Scholars unpack the ‘Toyota Way’ to depict the radiology ideal
Toyota has occasionally stumbled over quality-control issues across the decades, yet its recoveries have been admirable and its reputation for reliability all but unshakeable. Can radiology learn anything from the carmaker’s perseverance?
Indeed it can—and should, according to a decorated academic radiologist at Indiana University and a fourth-year medical student who previously worked as a production engineer at Toyota North America.
“At a time when most corporations and popular culture seem focused on the people at the top of organization charts, such as Elon Musk and Jeff Bezos, Toyota’s focus on production-line workers as essential collaborators in the quality improvement process deserves special attention,” write Ryan Stoffel, BS, and Richard Gunderman, MD, PhD. “More than most companies, Toyota is led from the bottom up as much as from the top down.”
Gunderman is IU’s chancellor’s professor of radiology, pediatrics, medical education, philosophy, liberal arts, philanthropy, medical humanities and health studies. Academic Radiology published the duo’s paper, “Radiology Quality Improvement: Lessons From the ‘Toyota Way,’” on June 28 [1].
The Toyota Way is a set of principles, 14 in number, by which the company’s people famously work and live so as to unceasingly strive for continuous improvement and respect for people. The framework deserves radiology’s attention, Stoffel and Gunderman submit, because it so effectively engages individuals at every level who can affect product quality.
“One of the reasons radiologists burn out is a Sisyphean sense that they are just rolling the same boulder up the same hill each day (reducing the number of exams on the worklist), only to return the next day and do the same thing over again,” they write. “By contrast, the Toyota Way helps to prevent stagnation, enabling workers to grow and develop by making meaningful contributions to quality improvement.”
Radiologists who make their work better, they add, “will not only do better work but also find more fulfillment through doing it.”
Mining the 14 principles for relevance to radiology, Stoffel and Gunderman flesh out three particular pointers in some detail. Excerpts:
PRINCIPLE 9. Grow Leaders Who Thoroughly Understand the Work, Live the Philosophy and Teach It to Others.
Often the most important insights and suggestions will come not from the C-suite but from the production line, where the people actually doing the work best understand how to improve it. … [E]ffective radiology leaders need to ask good questions and listen intently at the point of care, but they also need roll up their sleeves.”
PRINCIPLE 10. Develop Exceptional People and Teams Who Follow the Company’s Philosophy.
A real philosophy is one that respects the true purpose of the work—enhancing the care and health of patients—and seeks to promote it over the long term. … [T]ypically, good ideas occur to people when they are part of conversations or shared efforts to understand or improve a process. Toyota emphasizes teams of four or five people. In radiology, such multidisciplinary teams can help to break down siloes and ensure that people know and trust one another deeply enough to perform well as a team. Radiology leaders need to develop such teams, with an understanding that each radiologist can and should be part of multiple groups.”
PRINCIPLE 11. Respect Your Extended Network of Partners by Challenging Them and Helping Them Improve.
[R]adiologists need to be committed to quality improvement throughout the organization and should be helping to build such a culture and helping to drive such initiatives. Nearly everyone needs and wants to get better, whether they realize it or not, and helping them to do so enables them to achieve higher engagement and find greater fulfillment in their work. Collaborating in enhancing shared work also helps to build deeper and more enduring professional relationships, which are rewarding in themselves.”
Synopsizing the Toyota Way to wrap their argument, Stoffel and Gunderman condense the 14 particular points into four broad strokes.
“First, radiologists need to understand why we care about doing better work,” they write. “Second, we need to identify quality improvement opportunities. Third, we need to get to know our colleagues and their work, so together we can improve our product. Finally, we need to ask hard questions of one another, to make sure we are remaining true to our highest priorities.”
It’s no easy task to create and sustain a culture of continuous improvement and respect for people, the authors acknowledge. However, “nothing worthwhile in life ever is” easy.
“It is in the pursuit of such excellence,” Stoffel and Gunderman conclude, “that we find our highest fulfillment.”
More Coverage of Quality Considerations in Radiology:
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Image interpretation vs. workflow interruption: Quantified, analyzed, strategized
Seeds planted for a needs-based, radiology-specific AI curriculum
Homegrown POCUS education for IM residents demonstrated, deemed successful
70% of ‘mini-stroke’ patients imaged incompletely, risking full-on stroke
Reference:
- Ryan Stoffel and Richard Gunderman, “Radiology Quality Improvement: Lessons From the ‘Toyota Way.’” Academic Radiology, June 28, 2022. DOI: https://doi.org/10.1016/j.acra.2022.06.001