Category Archives: Recent Posts

Lean Transformation in a Barcelona A&E Department

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Lean healthcare is a subject that is becoming more and more commonplace and this is good news for each and every one of us.

Last year I attended the The Lean Enterprise Academy Summit. This Summit is always an amazing event – 3 days packed with presentations, learning sessions and masterclasses solely focused on Lean and the immense business and personal benefits a Lean culture brings.

My 2 favourite sessions were from industries both based in Barcelona. The first learning session introduced us to Augustin Tena Leon (Head of Sales, 365 Cafe) and Oriol Cuatrecasas (Founder and Lean Development  – Instituto Lean Management). My previous blog post ‘The Virtual Gemba Walk in Barcelona’ outlines the incredible work Cafe 365 have done on their Lean journey.

The second learning session was from Dr Miguel Sanchez, Head of the Accident and Emergency department at the Hospital Clinic of Barcelona

From the beginning of his presentation Dr Miguel Sanchez showed immense passion for the Emergency Department he works in, the work he does, his team and the Lean journey they are on. His passion was obvious as he spoke about the improvements they had made and was equally evident when he spoke about where level 3 of the Emergency Department was before they started on their Lean journey and all of the problem they originally had.

This was very impressive as for Lean to be successful you need to be as interested in your problems as you are in your proposed solutions. Human nature sends us running at the speed of light to solutions before we even know what the real problem is and before we have taken time to investigate exactly why (root cause) the problem is occurring.

Oriol brought us through a simulation to show how chaotic the A&E department was before they started their Lean journey. We split into teams of 4 hospitals with the quest to see how many patients we could get through the hospital process. We were all given ‘imaginary’ jobs, titles, tolls, instructions and 8 minutes.

As the simulation progressed the process and the people started to fall apart and chaos set in! Patients continuously flowed into the hospital, the administrator got stressed and confused, the blood and urine analysts started shouting that they needed to get more patients in, the patient discharge person was frustrated as they weren’t very busy. The doctor who had to sign off on all the tests were stressed and frustrated at the level of repeated analysis required, seeing patients many times and the overall chaotic conditions under which they were working.  At the end of the 8 minutes everyone was stressed. Does this sound familiar? Is this how your workplace works?

What was the problem?

As mentioned above, everyone started diving straight into solution mode – ‘I know what’s wrong’  ‘I know how to fix it’  ‘Let’s do this , let’s do that!’!!! Keep in mind this is a room full of Lean practitioners who had just created immense Lean waste and gone against every lean principle we had ever learned.

Now we had felt the stress and frustration that by Dr Miguel Sanchez’s team experienced on a daily basis it was time to see the results of their Lean journey.

The results were absolutely amazing, thanks to Dr. Sanchez and his team, the A&E department was transformed and reduced the patient waiting time by 44%. That is a phenomenal reduction in patient waiting time. If you work in a  hospital, can you imagine what this would do for your department, your patients, your employees?

They achieved this by some simple changes such as

1. One Doctor and nurse team

2. One medical cart per team

3. One computer and workstation per team

4. Assigned beds per team

These changes enabled the Accident and Emergency department to implement Standard Work, Flow, Visual Management and eliminate the immense amount of Lean waste that they had identified at the beginning of their journey.

The changes increased the patient throughput, enhanced the patient experience and also increased the safety and job satisfaction for all of Dr Miguel’s team.

Another fine example of Lean and the huge benefits is brings.

Could Lean benefit your A&E department or your workplace?

Keeping it Simple,


x x x


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The Virtual Gemba Walk in Barcelona

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Photo Credit – Mink Mingle (Unsplash)

Last year I attended the UK Lean Enterprise Academy Summit. This Summit is always an amazing event – 3 days packed with presentations, learning sessions and masterclasses solely focused on Lean and the immense business and personal benefits a Lean culture brings.

My 2 favourite sessions were from industries both based in Barcelona.

The first learning session introduced us to Augustin Tena Leon (Head of Sales, 365 Cafe) and Oriol Cuatrecasas (Founder and Lean Development  – Instituto Lean Management).

