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Engaging Staff in Improvement is Actually the Toyota Way, Too

Posted by Mark Graban

Feb 2, 2016 11:52:11 AM

doctor-patient-1080408_640.pngLean is such a powerful and engaging method, I get really frustrated when I see people write things about Lean or Toyota that aren't true, or are only half true.

We saw a lot of this recently in the debate over a controversial New England Journal of Medicine article that equated, essentially, rushing doctors and pressuring them to work faster, with Toyota and Lean. That couldn't be further from the truth. In a Lean system, we work with physicians and everybody in the system to identify ways to reduce waste and free up time for patient care. Instead of cutting corners or telling people how to do their work, as traditional management approaches might unfortunately encourage, Lean is a clear alternative where quality and respect are top priorities. See my post about the NEJM piece and where it was wrong.

Hear Mark Graban read this post (as part of our KaiNexus Podcast series):

I also recently saw a piece in Modern Healthcare that, while not critical of Lean, is inaccurate in that it shortchanges what Lean is about: "Try Google Way to start culture of innovation in healthcare." The physician who wrote the piece is at Stanford, so I can understand the allure of tech companies and Google as a model.

Dr. Alistair Aaronson wrote:

"Healthcare has sought guidance from the automotive industry to improve operations management through widespread adoption of the Toyota Way, and this has heralded significant improvements in operational efficiency and quality of care. However, in seeking guidance for the development of a corporate culture that spurs continuous innovation, healthcare leaders should look no further than the technology industry, with Google as the tacit and de facto leader. Much in the same way the Toyota Way has influenced healthcare operations and process improvement, the Google Way could positively influence the healthcare culture."

Yes, Lean can help improve both efficiency and quality. At least he got that right, instead of incorrectly saying that Lean is only about efficiency or productivity or cost.

But, the error is in not thinking that Lean and the Toyota Production System are not also methods for continuous improvement and innovation. We have many KaiNexus customers who demonstrate daily how creative and innovative they are with Lean and Kaizen methods.

We can probably learn something from Google, but we shouldn't miss or ignore what Toyota can teach us about innovation and improvement.

Ironically, everything that Dr. Aaronson says about Google can actually also be attributed to Toyota:

"Google... engage and empower front-line employees. Indeed, front-line employees often notice inadequacies in daily operations, and they are the ones best equipped to develop and implement solutions for the problems they encounter.

Google and comparable companies also foster a collaborative environment by implementing a flat organizational structure, where managers are seen more as resources, and less as bosses. This encourages open communication among team members and promotes a collaborative approach to problem-solving in which individuals feel free to voice ideas, no matter how radical or nontraditional those ideas may seem.

In this flat management structure, failures are not seen as errors that require punishment or remediation, but rather as necessary steps toward developing trailblazing ideas."

Again, that's all very true of Toyota. I wish we didn't have so many publications that spread half-truths or falsehoods about Lean. As the late Senator Daniel Patrick Moynihan famously said, "'Everyone is entitled to his own opinion, but not to his own facts."

The same is true when it comes to Lean and Kaizen.

What are your stories about using Lean to engage staff in continuous improvement?

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