The Impact of Toyota’s Quality Problems on “Lean Healthcare”?
As I'm traveling back from Sweden today, I think I'll be catching up on the web reaction to Toyota's major quality problems and recalls. I am not a Toyota insider and I don't claim to know what happened or what Toyota will do. All I can write about is public perception and how this impacts our efforts to spread the Toyota Production System and “Lean” to healthcare.
It's disappointing how the mainstream media and the web can't separate Toyota from “lean manufacturing.” Remember, the term “lean ” does not come from Toyota. It was coined by Jon Krafcik of the Womack / Jones / Roos team that wrote The Machine That Changed the World: The Story of Lean Production.
While the term “lean” has negative connotations, one advantage of defining a term “lean” and a set of principles is that we can separate “what Toyota does” from the lean methodology. The Wall Street Journal, once again, demonstrates that their writers don't understand lean at all. Normally, each year, they trot out a new article about how “just in time” doesn't work. (other links here).
“Just in time” parts delivery from suppliers is a practice often associated with lean, but it's a minor piece. Lean is really a management philosophy and improvement process. This time, the WSJ is blaming the use of common parts – a cost savings move where the same accelerator and other parts are used across multiple models, since who really cares if a Camry gas pedal looks like that of a Matrix? (A good perspective on this can also be found here from Northwestern's Kellogg school).
Whether JIT or common parts, the WSJ is looking at what Toyota (and other car makers) does and they can't separate that from lean. GM uses common parts (arguably, one practice that contribute to Saab's problems). Toyota clearly failed. But saying Toyota, the people and the company, failed is not the same as saying lean failed. Just because Toyota does something doesn't make it lean.
Toyota's failure does not discredit lean or even the Toyota Production System. As John Shook wrote recently, he learned early to separate the System (the ideal) with what Toyota actually does. There is often a gap. In this case, there's a major gap, where Toyota clearly hasn't lived up to its quality reputation and a lot of people have died.
That said, Toyota's (the company) failures and the resulting public perception impacts us in the lean world. If public perception falls too much, are we worried about lean sounding like the “Yugo Production System” or the “Pinto Production System“?? On the surface, it sounds like exactly NOT the kind of thing to bring into healthcare.
The reality is that lean methods for quality improvement are saving lives in healthcare – providing more timely care and reducing errors and infection rates. It would be a real shame if Toyota's problems lead to less adoption of lean in healthcare. In your hospital. you probably have your skeptics about lean — are they gleefully seizing this moment to say, “See, I told you Toyota isn't perfect!” That sort of argument might not be logically true, but it has emotional appeal, I'm sure. Will that interfere with your lean progress? Time will tell…
I've always told training classes that Toyota isn't perfect. They are human. Maybe that's the best lesson there – to recognize our human nature. Will people naturally overreact to the Toyota problems to discredit lean? Sure. But, in healthcare, are we not also human and fallible? Isn't that realization more of a reason to have better systems – methods like mistake proofing and checklists?
How are you prepared to address these issues when people ask you about Toyota's recent problems?