My "GM Bashing" in the ChangeThis Manifesto


Some of you might have read my “ChangeThis” manifesto, “How Toyota Can Save Your Life… At The Hospital.”

I've gotten a lot of positive feedback from lean professionals, healthcare professionals (including an MD), and lean healthcare professionals. Thanks for that, I appreciate it.

I got some negative feedback about my “GM bashing,” that it was unnecessary and that I could have made my argument without it.

On page 7, I made a reference to Jim Womack's story (which he recently confirmed is true, from his recollection) that said a GM plant in the 1980's sent most, if not all, of its assembled cars to either “minor repair” or “major repair.” My mistake was referring to Hamtramack instead of the older Clark Street Cadillac plant in Detroit as the location of Womack's story.

While it's probably unfair to single out only GM as an example of a non-Lean producer, my point was to compare the inspection driven approach to quality to the Toyota model of stopping the line and building in quality the first time. The Toyota model for quality is cheaper and more effective, and that's the model I would want healthcare to copy. I could have also pointed out BMW's plant in South Carolina as an example of inspection-driven quality, or at least that's how they portrayed it on their tour in 2005… they had hundreds of inspections and never talked about (nor displayed) anything that looked like lean/TPS practices.

I was also criticized for saying, on page 13, that the GM plant I worked in had “no oversight” for standard work methods. I'll stand by this statement, at least in the context of the machining departments I worked in. Management was hardly ever on the shop floor, including the front line “team leader” (I mean, supervisor). Management wasn't checking to see if quality gaging checks were being done at the right frequency (or didn't want workers to stop the line to do so). Management ruled in a decidely non-Lean fashion. We had “standard work” documents, but they were written by engineers and were old, dusty, and greasy. It might have been slightly more than “no” oversight, but it was pretty dang close.

It was also pointed out that GM is working to help hospitals utilize lean methods for improving healthcare, including at the U of M hospital. Duly noted, has been previously. I'd argue that GM should first fully implement lean methods within its own house before helping others. Yes, I'm harsh on GM. I want the company to do better. It was a big part of my hometown and my mom's hometown (Flint), I used to work there, it's played a big role in my family for many generations. That's why I get so frustrated with GM.

If you have any other feedback on the piece, let me know. I'll have a follow up post with some clarifications (and defending of myself) in regards to the “doctor bashing” charge that was leveled at me by one MD.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


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