Mark Graban's leanblog.org - Lean Healthcare, Lean Hospitals, Healthcare Kaizen, Lean Thinking, Lean Manufacturing, Toyota Production System

Did GM Forget that the Customer Should Come First? And Who Forgot Exactly?

gmI wrote an article for LinkedIn yesterday about the recent GM ignition problem controversy and recall. I commented mainly on the video put out by new CEO Mary Barra (which I encourage you to watch).

As a former GM employee, I reacted (at a gut level) to a few things in the video. The main thing was her admonition that, basically, quality is everybody's job and that everybody needs to put the customer first.

If I still worked there, I'd find that offensive. When I was an entry-level Industrial Engineer at GM, my default was to put employee safety and customer quality first. That wasn't always well received, to say the least. I shared one of those stories in the article and I might share more here.

As Dr. Deming taught, quality begins in the boardroom. If Barra thinks she has to remind the employees to put the customer first, maybe she and the board should look in the mirror and think about their role. It's hard for individuals to do quality work when the culture (management's responsibility) gets in the way.

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You can read my article here. Feel free to comment here (for a Lean audience) or on LinkedIn (for a more general business audience), depending on what you'd like to say.

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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an book titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

9 Comments
  1. Bob Emiliani says

    “If Barra thinks she has to remind the employees to put the customer first, maybe she and the board should look in the mirror and think about their role.”

    Not uncommon to find execs who created or were part of the problem admonish others for the problem.

    John Chambers, CEO of Cisco, whose failed experiment with a new management structure ca. 2009-2011 resulted in a reversal in which he told employees in a letter dated 4 April 2011: “…we have disappointed our investors and we have confused our employees. Bottom line, we have lost some of the credibility that is foundational to Cisco’s success..”

    In all three instances, “We” actually means John.

    1. Mark Graban
      Twitter:
      says

      Great example, Bob. Ah, the royal “we.”

      Reminds me of the CMO of Cedars-Sinai beating his chest after the Quaid twins were overdosed with heparin. He said:

      “Procedures were not followed and there’s no excuse for that.”

      I’m quite certain that procedures were not be followed all the time, not just that unlucky day for the Quaid twins. That’s a system problem.

      Who is responsible for “the system?” Management. But, they rarely take responsibility.

      Who should have been ensuring that procedures were being followed? That they *could* be followed in a chaotic workplace? Management, including the CMO and other Chiefs.

    2. Mark Graban
      Twitter:
      says

      There’s more evidence of top-down blaming here.

      What keeps a hospital CEO up at night? I’d like to think that the poor quality and patient harm would keep a CEO up at night above all else. There are so many risks and so much patient harm, I wouldn’t be able to sleep.

      There’s a comment in the piece:

      “To go after infections, we need nurses and doctors exhibiting best practices.”

      This sounds like blaming the nurses and doctors. Why aren’t they following best practices? Do they not know about them? Do they not have the time to do the properly? Are hand gel or foam dispensers empty (as I often find them)?

      This is a system problem that can’t just be dumped on nurses and doctors. Everyone needs to work together to solve it… but leadership is responsible for creating the culture and systems that make it possible.

  2. Anon says

    Yes, senior leaders can get insulated in the administrative suite. A former CEO in an organization I have just become familiar with lectures accross the country on the concept of patient first, accountability, and mutual respect. My own experience is that the senior leaders in this organization sincerely demonstrate these values to a high degree amongst themselves. On the other hand, there are areas of the organization where patient focus in trumped by expediency, mutual and downward respect is demonstrably lacking and there is an almost total absence of accountability. Unfortunately, it took an outside consultant to point out the reality of all this. Things are changing but it is difficult to stop 25 years of polishing the false facade and get your hands dirty.

  3. Mark Graban
    Twitter:
    says

    Three pairs of Nike Michael Jordan shoes fell apart on NBA players. Jordan himself called to apologize (well, called an agent).

    In healthcare, studies show that after a medical error, if the MD is honest and apologizes, they are less likely to get sued by a patient or family.

    I wonder if Mary Barra or Akio Toyoda personally call the family members who die in accidents caused by defective products (or Alan Mulally from Ford). If so, would it be a sincere apology or an attempt at positive public relations?

    What would you do? Would you call the families?

  4. Mark Graban
    Twitter:
    says

    I read today that Barra and GM created a new job in response to the ignition switch crisis…

    link

    Does that impress the public that they’ve created a new job for a GM lifer who is supposed to be responsible for global vehicle safety?

    I was impressed with her common sense about earlier changing the GM dress code policy from ten pages to two words:

    dress appropriately

  5. Mark Graban
    Twitter:
    says

    In this column in USA Today, the columnist praises Barra for taking ownership of the problem.

    link

    He writes, of CEOs in general:

    The obvious point is that Barra could have personally sidestepped this. She’s only been the CEO for two months—it didn’t happen on her watch. And, anyway, CEOs assign responsibility, they don’t assume it.

    So maybe she isn’t just blaming employees or blaming others.

  6. Vernon says

    100% agree. There is a huge disconnect between the Corporate level and the worker level. It seems every time there is an accident/recall/issue, the first response is to blame the culture or add additional steps to ensure policies and procedures are being followed by everyone. No one takes the time to identify the reason why employees quit following the policies or procedures. While I am fairly new to the LEAN game…I never implement anything until I understand the root cause. This has concept has served me well in the military and now the healthcare industry. An employees attitude and performance are a direct reflection of their leadership.

    Quality never takes a day off!

    1. Mark Graban
      Twitter:
      says

      Thanks for your comment, Vernon.

      That’s the right question… to understand why processes aren’t being followed.

      I’ve worked with a retired military medicine leader who would ask the civilian hospital lab staff where he now worked if there are legitimate barriers to doing your work the right way. Is it a situation where people truly CAN’T do the right work the right way or is it their choice, as in they WON’T follow the procedures or standardized work.

      More often than not, it turns out to be a system issue… such as being overburdened or being under pressure to hit unrealistic production targets, etc.

      Leaders often need to look in the mirror at their own policies or decisions instead of just blaming workers… I think that’s what really helps spur improvement.

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