Masaaki Imai, the author of books including KAIZEN, passed away recently at age 92, as announced by the organization he founded, Kaizen Institute. 

Greg and I have been deeply influenced by Mr. Imai and his book "KAIZEN: The Key to Japan's Competitive Success."

There would be no KaiNexus if Greg had not been given this book by his Emergency Department leader while he was a resident. In the video, Greg discusses the importance of the book to him and others -- and the broad influence it has had.

I also share stories about meeting Mr. Imai (once in Seattle and twice in Japan) and some of the classic ideas -- that Kaizen means everybody improvement, everywhere improvement, every day improvement.

First, please watch Mr. Imai talk about this in a short video:

In our conversation, Greg and I also discuss the connections between Kaizen and Lean books and practice -- and how Kaizen should be a core part of a Lean strategy, as it is at Toyota and other companies.

This approach should be the key to a hospital's success, or any organization's success -- not just manufacturing and not just in Japan.

Read Greg's journal article about Kaizen. 

Transcript:

Mark Graban: Hi everybody. I'm Mark Graban, senior advisor with KaiNexus. We're joined today by Greg Jacobson, our co-founder and CEO. How are you, Greg?

Greg Jacobson: I'm doing great, Mark. I'm looking forward to the topic. It's an interesting little exploration of our stories of pretty profound person in our lives. I think a celebration more than anything.

Mark: We're here to remember and celebrate and talk about Masaaki Imai who passed away very recently at age 92. Mr. Imai, very influential for the both of us. We want to share some thoughts and celebrate what we learned.

I had an opportunity to meet him a couple of times, and we just want to pay tribute to somebody who was a real legend in the realm of continuous improvement or, kaizen, this Japanese word that he helped bring to so many others.

Greg, maybe we can start off, and I'm going to simulate through the screen for those who are watching. The story that I wanted Greg to share about being handed a copy of Imai's seminal book, KAIZEN. Tell us about that, Greg.

Greg: We're back in 2004 or so. I was finishing my residency in emergency medicine back at Vanderbilt. My chairman said, "Hey I learned about this practice of improvement called Kaizen, and I think we could teach this to our..." I was going from being a resident to an attending.

"Then we'd teach this to our residents and it would satisfy one of the resident accrediting body's curriculum pillars of system-based practice. More importantly, it would teach our residents a framework for improving the emergency departments that they're going to be practicing in and running in the future."

I thought to myself, "All right, that's interesting." I said, "Why me? Why are you doing this to me?" He said, "You think like this. You're always asking, 'What if?' And, 'Why do we do it this way?' And, 'Wouldn't it be better?'"

I probably got to page seven. Aside from me, just floored that none of this information was taught during medical school or residency, but I realized that I did think like this. I just didn't know there was a body of literature that could really refine that and put that into a practice. That started a journey for me I guess just shy of 20 years ago.

Mark: The book I believe it was 1986 when it was published. You got it...Yeah. probably the book had been out 15 plus years at that point, maybe.

Greg: It has that kind of classic gray book cover with red print. You were just showing KAIZEN, something like that. "Competitive Reason for Japanese Success" is the white contrast is not showing.

Mark: "The Key to Japan's Competitive Success." It could be the key to an emergency department's success.

Greg: What's interesting is, and you know the literature better than I do, but you described it as it's a seminal work in which many of the readers of the book, it was written for a Western audience, and many of the readers of the book, it was the first time they were being introduced to these concepts.

Despite the fact that their seeds are back in the US from the '50s and even in the '30s. Perhaps you could talk a little bit more about where it fits in the arc of that literature.

Mark: Masaaki Imai, as a Japanese man, was not a Toyota employee directly. My understanding of his career is that he was working in the US as a translator. He was working in business circles, and then at some point he met Taiichi Ohno, who was directly employed byToyota.

Ohno is considered one of the fathers of the Toyota production system. There's a lot of quotes that get thrown around over time that people say are Ohno quotes, and it's unclear. Is it a my quote or how much of it was Imai passing along from Ono?

