In 2013, UMass Memorial Health was at junk bond status, defaulting on its bonds. Patient satisfaction was in the bottom tenth percentile. Employee engagement was in the bottom one percentile.

Dr. Eric Dickson became CEO that year with a specific theory: that a daily improvement system, built around the ideas of frontline staff, could change all three.

Eleven years later, the health system holds an A-minus bond rating — its highest in 35 years. 200,000 frontline improvement ideas have been implemented. The management system Dr. Dickson built is now in version 18.

This is the full session from the 2026 Lean Summit. Dr. Dickson walks through what the system looks like, how it works across 21,000 employees, where it nearly failed, and what sustained it.

What you will see

• The crisis that forced a new approach to leadership.

• The management system structure that emerged from it — now in its 18th version.

• How 200,000 frontline ideas get surfaced and acted on.

• The financial turnaround that followed. And what Dr. Dickson would do differently.