DailyKaizen

A long awaited journey was completed today, to the NUMMI plant in Fremont, California, by myself and the 3 business partners I work most closely with. Lee did not accompany us, unfortunately, due to a conflict (even though I did get clearance from his boss!). There is a no-camera policy in place in the interest of protecting the privacy of staff, so no pictures will accompany this post.

Our company is not one that has sent people to Japan as part of our journey, and I don’t know that this is a good use of our members’ dollars. Traveling to NUMMI, though was exciting. I consider it a gift to be supported in learning what we can from other successful businesses to help our members be healthier. And so we made this journey.

We began the tour with a short video of NUMMI’s history, followed by a Q&A session, followed by a tram tour. There were big signs on the wall with words like “Kaizen” and “Jidoka” which were of course familiar to us. The video was a lot about the people of NUMMI and less about the machines and the accomplishment is impressive. I remember the NUMMI announcement in the 1980’s and what a big deal it was - Toyota and GM working together? It was explained to us that GM was the landlord and Toyota ran the operations.

Before the actual tram tour, we were shown the training area, where mock cars were on a belt with andon cords over head. It was explained that some of the parts in the kits were purposefully defective, and the exercise was a training in pulling the andon cord whenever defects were seen.

What would it be like if we trained nurses and doctors to work in mock operating rooms or exam rooms where there was a quality issue or complication and they had to ask for help? What a great way to learn to solve the kinds of problems our patients face - problems of clinical excellence, care experience, and affordability. This approach was definitely not the one used in my (or most MD’s) training, by the way. The goal in my training was always to be self-sufficient - I have worked to unlearn this learning, but the attitude that spawned it still exists (do I really want to stop someone else’s flow to help this patient? YES!).

We were then on the tram tour, and I would say it most resembled a theme park ride. This particular plant builds Corollas, Vibes, and (UPDATED: Tacomas). I could not help but wonder at the amazing choreography of the building of these machines. It must have put together by a genius somewhere - or by a lot of smart people collaborating together to make things better every day.

What was really special, though, was the staff who ran by the trams to wave hello, and the spontaneous applause of the tour participants as an engine was bolted in or a worker crossed the tram path. People are excited by the idea that workers are empowered to do great work and take care of themselves and their families doing it. It’s what we want for ourselves, and what our patients want for their caregivers - they want to clap for a care team empowered to take the best care of people.

We were told at the end that one tour is not enough - 3 or 4 would be more useful. I would do it again. A parting request of mine was that the staff ask their doctors and nurses to come to their Gemba the next time they went for a health care visit. These are patients who have a lot to teach their teachers!

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