Augustin and Oriol held our attention throughout the presentation with their high energy, obvious passion for Lean and pride in what they have achieved through their Lean journey with Cafe 365. Augustin and Oriol made it very clear that culture change was at the heart of their Lean transformation as they spoke about

‘The most important part of our company is our people’, ‘The joy never has to be lost’ and ‘Customer first’

Their presentation took us through their Lean journey starting with their factory where their delicious products are created through to their shops where their products are sold. They involved us all in a hilarious simulation of the bakery shops pre 2009. This simulation highlighted the chaos, waste, unhappy customers and unhappy employees that used to be part of the daily operations of Cafe 365.

In contrast to this chaos Augustin and Oriol invited us to see what their business is like now that they work in a Lean environment. I expected a presentation or maybe another simulation but no….in true genius style  Augustin and Oriol connected us to one of their shops in Barcelona via web link! And so a virtual Gemba Walk in Barcelona began!

Photo Credit – Leon Ephraim (Unsplash)

The staff of Cafe 365 in Barcelona were as excited to be part of this virtual Gemba Walk as we were, they welcomed us to their cafe and introduced us to their Standard Work, Kanban system, Audit system and their problem identification, escalation and resolution system. They showed us their storage area which was tiny but hugely sufficient and their refrigeration area  that was also tiny but hugely sufficient.

This was a most impressive Gemba Walk – to see the simple tools of Lean implemented into a bakery and cafe environment instilled in me more confidence that Lean can be used and taken advantage of in absolutely every area of business no matter what the industry is.

The tools and principles implemented were obviously making Cafe 365’s business more profitable and sustainable and set them up for growth of which they have enjoyed at an exponential rate. More than this and what really stood out for me was the positive culture we were lucky enough to be witnessing.

As we moved from one area to the next of this virtual Gemba Walk it was the employees who spoke to us, it was the employees who answered all of our questions and it was the employees to whom gratitude and recognition was given by Augustin and Oriol and each other. Everyone was so proud to  show us how they work for the company and for each other.

Photo Credit – Kari Shea (Unsplash)

Cafe 365 is a supreme example of what a Lean culture is. Lean tools and principles can be learned from any of the many amazing books available on Lean, however it is the deep respect that is shown for each and every employee that will bring the real sustainable and transformational change that is required for a business to fully embed and enjoy a Lean culture.

When asked if there was any employee currently in the shop that was also there pre 2009 (pre Lean implementation) and what the transformation had meant to them,  one lady stepped forward from the back of the crowd of employees and with a beaming smile and said

‘Before things were difficult and hard, now they are enjoyable and simple’ .

These words were softly spoken, however the message was profoundly loud.

Augustin and Oriol left us with this statement

 ‘Lean brought us one of the most extraordinary and radicle changes we have witnessed in a  business’

This learning session with Augustin, Oriol and Cafe 365 left me with confidence that the career path I have chosen is completely the right one for me and that Lean is even more powerful than I had previously envisioned.

Could Lean transform your business?

Keeping it Simple,


x x x


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2 Crucial Steps To Continuously Improve Your Website

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In one of my previous blog posts,  Dr. Deming’s Gift To The World, I explain what the PDCA cycle is and how it can be used to implement/change/solve just about anything.

I used the Deming PDCA cycle to plan, create and launch this website. Previous blog posts go through the steps taken to plan my website, 6 Steps To ‘Plan’ A Website, the steps taken to create my website, 14 Steps To Create A Website and in this blog post I will go through the 2 crucial steps to continuously improve the website using the 2 last steps in the PDCA cycle, Check and Act.


The Deming PDCA cycle differs from other ways of working in that as you implement your PLAN in the DO phase you continuously check progress against your plan and if something has gone off target or not as planned you change direction accordingly.

In every Deming cycle of Plan, Do, Check, Act the CHECK part is used to determine if the changes made are creating the desired outcome.

