The Puck Stops Here: Kaizen and the Art of Goaltending

Submitted by Mark Wahba on April 23, 2012 - 18:21

Mark Wahba, Emergency Room Physician, Saskatoon Health Region

One of best parts about hockey is the goalie mask. Jacques Plante introduced it to the NHL in 1959 after taking a puck to the face. Although first introduced for safety reasons, it would go on to become one of the most personalized and recognizable pieces of sporting equipment ever developed. Is there another visible piece of sports equipment more individualized or customized? All goalies seem to put bits of their personalities on their masks. Like Gerry Cheevers’s “stitches” mask from 1975 or Ray Emery’s “Muhammad Ali,” they all tell a story.

Lamentably, the big news from the first round of the 2012 National Hockey League (NHL) playoffs has been blows to the head followed by suspensions. The violence has overshadowed this year’s feel-good story: the amazing play of the Washington Capitals’ goaltender, Braden Holtby. The 22- year-old rookie had no postseason NHL experience when he lined up against the defending Stanley cup champion Boston Bruins. At the time of writing (after game 6) Holtby’s save percentage was .935, placing him 9th overall in the playoffs. He was first in terms of most minutes played. He has outplayed the Bruins’ Tim Thomas, the reigning playoff MVP.

These stats are interesting, but I’m even more fascinated by Holtby’s mask. It looks like he has two masks to wear in the post season: a roller coaster theme and the Capitals’ eagle theme. But what is really neat is the back of the mask. Listen to Holtby’s description of the back plate


Continuous Improvement.

Sound familiar?

These terms are the same ones we use in healthcare.

Kaizen is Japanese for “improvement” or “change for the better.” It’s at the root of Lean manufacturing principles, the Toyota Production System (TPS) and the PDSA (Plan-Do-Study-Act) cycle. These concepts are all related. Virginia Mason Medical Center in Seattle, Washington successfully adapted the TPS to save the institution $12 to $15 million over the course of six years. It’s been named one of Leapfrog Group’s top hospitals for the past several years.

How does Holtby use Kaizen to sharpen his game? He systematically observes, adapts, and implements small changes to his game. He looks at what the high performers are doing and incorporates their techniques into his game. He is never complacent, and is always on the lookout for an edge.

The province of Saskatchewan has recently chosen to follow the example of Virginia Mason and apply Lean principles throughout its healthcare system. All healthcare workers can be Braden Holtbys in their own right. There are no limits to continuous improvement, no aspect of care that cannot be improved.

And while there is no Stanley Cup at the end of the health care season – the season that never ends – there are winners everywhere, every day. They are the patients who get safer, better care, and healthcare workers whose jobs are more rewarding. Saskatchewan is looking to Kaizen to create more of them.

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