Thursday, October 13, 2011

Success from Failure?

These thoughts were inspired by a conversation between Laurel Nelson-Rowe from ASQ and Terry Woychowski, VP for Global Quality at GM. 

The auto industry has a long and controversial relationship with healthcare, so it’s not clear that they have anything to teach us, particularly in the policy arena.  Historically, they used health benefits as a bargaining chip and eventually discovered that healthcare was costing them more than the steel in their cars.  Hard to put that genie back in the box.

Everyone would view GM as a product company.  Well, almost everyone, and maybe that’s one of their problems.  Some years ago, I looked at a new Honda, and the first thing the salesman did was take me into the shop area and introduce me to the service manager.  I bought a Honda.  I remember a survey of Ford Taurus owners which showed that buyers loved the car—until they had a problem, and then they hated it.  In other words, it looked good, but the company didn’t furnish the service to keep it running.

So, it’s a mission thing.  Are you selling cars or selling transportation?  Many years ago, Cunard line was going bankrupt.  Unthinkable!  So they sold a major interest to a hotel company, and the rest is history.  They had focused on driving ships across the Atlantic.  Now, they have become a vacation destination.

Mr. W. promised to build cars that performed as advertised and lived up to expectations.  To the extent that the customer defines quality, I wonder what new car buyers expect and how GM is addressing those demands.  Mr. W doesn’t seem to understand that building good cars isn’t enough.  They buy transportation or a status symbol, and in any case, service is part of the equation.

So what’s the message for healthcare?  I liked his comment that bankruptcy “clarified the mission for GM.”  Perhaps some healthcare institutions need to fail.  Price competition might do that, as institutions lose market share because they can’t meet a competitor’s pricing.  That would certainly get the word out that we’re serious about reducing healthcare costs.  For starters, how about an RFP from Medicare for total hips.

I also liked his comment about engaging every employee in defining their role in the GM mission.  That helps make the mission part of the organization’s culture.  How many hospital employees even know the mission of their institution?  How many healthcare institutions have a realistic mission that doesn’t include world peace or community health, etc?  Or something equally silly, like providing “the highest quality healthcare.”  What does that mean?  How would you measure it?  If you don’t have a realistic mission, how can your employees help you achieve it? 

Maybe that’s the lesson from GM.  Have a mission and get everyone on board to achieve it. 

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