Free field guide – Mark Graban
The Empty Suggestion Box
Why staff ideas die in hospitals, and what leaders do instead
Every idea that disappears into a suggestion box teaches the person who wrote it one thing: don’t bother next time. The cost isn’t one lost idea. It’s every idea after that, from that person and from everyone watching.
This free 21-page field guide, drawn from Healthcare Kaizen, the book I wrote with Joe Swartz, shows what replaces the suggestion box: asking for ideas, saying yes more often, helping people act on their own ideas, and closing the loop.
It starts with a distinction Norman Bodek taught us: a suggestion is something you want someone else to do. An idea is something you can do yourself. The guide covers everything after that.
Stories from Franciscan St. Francis Health in Indianapolis, ThedaCare, Children’s Medical Center Dallas, and the GM suggestion form that came back to me nine months later, marked “rejected.” About 20 minutes to read, with a one-page cut-out: “The Idea Conversation.”
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What’s inside
- Why the suggestion box fails, including the locked lab box whose key nobody could find
- Ideas, not suggestions: four things leaders do, and creativity before capital
- Quick and Easy Kaizen in five steps, plus a pharmacy’s “seven days’ grace”
- A real idea card from a lab technologist in her first week, written one day and done the next
- What leaders do: seven key actions, and the CEO who kept leaving the room
- Why paying people for ideas tends to get you fewer of them
- Small ideas from hospitals in the US, the UK, and the Netherlands
- A one-page cut-out to use at your next huddle
Read the book behind the guide
Most of the stories in this guide come from Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements, the Shingo Award-winning book I wrote with Joe Swartz, with hundreds of examples from hospitals.
Bring Kaizen to your leaders
I work with healthcare leadership teams on Kaizen, Lean management, and psychological safety, so ideas surface early and actually get tested. Keynotes, workshops, and coaching, in person or virtually.
More free guides
- Just PDSA It: how to test a change honestly, including the ones that don’t work
- Accountability Without Blame: what to say when someone tells you about a mistake
When ideas go nowhere, people stop raising problems, too. My next book, The Silence Tax (February 2027), is about why people go quiet and what leaders do differently. Read the free sample: the Introduction and Chapter 1.
About Mark Graban
Mark Graban is a consultant, author, professional speaker, and podcaster who helps organizations improve through Lean management, better use of metrics, and psychological safety. He’s the co-author of Healthcare Kaizen, the author of Lean Hospitals, a three-time recipient of the Shingo Publication Award, and the host of the podcasts “Lean Blog Interviews” and “My Favorite Mistake.”