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We are not Toyota!

Gert Linthout

Once upon a time…

It was some years ago, when we guided a lean transformation project in a regional hospital. The ambition was to drastically improve the experience of patients in the surgical ‘one-day pathway’. An in-depth patient survey and analysis of the value stream revealed that missing information for the patient and long and unpredictable waiting times were the main drivers for dissatisfaction. A sub-optimal planning and system appeared to be the most important root causes. Although the problems were recognized, quite some resistance existed in the organization to change the current way of working.

As part of the cultural transformation, we took a group of key players (such as doctors, nurses and managers) to a car manufacturing site. Not only for site seeing, but mainly to assemble cars together, as a team, in a simulated work environment. We experienced and practiced the principles of team work, coaching leadership, structured problem solving, flow and pull, quality at the source… at the assembly line.

It was some weeks later during the analysis phase, while measuring the waiting times as ‘zero measurement’, that we saw a sharp (and unexpected) decrease in waiting times for a specific patient group (those having small treatments with local anesthesia). Without notifying, one of the doctors present at the training, had changed his way of planning: instead of asking all patients to come at the start of his treatment block, he now called the next patient each time when a patient left the treatment room (with a buffer of 2). He in fact translated what he had experienced, into a ‘pull’ system for his patients… Waiting times dropped from 120 to 30 minutes, patient complaints dropped to zero.

The ‘We are not Toyota!’ hype

This is not someone shouting, it is the name of recently published book. Two weeks ago, while attending the European Shingo Summit in Cork, a similar title of a healthcare presentation caught my eye. It must be a new hype, I thought feeling quite curious, as I would find it odd to present myself as ‘Hi, I am not Bart’. What would the speaker actually mean: We are not car manufacturers? We are not Japanese? We use different tools?

It was in fact a quite inspiring talk on how the healthcare sector has a huge potential to benefit from insights from other sectors, yet stressing the importance of leadership, focus on the patient and his/her individual needs, quality… And of course: ‘not to copy the Toyota tools blindly’! Wondering who had suggested this in the first place, some desk research of known literature showed me no suggestions in this direction. The focus is and always has been the creation of value, respecting individuals and developing them, pursuing a long-term purpose, extreme focus on quality… It can be brought together as a carefully designed culture, a set of desired behaviors supported by an appropriate leadership style and strong guiding principles. Might this be what went wrong in the ‘Western’ translation of what Toyota did : as a culture is difficult to grasp and transpose to your own organization, we did try to copy the tools?

It reminds me of the Japan Kaikaku Experience together with @Markgraban in 2012. At the start of the gemba tour the Toyota Motor Corporation Motomachi plant, the guide advised us: ‘please do look beneath the visuals and tools you will see everywhere: they are only the result of our problem solving process, to find the answer for a specific problem we experienced at a specific moment in time. The true essence is in the underlying behaviors and principles’.

‘Proud to be…’

Coming back to the example of the surgeon, it gives me a great feeling: there are always more reasons not to change, yet he found one reason to do so. By ‘going to the gemba’, trying to grasp the essence and to find a practical solution to satisfy his patients in the context of his hospital, fitting in their culture.

Instead of a ‘we are not…’ position, I want to strike a blow for a ‘proud to be…’ attitude. Let us start with what we are strong at, proud of, the values we muster, the purpose we pursue. And let us continuously be inspired, and learn from each other.

What are YOU proud of?

I will go first: I am Gert, and I am proud to be part of my company, Möbius. I am proud of the touchdown results together with our customers and their customers, I am proud of our perseverance every day, our endless shoulder-to-shoulder mentality, and our guts to take every opportunity to try something new!

And yes, we learn every day from our customers and partners. And yes, we learned a lot from Toyota.

Thanks for reading

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Gert Linthout