I looked online for a definition of the phrase “Ford-Talk,” so maybe it was a term that was coined internally within the last organization I worked for, or the broader Toyota Management System community.

It refers to a culture where managers who are called into a room by their boss give positive assessments of how their areas are doing. This was ascribed to an American carmaker, but I think it could apply to many American companies, relative to their Japanese analogues, where it is expected that failures are pointed out, so they can be fixed. As it is said, an assembly line that is reported as being 100% functional is one that is not functional because it is not finding mistakes and fixing them.

I thought of Ford-Talk when I read This article, which talks about the failure of managers to tell the CEO that things weren't ready. and this article, which dissects the CEO’s memo about the failures to staff and does a nice job of bringing Steve Jobs’ talents in working with the public to light.

However, if articles like this one alluding to the inner workings of the company (“The Economist: Jobs’s Job”) are to be believed I think there may be a different perspective than, “the managers did not report that there were problems and luckily Steve owned the problem publicly so the company could regroup and succeed.”

What I have learned is even the most innovative environments may operate with a command-and-control approach, not by purpose, but by neglect. When that happens, the failure may be not to listen, rather than not to speak.

Did that happen here? I don’t know. The comment about managers failing to tell the boss something caught my eye as a Toyota Management System/LEAN aficionado and made me wonder if there was more to learn.

I am interested in stories like this because I’ve been working in healthcare to improve the listening. When we go from telling people, “You won’t hear anything from us if everything is normal (the ultimate Ford-Talk),” to listening to the question, “I just got my lab report and I have a question about this specific number” we’re more likely to pick up mistakes. It’s better to be embarrassed and change course quickly than wait in these individual cases, and when there is a bigger problem to ask “why?” the problem happened, five times. There may be more than a simple answer…..

May 10th through May 13th:

• Be Well Mobile, Patient Engagement Software that works - cell phone platform for disease management
• Medical Advances—Through Your iPhone? - Portable applications in health care that the iPhone could enable.
• Scientific Misconduct Blog: LSD and the corruption of medicine (Part III): Naming names - A chilling account of experimentation on US citizens without consent
• Texting may help teens remember meds - CNN.com - Cell phones as a tool in medication adherence.
• The Open Secret of Success: Financial Page: The New Yorker - One of the best summaries of what Toyota does well that I've seen.
• ITIF: Explaining International Broadband Leadership - Summary of broadband access in the US and other countries
• Ruthsarian Layouts - Some helpful CSS layouts for blog design

Thanks to Gilles Frydman for spotting this and sending it to me. It’s one of the best summaries I have seen of Toyota’s success to date. I like both the summary and the fact that patient centered leaders like Gilles are aware that I’m interested in the application of these concepts to health care.

Enjoy, and see what you think - what are your questions about using this approach in health care?

The Open Secret of Success: Financial Page: The New Yorker

I like how the advertising is different here, and I pay attention to advertising because it says something about the people who live here, and what can I say, I like to live in a place where people make things happen. In Seattle, advertising is more lifestyle oriented. Here it is more policy oriented, and I snapped a few shots of my favorite car company who are apparently doing a metro station “domination” (that’s the word the execs use) at Union Station, much as Kaiser Permanente did a very nice domination of Powell Street BART over the holidays (with a very cool nod to Kaiser Permanente’s excellence in supporting diversity).

The fun part is figuring out what’s behind this and what policy issue might be up for grabs that would make Toyota want to impress their commitment to the U.S. economy at this time. If anyone in the know knows, feel free to post a comment.

I’m adding one photo of the brand new Harris Teeter that’s about to open in my neighborhood. Apparently artsy photos are popular among the DC Flickr crowd. It’s a Web2.0 thing I guess.

February 7th through February 9th:

• Turning Chrysler Into Toyota - A classic misunderstanding of how Toyota excels, and a misunderstanding of LEAN. Toyota doesn’t lay off and cut to excel. It invests and improves, and respects.
• Technology Helps Hospitals Enhance Consent Forms - iHealthBeat - The title says it all. Giving consumers a chance to understand treatment options.
• JAY PARKINSON MD MPH | Polaroid, Health Plans, and Dinosaurs - Jay says they have a lot in common.
• Google Apps Team Edition - Going Viral on Companies - In the future, should enterprise IT use hosted apps? I think it’s worth a try.

• Providence Health Care - What’s New - Providence Legacy Project, St. Paul’s Hospital, Mount Saint Joseph Hospital, St. Vincent’s Hospitals, Arbutus, Brock Fahrni Pavilion, Heather, Langara, Holy Family Hospital, Youville Residence - The project has yielded great results, with an 87 per cent drop in the time from blood collection to the time of arrival in the lab, and a 45 per cent decrease in turnaround time from blood collection to result reporting.
• Primary Care And Health System Performance: Adults’ Experiences In Five Countries — Schoen et al., 10.1377/hlthaff.w4.487 — Health Affairs - Information about access and secure e-mail use, as well as quality measures across several countries.
• How NOT to lead geeks - This is an interesting post, although I think the title is at odds with the content (this is about leading people who develop great things for society). It adds more information to the LEAN idea that people are not the problem, it’s process.
• Toyota passes Ford as No. 2 in U.S. sales - Toyota’s ability to have humility in this situation is something a healthcare organization would be envious of.
• Running a hospital: Looking back after six years at BIDMC - I liked this. Compliment: It represents Hansei in a good way. Constructive Criticism: Thinking about applying LEAN to be more direct in the communication. Overall: More people should do this.
• Your New Title: Chief Inspiration Officer - I think I want to be this. Actually I think I try to be this. And I love it.