I'm not trying to paint him as just let's say a scribe for Ohno. Mr. Imai was a, I think, a deep thinker about Kaizen. As he worked with organizations over many decades, he was in his own light, an expert. That book came out in '86. That was before the phrase "Lean production" had been coined.

This was before the book The Machine That Changed the World. There were other books being written in the '80s about "Japanese manufacturing practices" and such. KAIZEN, the book, and through Mr. Imai, is credited with really spreading ideas.

One of the endorsements on the back of the book was John Young, the president and CEO of Hewlett Packard Company, another was the CEO of the American Management Association. It was published by McGraw-Hill, so this was for a mass market business book kind of audience and, I think, very influential.

It's interesting, like a lot of people who learn about Toyota, learn about tools and events. I'm like you should also be, whether you're getting it from Imai, which is a great place to get it from, or from Norman Bodak who unfortunately passed away a couple years ago, or from Toyota books.

What Mr. Imai defined Kaizen as, very simply, he said everybody, everywhere, every day improvement. I think there's still opportunity for people, whether they read Imai's books, later books that came out. Or I think sometimes people miss that.

I know that it's a passion of yours. It's a passion of ours at KaiNexus. When we say spread continuous improvement, we mean continuous, not sporadic or episodic or event-based. Mr. Imai, and he would emphasize different types of kaizen, right?

Engaging frontline staff and small improvements, but then also, larger, more strategic, if you will, top down, Kaizen.

Greg: This kind of low cost, low risk, continuous empowering people. I think what's really interesting is that as someone that was finishing my studies, my appetite to read was pretty low. I read that book and I was done reading about it.

I didn't think I needed to read anything more, and I just immediately started teaching these concepts to residents and started implementing these improvements. It ultimately my realization that we had no way to manage this and there was a better way to do this than paper. Ultimately led to the founding of KaiNexus.

I then wrote a paper about it and was looking in the medical literature, but I was really looking for the word kaizen. I probably came across the word lean in that, but it didn't, like lean manufacturing was probably mentioned.

Really think about this. You're talking about '05, '06 in healthcare literature, I found references to "kaizen blitzes" in the early '80s. That if you look at the vernacular now, I think we would call them rapid improvement events or kaizen events.

I really was introduced the term "lean" and its importance, and the realization that Kaizen is a small part of a bigger structure by you when we met in 2011. That was even after the founding of KaiNexus...

Mark: See, those 12 years ago. I'd say I've forgotten that. To me, I assume people know Kaizen and Lean are  intertwined.

Greg: I think it's a good reminder that sometimes we don't need to read another book. Sometimes it is time just to roll up the sleeves and get stuff done. Especially if you are a frontline person. If doing improvement work is not what you do every day, then I think you can go a long way with a little knowledge.

If doing improvement work is what you do 90 plus percent of your day, you probably need a little bit more knowledge. I think that's just evidenced by the fact I read one book and then I was off the races. Obviously, I've read quite a bit more since then. I want to credit that, I want to credit that he wrote this book.

It is interesting because you don't think about books as being technology, but I was talking with the director of the LEAP Institute at San Mateo County, and he made a comment to me, he said, technology is the multiplier of intent.

I think this is such a great example of that because if you ask someone in 1300, "Is a book technology?" They would've looked at you like, "I have no idea what you're talking about. What is this book?" The printed press has really allowed dissemination. That is technology at its core.

That's what Mr. Imai did. He influenced people's lives way beyond the people that he met.

Mark: It's fair to say there would be no KainNxus if you hadn't been given Mr. Imai's book.

Greg: That is not a stretch. That was like 100 percent.

Mark: I wanted to talk a little bit, I have the opportunity, thankfully, to meet Mr. Imai on three different occasions. Once in Seattle and then twice in Japan, when I was going and doing trips, study trips, run by the organization. He founded Kaizen Institute.