When I planned and built this website, I moved into the ‘CHECK’ phase of the Deming PDCA cycle many times and every time I did I found something that required changing. Some of these observations included the following

1. I wasn’t happy with the look and feel of the website and it wasn’t what I had originally envisioned in the ‘PLAN’ phase

2. I was still undecided about the name of the website which has changed more times than the Irish weather!!!

3. I wasn’t completely happy with the original tagline which was long and vague

In the ‘ACT’ phase iI implemented the following changes

  1. Originally this site was built using the WordPress Standard Theme. It’s a minimalist theme but even with a lot of customisation I didn’t like how it looked. And so just before I launched my website I changed the theme to ‘Twenty Twelve’  and I am now really happy with it. It has the minimalist look and feel that i originally envisioned
  2. During the build of this website I changed the name many times but always came back to ‘The Art Of Positive Change’ which totally reflects the philosophy I believe in.
  3. The tagline ‘Lean in Business, Simplicity in Life’ was created at the very last minute having been another tagline since the build of the website commenced

And so the never ending cycle starts again ensuring my website continuously improves…...Plan, Do, Check, Act

Keeping it Simple,


x x x

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14 Steps To Create A Website

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Do website_Picjumbo

14 Steps To Build a Website a using PDCA (PLAN, DO, CHECK, ACT)


Following on from my previous blog post ‘6 Steps To Plan A Website’, here are the 14 steps I used to create this website which was very much stress free due to the detailed planning carried out in the ‘Plan’ phase.

Below is a list of everything I  needed  highlighted from the ‘plan’ phase and what I used for each element to become part of my website.
  1. Hosting  – I use Bluehost for hosting as it is recommended by Michael Hyatt, author of ‘Platform’ and one of the world’s most successful and influential writer and bloggers

2. A reliable platform  – most of the bloggers in the world including me use WordPress.  I have used WordPress for my Travel Photography blog for a few years now so no need to change. WordPress is easy to use, easy to navigate and integrates with loads of plug ins

3. A suitable theme – I started using Standard Theme and went through many iterations and customisations to try to achieve the minimalist look I had envisioned. The theme changed to Twenty Twelve just before this website was launched as Twenty Twelve suits my vision for my website much better

4. A domain name – I chose – thankfully no-one else was using this domain name!!

5. A website name  – The current name for this website changed many times and I finally decided on ‘The Art Of Positive Change’ as I think it represents the holistic nature of Lean in Business and Simplicity in Life that I will write about

6. A tagline – the tagline for this website stayed the same up to a few days before the launch of this website when it was changed to the current ‘Lean in Business, Simplicity in Life’

7. Headings for the menu –  ‘About Me’, ‘What is Positive Change’ and ‘Recent Posts’ are the current headings in the menu – more headings will be decided as I create blog posts

8. The website needs to be responsive (mobile device friendly) –  the WordPress theme I am using, ‘Twenty Twelve’, is fully responsive

9. Enable sharing of blog posts through social media networks – I use the Plugin ‘AddToAny Share Buttons’ for sharing blog posts. The share buttons are colourful, clear and minimalist which fits in with the theme of my website

10. Enable readers to connect through social media networks – social media icons that connect to my social media networks are built into the WordPress ‘Twenty Twelve’ theme

11. Enable readers to contact me directly through the website/blog – I use the Plugin ‘Contact Form 7′ for a contact form that is connected to my e-mail

12. Enable readers to sign up to my e-mail list  – I use MailChimp which is fully integrated with WordPress.  MailChimp is the e-mail service provider (ESP) of choice for many well established bloggers. It is really easy to set up and create e- mail templates with

13. Determine the metrics required from the website, how will you know if your targets/objectives are being met? I have been tracking metrics on my Travel Photography blog for 5 years and so have an idea what metrics are required for this website

14. FInd time to write and create content – this requires a PDCA (Plan, Do, Check, Act) cycle of its own!!!

Below is an excellent video by Michael Hyatt explaining the steps required to create a WordPress website of your own,

That’s it,

Keeping it Simple,





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Dr. Deming’s Gift To The World

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Who was Dr W. Edwards Deming?

William Edwards Deming (October 14, 1900 – December 20, 1993) was an American engineer, statistician, professor, author, lecturer, and management consultant.

Dr Deming’s philosophy below (thanks Wikipedia) will give you an insight into his profound wisdom and deep understanding of systems and operations and how they work efficiently, effectively and optimally.

‘Dr. W. Edwards Deming taught that by adopting appropriate principles of management, organizations can increase quality and simultaneously reduce costs (by reducing waste, rework, staff attrition and litigation while increasing customer loyalty). The key is to practice continual improvement and think of manufacturing as a system, not as bits and pieces.”

See ‘Wikipedia’ for more information on Dr Deming and his great work.

What is the Deming cycle?

