12, 2017 2:35:15 PM

A sustainable culture of continuous improvement needs five things: bottom-up improvement, top-down improvement, strategy deployment, coaching, and visual management. Every organization claiming to be Lean incorporates some of these 5 elements, but only the best incorporate them all.

Part of the trouble companies have is that they find themselves focusing too much on top-down initiatives such as Rapid Improvement Events, Kaizen Events, and Lean projects. Yes, these approaches are all valuable - but they’re not the end all, be all of an improvement culture. Bottom-up improvement is necessary in order to make incremental, impactful improvement by engaging every person in the organization in solving the most pressing business concerns.

There are some major differences that must be accounted for when coaching bottom-up improvement as compared to top-down. In this post, we’ll take a look at what some of those differences are - and why increasing bottom-up improvement is worth making a change to your coaching style.

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The Trick to Implementing Efficient Bottom-Up Improvement

Posted by Maggie Millard

Jul 6, 2017 7:37:00 AM

Organizations all over the world, in almost every industry, are turning to continuous improvement software to solve their most challenging issues. The most successful of these Lean organizations are aware that they need 5 elements to succeed in creating an improvement culture: bottom-up improvement, top-down improvement, strategy deployment, coaching, and visual management.

That sounds like a lot to excel at all at once, doesn’t it?

So how do these Lean organizations pull it off?

With continuous improvement software. In today’s post, we’re going to take a look at how technology facilitates improvement from the bottom-up, looking at it from both the perspectives of the staff AND of the coaches.

Listen to this Episode and Subscribe to the Podcast:

With improvement software, employees are able to:

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Topics: Improvement Culture, Continuous Improvement Software

5 Unexpected Benefits of Improving from the Bottom Up

Posted by Maggie Millard

Jun 26, 2017 11:30:11 AM

What are the traits you look for when you hire new employees? If you’re like most people, you’re looking for employees that are intelligent, capable, problem solvers who take the initiative to get stuff done and do it well. It’s a shame that these same people who got hired for their mental faculties then so commonly get relegated to being a pawn in the corporate machine, with no autonomy or power to improve the business through their work.

In fact, some of the top reasons people leave their jobs are that they feel underutilized, aren’t given the opportunity to learn, grow, and improve, don’t feel that their work is meaningful, and are bored by their work. 

This is one of the striking differences between regular companies and those that strive for a culture of continuous improvement. The foundation of an improvement culture is the employees, who are empowered to make daily improvements to their work that increase their own happiness, add value to the products and services provided to customers, and improve the efficiency and effectiveness of their work.

Listen to this Post or Subscribe to the Podcast:


Employees in a culture of improvement are engaged in their work, know that their work is valued by their employer, and are invested in the success of the company.

Let’s take a look at the result of such engagement:

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Deciding to Take the Leap: A Look at Improvement Software

Posted by Maggie Millard

Jun 22, 2017 7:02:00 AM

Deciding when to move from a paper system of managing continuous improvement to a digital system is tough. You know that you're not as effective or efficient as you could be, but growing pains in an improvement culture come on so gradually, it's hard to know how much better things could really get with the right platform.

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Topics: Continuous Improvement Software

Continuous Quality Improvement (CQI) and Snow Cones

Posted by Maggie Millard

Jun 21, 2017 7:26:00 AM

Preface: I’m in northern California today. Summer doesn’t even officially begin for three days and it is 107 degrees! So, the fact that I started thinking about what quality improvement and delicious frozen treats have in common should not imply that I’ve finally lost it.

Continuous quality improvement (CQI) is one of those things that is like a snow cone. It’s something that pretty much everyone can agree is awesome. Who wouldn’t want it?  “Always getting better is overrated,” said nobody – ever. Yet for some reason, not every organization has a plan for how to achieve CQI. Fewer still, have systems and processes in place to support it, and many that try never successfully reach their goals.

Why is that?

Let’s see if my snow cone analogy can help explain some of what conditions are necessary for CQI to catch hold.


If Neglected, It Will Melt

We don’t have hard data to back it up, but it is quite likely that the number one killer of CQI programs is simple neglect. Leadership gets very excited about this opportunity to revolutionize the organization, cut waste, and clobber the competition. They hold a meeting, send out a message, maybe even put up some signs and then go back to business as usual. Pretty soon, everything reverts to the old way of doing things, except that maybe employees are sharing Dilbert strips about CQI, or TPS, or Lean, or whatever you’ve called the program. (Don’t doubt that there is a Dilbert strip for all of them.) If you want to see what happens to CQI programs with disengaged leadership, just leave your snow cone on the driveway for the afternoon.

Listen to this Post and Subscribe to the Podcast:

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Topics: Improvement Culture, Continuous Improvement Software