My friend Roger is the head of continuous improvement at a major hospital system in Florida. He's also an amateur magician. Shortly after started working at this hospital, he and his team made some significant improvements -- among other successes, they managed to avoid spending many thousands of dollars on unnecessary ventilators, they solved the (seemingly) intractable problem of missing wheelchairs, and they cut down on expired medications. When I would compliment Roger on these wins, he would always say, "Nah, those are just magic tricks. They're not important."

And I would nod sagely over a beer and agree with him, without really understanding what the hell he was talking about.

But I finally realized what he was getting at. The quantifiable successes like lower costs are the carefully planned misdirections that the magician uses to keep our focus away from what he's really doing. "Pay attention to the shiny coin; don't look at what my other hand is doing."

The quantifiable wins are the misdirection that keep senior leadership happy. The CEO can calculate the ROI on the process improvement group and feel good about supporting it.

But for Roger, the real magic isn't those successes, no matter how impressive. Rather, the magic is the development of people's problem solving abilities. It's the creation of a culture driven to improve. It's getting doctors, nurses, and administrators -- getting all employees, in any organization -- deeply engaged and passionate about lean.