The Plan, Do, Check, Act Cycle, or PDCA cycle, is a technique designed to facilitate continuous improvement in the workplace. It is also referred to as the Deming Cycle, as it was popularized under the instruction of Dr. W. Edwards Deming. Deming, a statistician and quality revolutionary, was introduced to the concept by Walter Shewart, a statistical quality control expert. PDCA has also been referred to as PDSA (Plan, Do Study, Act), PDSA (Plan, Do, Study, Adjust) and numerous variations in between.

Whichever version you decide to you the principles are the same.

Why is the PDCA cycle important to Continuous Improvement?

The below image I found on LinkedIn (origin unknown) sums up the PDCA cycle perfectly and the differences between traditional ways of working and the PDCA cycle. Does the traditional way of working sound familiar to you?

Dr Deming’s PDCA cycle has completely changed how I work and how I live. Everything I do in relation to projects and work now goes through this cycle or some variation of it. Let me give you an insight into how it works and the benefits it brings.


(Develop a plan re the changes that are going to be made)

This is the first step in the Deming cycle and it is here you determine exactly what the opportunity for improvement/change is identified.  In this first step, it is important to determine your goal, what problem you are solving, measurements of success, and methods of implementing the improvement/change.

It is here that you determine exactly what you need to achieve success and how you will know you are successful. The only way to know if something has improved is by measuring improvement. It is here in the ‘Plan’ phase that you determine what metrics will give you the evidence required to determine success.

When you are happy you have a detailed plan, know what metrics you will monitor (and how you will gather and monitor these), it’s time to move into the ‘Do’ phase.

The above sounds very simple but it’s not uncommon for people, departments and organisations to plough ahead with improvements/change without a detailed well thought out plan.


Implement the changes according to the plan above

Here it is time for action and time to use the plan developed above to put that action in place. The plan will serve as an excellent guide and reminder of exactly what it is you want to achieve. The metrics you will gather during the ‘Do’ phase will ensure you are continuously moving in the right direction towards success.


Evaluate results – is the change/improvement successful, do the metrics confirm this?

This phase reduces rework and provides clarity

 This step is sometimes referred to as the study phase. Here we are reviewing and analysing the results of the improvements implemented in the Do phase – Are they working? Are they not working?

In this phase you ‘Check’ if your initial goal from the ‘Plan’ phase has been reached and ‘Check’ if the metrics gathered support this goal achievement.


(Yes it is working – continuously improve, No it is not working -change and try again)

This step is our last in the cycle. What takes place at this phase depends greatly on the results achieved in the ‘Check’ phase. You may need to alter your methods of implementation, develop a new plan, or test your improvements on a larger scale.

When happy with the results – it’s time to standardise the process/improvement.

As this is a cycle, the PDCA process never really ends. Instead, it repeats itself providing the path to continual improvement.

Below is a really good image (origin unknown) outlining the importance of planning – this is a lesson I continuously learn on a daily basis!

Could the PDCA cycle help you transform how you live and work?

Keeping it simple,


x x

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Meeting Art and Understanding Lean

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Oprah calls it an ‘Aha’ moment – the moment when something falls into place, when the penny drops, when a lightbulb goes off in your brain and you understand something with an immense clarity that you previously didn’t have.

I experienced this ‘Aha’ moment over 3 years ago when Art Byrne delivered his keynote speech at the 2013 Lean Enterprise Academy Summit. As well as a great guy, Art is a powerhouse of Lean knowledge having lived Lean with it’s highs and lows for many decades. I have read Art’s wonderful book ‘The Lean Turnaround’ many times and knew I was in for something special as Art took to the stage.

My ‘Aha’ moment came in as short a time as 4 minutes into Art’s talk. I had always known that Lean enabled a better, more efficient, more inclusive way of working however after listening to and understanding Art’s simple explanation of Lean, the power of this methodology was finally clear to me. Key elements from these short 4 minutes of Art’s talk that helped me understand the power of Lean are as follows

  • Lean is not a bunch of tools
  • Lean is not a collection of projects or belts (Art in his fabulous honesty makes it clear that in running a business you are not running a karate class!!!)
  • Lean is ‘the biggest strategic business weapon you can ever have’  – a business being ‘a collection of people and processes trying to deliver value to a set of customers and always the best team wins’.
  • Lean is a growth strategy not a cost cutting strategy.

