What can we learn from Toyota’s fall from grace? This is thequestion I ask in a blog posted on February 11th. In that piece I write about Toyota’s need to learn about the deficiencies in its corporate culture rather than framing their problem as one of defective parts. Other organizations that are trying to adapt “The Toyota Way” to their own operations should look at Toyota’s experience as a wake-up call. For example, a number of health-care organizations are implementing the quality tools and efficiency procedures developed by Toyota. They want to save money and improve the quality of health care in their systems. These are admirable goals. However, in light of Toyota’s recent travails, these organizations should look closely at their own cultures and what could become barriers to effective change over time. They might have a Hawthorne effect in the short run but fail in the long run if they don’t stay cognizant of the same threats that are causing problems for Toyota.

What are some of these potential threats? One is focusing all of their energy on change in parts of the organization that are easiest to change (e.g., nursing, housekeeping, purchasing) with little effort in the parts of the organization that are hardest to change (e.g., doctors, senior management). Another is building a capacity for continuous improvement inside the organization while at the same time being unable to respond to economic, competitive, and political threats from outside the organization. A third potential threat is resting on one’s laurels of short-term gains but not doing the hard work of creating and sustaining a culture of continuous improvement that permeates every nook and cranny of the organization.

What do you think are other potential threats to long term successful implementation of “The Toyota Way” in health care?