The continuous improvement community lost Kim Barnas earlier this year. She passed away on January 3, 2026, after several years of navigating significant health challenges. Kim was 69. Her work in healthcare Lean -- as a senior leader at ThedaCare, as CEO of Catalysis from 2014 until she stepped down in late 2023, as the author of Beyond Heroes and the co-author of Becoming the Change with John Toussaint, as a teacher and coach to hundreds of healthcare executives around the world -- shaped how a generation of healthcare leaders thinks about Lean management systems and personal leadership development. The Shingo Institute recognized her contributions with its Lifetime Academy Award in 2023.

The right way to honor Kim, I think, is not just to remember her. It's to take her work seriously enough to apply it. So this post is about two specific questions she wanted every leader to ask themselves -- questions that are simple to state, harder to actually answer, and powerful enough to change a leader's practice if they're asked honestly and often.

I had the privilege of hosting Kim and John Toussaint on a KaiNexus webinar in August 2020, previewing the framework that became Becoming the Change. The questions she shared that day have stayed with me. They're worth sharing again now.

The two questions

The questions come from the reflection practice Kim built into her own leadership work and taught to executives she coached. They're meant to be asked at the end of every day, written down rather than rehearsed in your head, returned to as a discipline rather than as an occasional exercise.

1. What did I do today to unleash the creativity of my people?

2. What did I do today that got in their way?

That's it. Two questions. They take maybe ten minutes to answer honestly. They take years to answer well.

The questions don't sound like much. Most CI practitioners reading them will think "of course" and move on. The discipline Kim was naming isn't in understanding the questions. It's in actually asking them, every day, for long enough that the answers start to change how you operate.

What makes them harder than they look

The first question presumes something most leaders haven't quite accepted: that your job is to unleash creativity, not to produce results yourself. Many leaders, especially leaders with clinical or technical training, became leaders because they were good at producing results themselves. The promotion rewarded their problem-solving. Their identity is built around being the person who knows the answer. The question "what did I do today to unleash creativity in my people" requires admitting that this is now the job, that getting the answer right yourself is no longer the point, and that the metric has shifted from "did I solve the problem" to "did I develop a problem-solver."

Kim was direct about how hard this transition is. She and John used to point to a specific pattern they saw in healthcare leaders who came up through clinical work. The pattern Al Pilong, then COO of a Michigan health system, named in his own Personal A3: "I'd rather do things than coach others to do." Frankly, he wrote, it's easier to do things yourself. You get positive feedback. You see the result. The whole reinforcement loop is set up to reward the old pattern. Changing it requires deliberate, sustained effort against habits that have worked for decades.

The second question is in some ways harder. "What did I do today that got in their way?" asks leaders to identify their own contribution to the problems they're trying to solve. The reflex is to identify external constraints -- the system, the culture, the resources, the regulations. Those constraints are real. But the question Kim wanted leaders to sit with is about their own behavior. Did I interrupt someone today? Did I solve a problem someone could have solved themselves if I'd waited? Did I tell when I should have asked? Did I send a signal that disagreement wasn't welcome? Did I miss a coaching moment because I was rushing to the next thing?

The honest answers are uncomfortable. That's the point. Comfortable answers don't change anything.

Why daily, why written, why returned to

Kim was insistent that reflection time had to be on the calendar. Not in the shower. Not on the drive home. Not "when I have a few minutes." Scheduled, deliberate, with a notebook. The discipline she taught was simple: twice a week, fifteen minutes, written down, returned to.

The reason is that reflection without artifact disappears. You think you reflected, but next week you can't remember what you reflected on. The patterns that should be obvious from looking at your own thinking over time stay invisible because the thinking never accumulated anywhere. Writing it down -- even briefly, even in a notebook nobody else will ever see -- is what turns reflection into something you can learn from.

The questions matter more than the format. A leader who answers Kim's two questions honestly in a notebook for six months will see things about themselves they would never have seen otherwise. The pattern of when they get in their team's way. The kinds of meetings where they unleash creativity versus the kinds where they shut it down. The specific behaviors that show up when they're stressed, when they're under time pressure, when the stakes are high. The information is there. The reflection practice is what makes it available.

The Personal A3 builds on this

Kim and John's broader framework -- the Leadership Self-Assessment Radar Chart and the Personal A3 -- builds on the reflection foundation. The Radar Chart measures five traits (willingness, humility, curiosity, perseverance, self-discipline) and their observable reinforcing behaviors, giving leaders a structured way to see where their practice is strong and where the gap between aspiration and behavior is largest. The Personal A3 applies A3 thinking to that gap -- naming the opportunity, analyzing why current behaviors exist, designing experiments for new behaviors, tracking what happens over time.

The whole framework is downloadable from the Catalysis website. The book Becoming the Change walks through it in detail. The KaiNexus webinar Kim and John did together previews the framework with worked examples, including Al Pilong's Personal A3 in full.

But you can start with the two questions before you build any of that structure. The questions don't require a template, a coach, or a workshop. They require ten minutes at the end of the day and the willingness to answer honestly.

What Kim's work asks of us now

Kim's obituary quoted Dr. Caroline Leaf: "Your purpose is not what you do, your purpose is what happens to people when you do what you do."

The line could have been Kim's own. The whole framework she built with John -- the radar chart, the Personal A3, the coaching cadence, the public Personal A3 work that leaders like Susan Ehrlich and Gray Dubé practiced -- is built around the same principle. Leadership isn't measured by what you do. It's measured by what happens to your people because of how you operate.

The questions she wanted every leader to ask are about that measurement, asked honestly and at the right scale. Not the quarterly engagement survey. Not the annual review. Today. The people you led today -- were they more capable at the end of the day because of how you led, or less? Did your presence unleash something, or did it get in the way of something?

You can honor Kim by asking yourself these questions tonight. Write the answers down. Return to them tomorrow. See what they show you over six months.

That's the legacy that outlasts her.

Watch the webinar with Kim Barnas and John Toussaint →