He was funny. I've got some notes from the time I saw him speak in Seattle when we read a little bit, he said, Mr. Mai said,

"Too many top leaders think Kaizen is a bunch of tools for the shop floor. Instead, you need to start with the top three most important things. One, top management involvement, two, top management involvement, and three, top management involvement."

Then here's the punchline that really got a laugh. He said, "Too many companies skip all three." He really emphasized Kaizen being Strategic, something that would benefit customers. Something involved in...He was saying about manufacturing, but this could apply to KaiNexus.

The design phase, the making phase, and the selling phase.

I think KaiNexus has tried, it really has developed and cultivated a culture of continuous improvement. What are your thoughts there on like, how we design the product and in our services, how we make it, how we sell it?

Greg: No, there's no question. I'm at the risk of this becoming about KaiNexus. I think that we're constantly listening, incorporating, experimenting, testing, and doing that process. Even the release process just at the most basic is this iterative process.

It's why it's called a journey, right? It's a journey because you don't quite know the paths you're going to go on. It's remarkable that someone who -- I never met, you met him several times -- just had this influence on the world.

Quite frankly, if I pass at 92 and two people are talking about me and just the influence, I think I'll have lived a meaningful and satisfying life. I'll tell you this. I was in an ER. I was doing locums work in '05 in an ER in Hawaii, which obviously we're seeing a lot of people across their Pacific Ocean that are there, a large Asian population.

This Japanese gentleman was visiting Hawaii and had a devastating stroke in the ER. Not in the ER obviously before, I was coming. There was a translator and he was speaking in Japanese. Of course I don't understand Japanese.

There's all these sounds that I don't understand. Then every now and then, the word kaizen came out because we were talking about the clot-busting drugs. Would he benefit or would he get improvement from them?

It would be gibberish and then I would hear kaizen and then it'd be more gibberish. It was an interesting cultural vignette about the word kaizen and it seemingly embedded as a regular word in Japan and part of the culture.

Mark: Yeah. It's a word people know. Final thought I'll add is, I think part of Mr. Imai's passion for sharing these ideas is that it wasn't practiced equally at every Japanese company. There's something different about what Toyota created and what some other organizations that I've been able to visit in Japan, thanks to Mr. Imai and Kaizen Institute.

They've created something where they might know the word and there are words, the word Gemba gets used in everyday language. Some of the context and some of the practice, it doesn't come easy. Like it's not necessarily a default, but it's certainly something a lot of organizations do practice in Japan.

Again, back to the subtitle of the book, the Key to Japan's Competitive Success. It's really the key to anybody's competitive success. The beauty of it is we don't have to be Japanese to practice these things.

Greg: I can't recommend the book more because it was accessible. It spoke to me. It obviously changed my life. It's changed all the people's lives that I've had the honor of influencing. Pick it up. Geez, I should have looked it up, but I'm sure you can get a used copy on Amazon or eBay for pennies. I don't know if there's an audio version or...

Mark: His second...

Greg: I think it's often credited and cited more than his first, was it Gemba Kaizen?

Mark: Gemba Kaizen was the second book, and then actually he wrote a third—that I haven't read and I should—called Strategic Kaizen that was published when he was like turning 90. He was still thinking, traveling the world, and working with people.

Yeah, I'd recommend it. Now I've got a copy that's well marked up and highlighted. I want to read one last thing before we wrap up and see if you have a final thought, Greg. Just says here,

"The Kaizen philosophy assumes that our way of life, be it our working life, our social life, or our home life, deserves to be constantly improved."

Greg: I think that's a perfect way to end our remarks about a remarkable person and at least from our vantage point, a remarkable life. Thank you so much for serving us and teaching the concepts that obviously he didn't completely create, but he certainly helped translate and add to throughout his life. Yeah.

Mark: Thank you Mr. Imai, and thank you Greg for getting together and kind, just having a good chat about Mr. Imai and Kaizen. Appreciate it.