Art continued by explaining the key elements required to be successful at Lean which are that Lean and  Operational Excellence are your core strategy, that Lean is led from the top and that people are transformed. Without these elements, Art explains very honestly,  failure will be the outcome!

As Art spoke about transforming people, he explained that people are the only asset you have that appreciates and you want them to keep appreciating, that you also need to respect your people because the best improvement ideas come from the people doing the work. To do this you need to create a learning environment where people are learning every day and are excited to come to work. This then becomes your culture, the way things are done around here – this is Lean.

Art summed up all of the above by simply saying –  Lean is a people thing!

I met Art at one of the break out sessions. He was gracious, humble and generous with his time. I spoke with him around challenges I was having in implementing Lean in my role as I  did not have the influence of a CEO for Lean to ‘come from the top’. He smiled and gave me some of the best advice I have ever received. He said ‘be the CEO in your area’, excellent advice for anyone trying to make things better when it’s not coming from the top!

Art signed my copy of his book ‘The Lean Turnaround’ by using a popular phrase synonymous with Guinness – it was Art’s way of saying how much he loved Ireland and how much he respects Kaizen. And yes, I totally agree with him, Kaizen is good for you!!!!

I left the 2103 Lean Enterprise Academy Summit energetic, enthused and looking forward to the next steps on my Lean journey.

Almost 4 years later my Lean journey continues to experience highs and lows, I’m happy to say more highs than lows these days and always, always learning lessons which is at the core of what Lean is about, continuous learning!

Thanks for reading,

Keeping it Simple,




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Know Your Why

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Photo Credit: UnSplash – Evan Dennis

Simon Sinek’s ‘Start With Why’ Ted Talk has had over 1.2 million views on YouTube.

In this popular video Simon talks about starting with your ‘Why’ when you are doing something. It is one of my favourite Ted talks and is absolutely worth a watch.



‘Why’ makes sense as a good place to start anything!

And so that is where this new website started.

It started with my ‘Why’.

My ‘Why’ is – I want an online platform where I can share Lean and Simplicity learnings with an audience who wants to learn more about Lean, Simplicity, Positive Change and immense benefits of same.

I want to share these learnings and benefits because I have seen the advantages of using Lean principles in business where employees are valued above anything else and are nurtured, encouraged and developed to be the very best they can be. I have also seen the disadvantages of not using Lean principles  in business where employees are not valued, not nurtured, not encouraged and developed to be the best they can be.

The presence or the absence of Lean principles will drive your company culture, what culture would you prefer to work in and be part of?

In the Lean world we always speak about ‘Knowing Your Why’ – this means to know why you are doing something, why it is part of your business, why you are improving it, why the business should spend resources doing this etc. We like the word ‘Why’ so much we use a tool called the ‘5Whys’ (excuse the pun!).

Knowing your ‘Why’ is the most critical step in accomplishing, enjoying and being successful at anything – when times get tough (as they always do), your ‘Why’ will be what keeps you going.

Here is a great post on ‘WHY’ from Dale Partridge on the philosophy he refers to as ‘Whyology’, Dale also refers to Simon Sinek’s Ted talk in this post.

‘How To Build An Emotional Brand That Stand Out’

 What is your ‘Why’?

Keeping it Simple,



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6 Steps To ‘Plan’ A Website

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 Plan Website_Picjumbo

As outlined in my previous blog post ‘Dr Deming’s Gift To the World‘, the PDCA (Plan, Do, Check, Act) cycle can be used to implement/change/improve just about anything.

From high level organisation strategy to detailed day to day change PDCA is a recipe for success in both cases and everything in between.

This is the first blog post in a 4 part series of how you can use PDCA to build a website (which is the methodology I used to build this website). This first post focuses on what is required when planning a website.

There are a lot of great websites out there and a lot of great web designers who are skilled and qualified at building websites. if you have a budget to do so then the best thing is to hire someone to build your website.

 I’m not a professional web developer and all I know about online marketing, website/blog building and social media presence is self taught so if I can build a website anyone can!



1. Outline exactly WHY you want a website

In the Lean world we use the phrase ‘Know Your WHY’ which continuously makes us question WHY we do what we do. My  blog post ‘Know Your Why‘ takes a closer look at the importance of knowing exactly ‘Why’ you are doing something.

