My guest for Episode #530 of the Lean Blog Interviews Podcast is Ken Segel, Co-Founder and Chief Relationship Officer at Value Capture. Episode page with video and more With over two decades of experience in healthcare improvement, Ken has been instrumental in guiding Value Capture's mission: helping healthcare organizations pursue habitual excellence by applying principles of safety, transparency, and systems thinking. In this episode, Ken shares lessons drawn from his unique and non-traditional journey--from public policy work in Washington, D.C. to transformative partnerships with industry icon Paul O'Neill and the Pittsburgh Regional Health Initiative. Ken and I explore why world-class safety, quality, and financial performance can and must co-exist, and how starting with safety unlocks powerful learning across any organization. He reflects on how Paul O'Neill inspired leaders to set seemingly audacious goals like "zero harm"--not to punish failure, but to align people around shared purpose and continuous improvement. We also discuss the importance of creating a comprehensive operating system, one that fully integrates work systems, management systems, and improvement systems--not just Lean tools or events in isolation. Listeners will learn why Ken believes deeply in the Shingo Principles, and why Value Capture remains the only Shingo Affiliate firm dedicated exclusively to healthcare. He also talks about the recent leadership transition at Value Capture, passing the CEO baton to longtime colleague Shanna Padgett. Whether you're a Lean healthcare leader or someone passionate about values-based leadership, this conversation offers rich insights into guiding with purpose, learning from failure, and building systems that support excellence for all. Ken previously appeared on My Favorite Mistake (Episode 147), where he shared a powerful story about early-career lessons in leadership and systems thinking that helped shape his path into healthcare improvement. Questions, Notes, and Highlights: Can you share your Lean origin story? (How did your unconventional path lead you into this work?) What was it like working with Paul O'Neill, and how did he influence your thinking? What was the vision and impact of the Pittsburgh Regional Health Initiative? Why was setting a goal of zero harm so controversial--and so powerful? How did leaders like Dr. Richard Shannon apply these principles to dramatically improve patient safety? Where do you see progress--and continued challenges--around transparency and safety sharing in healthcare? Why is safety such an effective entry point for broader transformation? How do you define a "comprehensive operating system" in a healthcare context? What's the difference between a management system and a full operating system? How can the Shingo principles support healthcare organizations on their improvement journey? What does it mean for Value Capture to be a Shingo Affiliate focused solely on healthcare? What advice would you give to a health system leader who thinks they already have a Lean system in place? Can you share the recent leadership transition news at Value Capture? This podcast is part of the #LeanCommunicators network.