Building an Engaging Toyota Production System Culture to Drive Winning Performance for Our Patients, Caregivers, Hospitals, and Communities

Abstract

Healthcare systems worldwide are seeking to drive improvement on their journey to high reliability, but are searching for validated improvement science and cultural management frameworks for assistance. Too often, large investments have been made to improve outcomes, resulting in short-lived successes when the organizational focus is on these high-value initiatives. Once the organization focus is shifted to another “flavor of the month,” the results are not sustained, or new innovative methods that have been developed fail to spread successfully to other units. Not surprisingly, healthcare has reached out to other industries for their best practices over the past 15–20 years. In 1990, James Womack and his colleagues from Massachusetts Institute of Technology (MIT) were one of the first to report about a relatively unknown (at the time) automotive manufacturer and their cultural management and improvement system, known as the Toyota Production System (TPS). They introduced the term “Lean production” to refer to TPS, an unintentional misrepresentation of TPS, which implies to some that organizations will become lean through the elimination of jobs. Actually, TPS places the utmost value on the development of an organization’s people or workforce. This focus has been emulated by other improvement frameworks. Many hospitals have tried to translate TPS to healthcare, often termed “Lean healthcare” – some have been successful, while others have struggled. Generally speaking, the application of TPS to healthcare is a relatively recent development since the early 2000s and is still evolving. In this chapter two major challenges related to building a TPS culture will be discussed: (1) clarification of the meaning of TPS as an organizational culture of highly engaged people driving performance and (2) how to build an enduring TPS culture. Successful implementation of TPS requires dedication of organizational leadership, managers, and workforce. When done properly, culture driven by TPS can be a win for patients, families, caregivers, hospitals, and communities. If it is not win, win, win, win, win…, then it is not TPS.