I have been to Japan on a number of occasions and learned a great deal from the people I have met there, and from what I have read.
The National Screening Programmes were based on the design and engineering principles of the Japanese car industry; initially, on what I could learn about Nissan and latterly from books on quality assurance in general. This includes Kaoru Ishikawa’s book on What is Total Quality Control? The japanese Way and, later, later from the books about Toyota, such as The Toyota Way and of course the classic text from the iconic figure Taiichi Ohno; called The Toyota Production System with its wonderful sub title – Beyond Large Scale Production.
Then came the fall – the SUA (Sudden Unintended Acceleration) problem. This led to ten million recalls, headlines galore, Schadenfreude from other auto manufacturers and a sense of shock from people like me who had spent a decade or more using Toyota as a model for healthcare.
Now the good news, learned from a newsletter from the Lean Institute’s excellent John Shook, author of Managing to Learn. Using the A3 management process to solve problems, gain agreement, mentor, and lead.
It wasn’t a problem with the accelerator or the electronics or any of the systems design and engineering that had been such an influence on me. It was a mat, a floor mat, a too big floor mat jammed in by a car dealer employee. The problem had even been reported to a receptionist by the driver of the car on an earlier journey to the one with fatal outcome.
So Toyota Production Systems work after all, as a book to be published in May called Toyota Under Fire will reveal. Japan will need Toyota back with its reputation untarnished to lead the revival the economy.
It was astonishing that the Japanese Prime Minister likens the challenge now faced by Japan to that of the Second World War after two nuclear exploisions.
The cultural and technical responses are best described in the account of the rise of the Japanese car industry, and the decline of the American, told in his inimitable style by the late David Halberstam in The Reckoning. This is a book of great relevance to healthcare because it describes the consequences of complacency and how the Japanese people overcame huge problems to become the society that the earthquake and tsunami has hit so hard. I am sure people will adapt and work to mitigate their effects; my thoughts are with friends and colleagues in Japan.
Muir Gray is visiting professor of knowledge management, Nuffield Department of Surgery, University of Oxford.