- The Washington Times - Sunday, July 1, 2007

ANALYSIS/OPINION:

Why is no national leader or candidate discussing or studying solutions for three of the country’s most pressing problems: unsafe and wasteful hospitals, the failing auto industry and an inadequate K-12 school system? This is especially puzzling when there is an answer—unexpected — nearby.

A significant number of hospitals and schools are applying Toyota management principles — originally developed by an American — and cutting costs, reducing errors and deaths and turning out pleased patients or educated students. But there is little notice or discussion of these successes.

American auto companies are exporting jobs and losing money. Toyota is building more factories in the United States and making big profits.

The hospital crisis discussion is about funding health insurance for more people. More effective, efficient and safer hospitals would save enough money to extend care to all. No national leader or political candidate questions the wisdom of extending insurance coverage for an American hospital system that daily allows hundreds of patients to die from preventable errors and infections.

Hand-wringing over the failing auto industry focuses on worker and retiree benefits and foreign manufacturers. The school policy to combat lack of quality is to administer more tests. It hasn’t helped teachers or students to achieve the real objective of better-prepared minds.

The long-term solution to all of them is not more money or better technology. The problem is managerial. Surprisingly, although the auto assembly line, the surgical unit and the classroom seem vastly different, productive questions and solutions are similar and can be found in the same management thinking.

The solution requires looking with “new eyes” at the 2007 school, hospital or organization as a system and using problems as opportunities for continual learning and improvement. This is the “Toyota method” and it allows us to manage what we can’t control. The idea of lack of control is a difficult hurdle for Americans and their politicians.

Meanwhile, each day hundreds of people die from avoidable errors and infections and millions of dollars are wasted in hospitals. Auto companies and jobs are declining more rapidly than auto profits. And more and more students are dropping out or not learning.

Americans like quick fixes and are suspicious of solutions “not invented here,” so it is important to note that the man who developed the theory to better manage modern organizations began to devise his ideas as a young man on the Wyoming frontier in the early 20th century. W. Edwards Deming understood that Western towns prospered from barn raisings, quilting bees and other cooperative efforts, not lone rugged individualists.

From 1950, he led Toyota and other Japanese export companies to work “smarter not harder” with his revolutionary ideas of continual improvement of products, processes and workers. His methods led to lower costs and better products and more profits. Dr. Shoichiro Toyoda, chairman and former president of Toyota, said, “Dr. Deming is the heart of our management.”

Mr. Deming warned that hard work, cost-cutting and people doing their best would not work in the complex enterprises of the 21st century.

For example, doctors and nurses from SSM Health Care, a Midwest system, with 22,000 employees and the Pittsburgh Regional Health Initiative, a group of 40 competing hospitals, report how they did their best in the past, working overtime, while hospital conditions worsened. They were initially dubious and then delighted to learn systems thinking and Toyota methods to improve patient care dramatically and reduce unnecessary deaths, suffering, errors, infections and costs without additional resources or government regulations.

SSM is the first hospital system to win the Baldrige National Quality Award, which is a Commerce Department program based on the Japanese Deming Prize dedicated to spreading these quality management ideas.

The Baldrige criteria, a practical approach to better management, are virtually ignored by most government agencies and American businesses or practiced piecemeal, which does not work.

Scotland’s National Health Service uses these ideas to train its clinical workers and a government task force is at work on a plan to make Scotland the world’s first learning society based on this approach.

The Deming-Toyota-Baldrige method and systems thinking can improve schools, government agencies or any organization, even military invasions and occupations, because it offers new ways to look at the bigger picture. It allows an organization to be greater than the sum of its parts as the people in the system learn to work together more effectively.

One thing more. The doctors and nurses in the successful hospitals frankly say the patient has been lost amidst new technology, regulations, reimbursements, etc. They say the Toyota approach allows the medical staff to spend more time with patients and deliver more effective care. So the solution is not computers or information. It is a new way of seeing and thinking.

And the puzzling question is why more hospitals, schools, government agencies, etc. are not trying it.

Why is there no national debate on more effectively managing these critical systems of our society? Why don’t leaders/candidates investigate and discuss new ways of approaching problems? The role of leadership is to identify problems and propose solutions. If new ways of thinking and defining problems are needed, that should be the subject of the presidential campaign.

Television news interested in delivering audiences to advertisers will continue to concentrate on sick celebrities and missing persons, so raising the pertinent issues is up to the candidates.

Effective management ideas don’t fit in 15-second sound bites or on bumper stickers. Perhaps our leaders and candidates have too short attention spans to propose and debate complex solutions or are worried about boring the voters.

Hopefully, it is not as G. K. Chesterton said, “It isn’t that they can’t see the solution. It is that they can’t see the problem.”

Clare Crawford-Mason is the producer of “Good News: How Hospitals Heal Themselves” on PBS stations and co-author with Louis Savary of the companion book, “The Nun and the Bureaucrat — How They Found an Unlikely Cure for America’s Sick Hospitals” and co-author with Lloyd Dobyns of “Quality or Else: The Revolution in World Business,” and “Thinking About Quality: Progress, Wisdom and the Deming Philosophy.”

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