Yesterday, I was in Dearborn, Michigan for a meeting, in the shadow of the “Blue Oval” or Ford Motor Company world headquarters. Part of the day included a visit to a famed museum that I remember well from my childhood and school field trips – The Henry Ford. The timing didn’t work to take the Ford Rouge Plant tour, unfortunately (although I had a chance to visit there long ago).
Below is a picture I took of a 1909 Ford Model T. Notice the color — RED!
From Wikipedia (“the world’s laziest site to cite!”):
By 1918, half of all cars in America were Model T’s. All new cars were black; as Ford wrote in his autobiography, “Any customer can have a car painted any color that he wants so long as it is black“. Until the development of the assembly line, which mandated black because of its quicker drying time, Model Ts were available in other colors, including red.
Shamelessly recycling a bit from that post, I shared this quote from the book — remember this was written in 1922.
“In the ordinary hospital the nurses must make many useless steps. More of their time is spent in walking than in caring for the patient. This hospital is designed to save steps. Each floor is complete in itself and just as in the factories we have tried to eliminate the necessity for waste motion so have we also tried to eliminate waste motion in the hospital.”
Henry Ford not only created the Model T. Not only did he popularize the moving assembly line. He also dabbled in hospitals — he was helping transform the former Detroit General Hospital — the “this hospital” in his above quote.
And you know what? He was right then — and he would be right TODAY if he walked into most hospitals. I show that 1922 quote to people today (as I have been for the last seven or eight years) and it still resonates with people. Much of the wasted motion and wasted time is due to the physical layout of the hospital or the patient care floor/unit. The waste is also driven by processes and lack of proper organization — where are tools, equipment, and supplies stored? It’s not the nurses’ fault – it’s the systems.
So with many hospitals today trying to tackled those same challenges, it goes to show that Henry Ford was very much ahead of his time.
OK, done with the recycling… back to new content.
More quotes from My Life and Work:
The Ford Hospital is being worked out on somewhat similar lines, but because of the interruption of the war–when it was given to the Government and became General Hospital No. 36, housing some fifteen hundred patients–the work has not yet advanced to the point of absolutely definite results.
I did not deliberately set out to build this hospital. It began in 1914 as the Detroit General Hospital and was designed to be erected by popular subscription. With others, I made a subscription, and the building began. Long before the first buildings were done, the funds became exhausted and I was asked to make another subscription. I refused because I thought that the managers should have known how much the building was going to cost before they started. And that sort of a beginning did not give great confidence as to how the place would be managed after it was finished.
However, I did offer to take the whole hospital, paying back all the subscriptions that had been made. This was accomplished, and we were going forward with the work when, on August 1, 1918, the whole institution was turned over to the Government.
It was returned to us in October, 1919, and on the tenth day of November of the same year the first private patient was admitted. The hospital is on West Grand Boulevard in Detroit and the plot embraces twenty acres, so that there will be ample room for expansion. It is our thought to extend the facilities as they justify themselves. The original design of the hospital has been quite abandoned and we have endeavoured to work out a new kind of hospital, both in design and management.
There are plenty of hospitals for the rich. There are plenty of hospitals for the poor. There are no hospitals for those who can afford to pay only a moderate amount and yet desire to pay without a feeling that they are recipients of charity. It has been taken for granted that a hospitalcannot both serve and be self-supporting–that it has to be either an institution kept going by private contributions or pass into the class of private sanitariums managed for profit. This hospital is designed to be self-supporting–to give a maximum of service at a minimum of cost and without the slightest colouring of charity.
In the new buildings that we have erected there are no wards. All of the rooms are private and each one is provided with a bath. The rooms–which are in groups of twenty-four–are all identical in size, in fittings, and in furnishings. There is no choice of rooms. It is planned that there shall be no choice of anything within the hospital. Every patient is on an equal footing with every other patient.
Private rooms with your own bath — that was ahead of his time. Having identical rooms is certainly a 2014 trend in “Lean Design.”
Now get this — again, from 1922!!
It is not at all certain whether hospitals as they are now managed exist for patients or for doctors.
I am not unmindful of the large amount of time which a capable physician or surgeon gives to charity, but also I am not convinced that the fees of surgeons should be regulated according to the wealth of the patient, and I am entirely convinced that what is known as “professional etiquette” is a curse to mankind and to the development of medicine.
Diagnosis is not very much developed. I should not care to be among the proprietors of a hospital in which every step had not been taken to insure that the patients were being treated for what actually was the matter with them, instead of for something that one doctor had decided they had.
Professional etiquette makes it very difficult for a wrong diagnosis to be corrected. The consulting physician, unless he be a man of great tact, will not change a diagnosis or a treatment unless the physician who has called him in is in thorough agreement, and then if a change be made, it is usually without the knowledge of the patient. There seems to be a notion that a patient, and especially when in a hospital, becomes the property of the doctor. A conscientious practitioner does not exploit the patient. A less conscientious one does.
It has been an aim of our hospital to cut away from all of these practices and to put the interest of the patient first.
Ford was 100 years ahead of his time, in many ways.
In some ways, he was a “Kaizen” thinker, writing:
“Our own attitude is that we are charged with discovering the best way of doing everything, and that we must regard every process employed in manufacturing as purely experimental. If we reach a stage in production which seems remarkable as compared with what has gone before, then that is just a stage of production and nothing more.”
But, he sadly was alleged to say this:
“Why is it that when I want to hire a pair of hands, a brain comes attached to them?”
That’s not Kaizen thinking… but maybe not uncommon thinking of the day.
I’ll share more quotes from the book in a future post.
I’m going to blog again soon about some of Ford’s ideas on entrepreneurship and engineering that reminded me of Lean or even “Lean Startup” principles.
About LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. Mark is also the VP of Customer Success for the technology company KaiNexus. He lives in San Antonio, Texas.