Learning from Toyota’s Snafu

Rapid growth can leave employees’ skills behind.

The Toyota Production System and U.S. health care improvement share a long history. What lessons can health care leaders learn from Toyota’s recent production troubles? A few experts recently discussed this on WIHI, an audio program sponsored by the Institute for Healthcare Improvement (IHI). Here are some highlights from the May 6 broadcast.

“Toyota has set the direction for all of us who are on the lean journey,” observes John Toussaint, M.D., founder and president of ThedaCare Center for Healthcare Value, in Appleton, Wisconsin. “We all try to watch and emulate them. There’s a lot to be learned from this latest snafu.” Toussaint adds that Toyota has promised a return to basics after having lost sight of two of its fundamental principles—continuous improvement and respect for the customer. “It just proves that the lean journey is an [ongoing] challenge to implement for all of us, even Toyota.”

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Comments

80%?!?

"Toussaint stresses that a standard process of care works for patients 80 percent of the time." WOW!! What a statement! Who wants to be in the other 20%?? That's one in five times the system doesn't work. I wouldn't want to "stress" this point. I would be ashamed.

Steve you are right on

The movement to "lean" in healthcare is a move to manufacturing tools and healthcare has different problems. A big one being the variety of demand we see in healthcare. Standardization gets to a solution before we understand the problem. It is as Russ Ackoff said "Doing the wrong thing, righter."

Theory vs. practice

Tripp:

I agree with your assessment that any time a solution doesn't address the root cause it doesn't fix the problem. In fact it might be termed "tampering". However, there are two points I'd like to make and see if we can discuss further.

1. Protocols and pathways have been in health care for many years and are definitely a form of standard work. They just need to be applied AFTER we know what is wrong, not before.

2. There are many processes in any health care system that have nothing to do with patient care and would greatly reduce waste (reducing costs, time and hassle) while potentially improving outcomes because they allow the providers to spend more of their time on "value added" activities (i.e. caring for the patient).

Regards,

80%?!

Steve:

There may be a misunderstanding. I believe the author intends to say that a standard process "applies" to a patient presenting with a given set of symptoms 80% of the time, and that by employing standardized work we can remove 80% of the variation in the way providers do their job. That is definitely worth emphasizing, especially to those practitioners who insist that because each patient is a unique being that treatment must also be unique.

Standardized work, if properly hardwired, can be successfully completed 100% of the time. Whether that course of treatment "works", i.e. outcomes for the patient, depends in part on the biology of the patient. Not the variation we are able to reduce and not the point.

Regards,