How Not to Live With Chaos

In this episode, Ken speaks with Meghan Scanlon, Director of Operational Excellence at Penn State Health, for a candid and hopeful conversation about a question many healthcare leaders quietly wrestle with: Why does chaos persist—even when we know better systems exist?Rather than placing blame on individuals, Meghan reframes the issue as one of implicit learning and inherited systems. Most leaders aren’t choosing chaos intentionally; they’re often operating within patterns they were taught, rewarded for, or never given the time or support to redesign. The result is a culture of firefighting and heroics that feels necessary—but ultimately limits performance, safety, and sustainability.The conversation explores how leaders can move beyond individual excellence to team-based performance, drawing lessons from sports, coaching, and high-reliability organizations. Meghan emphasizes that real progress comes when leaders act as coaches, build capability across the system, and create environments where small problems are surfaced early—before they become crises.Ultimately, this episode is a message of optimism. Healthcare doesn’t need more heroics. It needs better systems, stronger coaching, and the courage to make the invisible visible. When leaders commit to developing operating systems that support learning, safety, and alignment, better outcomes—for patients, teams, and leaders themselves—are not just possible, they’re repeatable.

Welcome to Episode #98 of Habitual Excellence, presented by Value Capture. In this inspiring episode, Geoff Webster, Chair of the Pittsburgh Futures Collaborative, and Ken Segel explore what it takes to create healthier, safer, and more thriving communities. Geoff shares how his public-health roots and community work taught him that real change begins when leaders challenge themselves, step into uncomfortable spaces, and keep learning. He highlights the transformational gun-violence reduction effort in Pittsburgh—where a neighborhood once experiencing around 35 non-fatal shootings a year saw that number drop to just 4. Geoff calls it some of the most powerful work he’s been part of, proving that what once seemed impossible becomes achievable when communities come together with courage and conviction. Throughout the conversation, Geoff and Ken emphasize visionary leadership, systems thinking, and the belief that people thrive when they’re supported to grow. The conversation underscores how data, collaboration, and consistent leadership practices can drive meaningful progress in communities.

In this episode, host Ken Segel talks with Donise Musheno, Vice President of Perioperative Services at Lancaster General Hospital (Penn Medicine), about leading large scale operational transformation through trust, culture, and systems thinking. When she began, her team faced a 30% instrument defect rate and 9% case delays, issues that undermined efficiency and morale. By focusing first on relationships and trust, then simplifying priorities around quality and efficiency, Donise helped her team achieve dramatic improvements: defects dropped to 4% and delays to less than 0.2%. She emphasizes real time problem solving, transparent data, and empowering frontline leaders to test and learn quickly. The conversation highlights how building culture first enables sustainable excellence, turning crisis into collaboration and measurable, lasting results.

In this episode, host Ken Segel talks with Donise Musheno, Vice President of Perioperative Services at Lancaster General Hospital (Penn Medicine), about leading large scale operational transformation through trust, culture, and systems thinking. When she began, her team faced a 30% instrument defect rate and 9% case delays, issues that undermined efficiency and morale. By focusing first on relationships and trust, then simplifying priorities around quality and efficiency, Donise helped her team achieve dramatic improvements: defects dropped to 4% and delays to less than 0.2%. She emphasizes real time problem solving, transparent data, and empowering frontline leaders to test and learn quickly. The conversation highlights how building culture first enables sustainable excellence, turning crisis into collaboration and measurable, lasting results.

In this episode, Justin McElhattan leads with humility in such a deeply authentic way that it took us years to convince him to be a guest on this podcast.  We persevered because as the CEO and then Group President of Industrial Scientific, Justin brought to life the inspiring results and models to follow that Habitual Excellence leadership - rooted in safety - makes possible. And now he and his wife, a physician, are bringing the same inspiring leadership framework to a whole other sector – agriculture – determined to magnify our food system’s ability to nourish, connect and heal. At the same time, the family remains perhaps the most significant investor in the workplace safety movement in the country.  We grow and take on energy every time we talk with Justin, and are excited to bring this episode to you.