Why you want a website can vary from having somewhere to share your thoughts through blog posts to wanting to set up a business selling goods/services etc. Knowing exactly what you want from your website is critical to building your website efficiently.

2. Determine exactly what you want the website to look like

Know what your vision for the look and feel of your website is.

There are a lot of great websites out there, researching these will help in determining the required look and feel of your own. This is especially helpful if someone is building the website for you as it gives them a visual guide to what you require.

3. Apply learnings from previous experience with websites/blog

A key part of Lean methodology is learning and using these learnings to continuously improve. It is from failure and mistakes that our greatest learnings are achieved. However the learning is not taken advantage of if it is not applied in the future.

Much of this blog series has come from learnings from my current Travel Photography website and Travel Photography blog which have both been live for 5 years.  I have also learned loads from well established and experienced bloggers who have been doing this for a much longer time

4. Determine exactly what you want the website to be able to do, what will be the capability. This is of the utmost importance and deciding this now will remove the need for reiterations of your website in the future

The below is a simple yet crucial list for the functionality of your website. You may need more functionality in your website, for my website this was a sufficient list to get it launched.

  1. Hosting – Reliable hosting is critical and so you will need a  reliable hosting company – there are many hosting companies, it is a worthwhile to research the ones the most influential bloggers use
  2. A reliable platform  – most bloggers including me use WordPress and I have loved using WordPress for my Travel Photography blog so no need to change
  3. A suitable theme – if WordPress is your chosen platform you will find a huge range of themes to chose from
  4. A domain name – learning from master bloggers the best domain name to choose is your own personal The direction of your website and the type of content you share may change over time but your name will remain the same. When your domain name is chosen and activated it is not so easy to change. Your personal name is something you have had for a very long time and so chances are you won’t be changing it any time soon!
  5. A website  name – this can be your domain name but can also be something different. The name can be changed easily in WordPress so not a big deal if you want to change it. In saying that a name is not just a name, it is a brand and so it’s not ideal to be chopping and changing it – think ‘Apple’!
  6. A tagline – same as 6 above – your tagline will become part of your brand
  7. Headings for the website menu –  determine  what your headings for the website menu  will be and how many you will have, these will be on every page of your website so choose wisely
  8. Does your website need to be responsive (mobile device friendly)? The answer to this is yes – having a responsive  website and in this day and age it is an absolute must as most websites are visited using mobile devices. If your website is non responsive (not mobile friendly) it dramatically reduces the chance of people reaching you and your content
  9. Enable sharing of blog posts through social media networks – when someone reads your blog posts a simple click of a button enables them to share your content with their social media networks, this needs to be easy to do as no-one likes to spend too much time figuring out how to share a post!
  10. Enable readers to connect with you through social media networks – similar to the above, if someone visits your website or reads your blog posts and enjoys what they see/read, they will want to connect with you on social media networks – as above, make this very easy to do – one click should suffice
  11. Enable readers to contact with you directly through the website/blog – as well as being able to connect with you through social media channels it can be helpful to include a contact form connected to your e-mail address so readers can mail you directly
  12. Enable readers to sign up to your e-mail list – this is one of the most important parts of our website as it enables you to connect directly with your readers and send them updates on your posts and content

5. Determine the metrics you will require from the website, how will you know if your targets/objectives are being met?

As in any project, Lean or otherwise, metrics are hugely important. how will you know if you are improving, how will you know if your objectives are being met, how will you know if your project has been successful? How will you know when to change course? Metrics, Metrics, Metrics.

It is here in the planning stage that the metrics you require and the management of these metrics will be determined. What information would you like your website to tell you? How do you know if your website/blog is delivering what you want it to?

6. Find time to write and create content for the website/blog

I have had an active blog for 5 years and have learned that it is one thing creating and launching a website, the challenge is creating interesting content that people actually want to read on a regular basis.

This requires a Plan, Do, Check, Act cycle of it’s own!!!!

That’s it – 6 steps to ‘PLAN’  a website!I’m sure there are many more items I could have planned for, is there anything you think I have missed?

Keeping it Simple,


My next post will focus on the ‘Doing’ part of the PDCA (PLAN, DO, CHECK, ACT) cycle to create a website. Plan


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