In this episode, Ken Segel talks with Donise Musheno, VP of Perioperative Services at Lancaster General Hospital (Penn Medicine), about leading improvement through trust and systems thinking. When Donise stepped into her role, the perioperative area faced high instrument defects and frequent surgical delays. Instead of jumping to solutions, she spent her first weeks listening at every level to rebuild confidence and align around shared goals.

With trust established, the team set clear priorities focused on quality and efficiency, using transparent data, daily huddles, and real-time problem solving. Staff were empowered to test ideas and own improvements.

The impact: instrument defect rates fell from 30% to 4%, case delays dropped from 9% to under 0.2%, and first case on-time starts rose from 34% to 75%. Just as important, the culture shifted to one of collaboration, engagement, and pride. Donise’s core message: Start with relationships, simplify the focus, make data visible, and stay close to where the work happens.