In this episode, the Lakeridge Health team reflects on their shift from DMS 1.0 to 2.0. Their first system was filled with activity, but huddles and routines often felt disconnected from real daily problems, and strategy came across as too top-down. With support from Value Capture’s Didier Rabino, leaders stepped back to observe together, ask sharper questions, and uncover gaps. This created new habits that helped teams solve problems at the root cause, link daily work to strategy, and strengthen leadership development in the flow of work.What once were occasional offline conversations about improvement and growth became part of the daily rhythm. Managers quickly adapted, raising the level of dialogue and capability across the organization. While challenges remain, the team has embraced persistence and problem-solving as the path forward. Their journey shows how DMS 2.0 is creating stronger results, greater alignment, and a culture of continuous learning and improvement—momentum they’re excited to share with peers at their October 15 learning event.

This episode of Habitual Excellence featuring Jake Raymer will have health care leaders thinking deeply and acting differently.  Raymer is both the past education director for the Shingo Model and just did 7 years as the Chief Transformation Officer at Munson Healthcare in Michigan, an operational excellence (or “lean”) leader.  Jake is a renowned, powerful and entertaining thought leader across the world of operational excellence, who believes the only research worth its salt is research that holds up in the field, so it’s a special opportunity to tap into his key learnings for today’s healthcare leaders.  Hear Jake point the way to more powerful and practical ways to shape a great “culture,” to manage change much more systematically and specifically, and talk about why more and more healthcare leaders are starting to learn about the Shingo model to take their own operating systems to a more grounded and powerful place, so they can drive more enduring mission-based performance.

Robert Mandel MD, is the President of Clinical Excellence and Chief Medical Officer for Carelon Health, a subsidiary of the huge payer-provider platform Elevance Health.  He is also a physician leader steeped in the principles of Habitual Excellence who has been associated with some of the building block breakthroughs in delivering better healthcare quality and outcomes for patients, from individuals to huge populations, through his career across the payer-provider interface.  In this episode, hear why he is encouraged by what we’ve been able to learn and apply to improve care from the emerging large datasets so far, and how he and Carelon hope to support further improvement across healthcare by making clinical evidence even more front and central for members and providers and payers experiences with each other, and for members during the 95% of the time they aren’t directly interacting with the healthcare system as well.  Robert also shares 5 ways he leads with the principles of Habitual Excellence to help everyone in the organization show up in the best way they can, every day, to advance the mission.

Robert Mandel MD, is the President of Clinical Excellence and Chief Medical Officer for Carelon Health, a subsidiary of the huge payer-provider platform Elevance Health.  He is also a physician leader steeped in the principles of Habitual Excellence who has been associated with some of the building block breakthroughs in delivering better healthcare quality and outcomes for patients, from individuals to huge populations, through his career across the payer-provider interface.  In this episode, hear why he is encouraged by what we’ve been able to learn and apply to improve care from the emerging large datasets so far, and how he and Carelon hope to support further improvement across healthcare by making clinical evidence even more front and central for members and providers and payers experiences with each other, and for members during the 95% of the time they aren’t directly interacting with the healthcare system as well.  Robert also shares 5 ways he leads with the principles of Habitual Excellence to help everyone in the organization show up in the best way they can, every day, to advance the mission.

Carrie Willetts is one of the next-generation leaders of the Habitual Excellence movement, finding new ways to connect its ideas to everyone in the organization, practically and efficiently, using plainer language and simpler core concepts to achieve profound results at scale.As Chief Administrative Officer of the rapidly growing WVU Medicine, Carrie has succeeded at increasingly higher levels by thoughtfully aligning her deepest values, the institutions she chooses to serve, and a repeatable leadership framework rooted in the belief that culture is the answer to every challenge.In this episode of Habitual Excellence, Carrie delivers a tour de force explanation of her leadership framework, sharing compelling stories that illustrate how she applies it, along with evidence of major success. She also explains how she has become a rare C-suite leader who is equally comfortable with strategy and execution.Carrie’s story will energize listeners and offer insights that make the leadership path ahead both easier and more fulfilling.