I was recently reminded of a fundamental statement about continual improvement. In Out of the Crisis (Massachusetts Institute Center for Advanced Engineering, 1986), W. Edwards Deming stated, “I should estimate that in my experience, most troubles and most possibilities for improvement add up to the proportions something like this: 94 percent belongs to the system (responsibility of management).”

A couple of weeks, ago, I went into the hospital for a hernia repair, one of the most common surgeries there is. The plan was to have the surgery, go home the same day, and recover at home in a few weeks. According to the surgeon, the surgery went fine. That still seems to be true. However, the morning after surgery, I woke barely able to stand, with severe body aches as well as nausea and vomiting.

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