Traveling by bullet train to Toyota City’s Hospital in Japan – what questions do you have?

Shinkansen bullet train arrives at Nagoya station.

I’m writing this post while on the Shinkansen from Tokyo to Nagoya.

No matter how many times I travel on the bullet train – it must be over 20 times in the past 16 months – I still get excited when the train pulls into the Station.

Train travel in Japan is incredibly efficient and pleasant, as I’ve written about before. I am going to miss the convenience and comfort of Japan’s rail system when I move back to the United States in two months.

Precision morning commute

It’s amazing that I can get to Nagoya in 90 minutes. I’ve perfected my morning process to get to the station with just 10 minute buffer to allow time to grab a coffee and pastry, and get to my track on time.

The only two high risk variables that I have to manage are: 1) my children waking up early and 2) not finding a taxi quickly.

Thankfully today was easy, my taxi driver was quick and crafty with taking back streets to avoid traffic, I got to my track with the allotted 4 minutes buffer to spare with my hot latte and pastry in hand.

With many visitors in town and preparation for classes and tours I’m leading, my desk time to write has been limited and blog posts that I want to write are still in my head (stay tuned).

Today, my desk is my seat on the bullet train with Mt. Fuji zipping past.

Friendship Anniversary and 1 year of travel to Nagoya

When I looked at the date just now, I realized that it is exactly one year ago to the week that I first traveled to Nagoya to meet Isao Yoshino.

I didn’t know at the time what a good friend and mentor this retired 40-year Toyota executive would become for me (although I had hopes!), and that 12 months later I would have taken the Shinkanesen 5 more times to visit with him, including three times in the past month (factory tours outside of Nagoya that I will write in more detail about in future posts, meeting up in Kyoto two weeks ago, and then today for our trip to Toyota City).

Today, Mr. Yoshino is generously serving as my interpreter and driver on a private visit to Toyota Memorial Hospital. I have wanted to visit Toyota City’s hospital since I have moved to Japan. A Japanese friend of mine introduced me to two people inside the hospital and we set up this visit three months ago. It took that long to coordinate our four schedules!

Does Toyota Memorial Hospital practice the Toyota Production System?

The past ten years of my career have been spent helping hospitals in the United States and Australia improve at improving – through application of Lean production principles and development of a management system focused on developing people as problem solvers.

As I’ve written about many times, most recently in one of my most popular blog posts to date, Japanese hospitals appear to not be practicing Lean or TPS to the same degree that many hospitals in the Western world have been.

I’m very interested in learning about how Toyota Memorial Hospital practices – or doesn’t practice – the Toyota Production System (TPS), or what we call “Lean”. How does Toyota think about the application of TPS in healthcare? Compared to other hospitals I’ve visited in Japan, where the emphasis has been on Total Quality Management, what is the approach in Toyota City?

What questions do you have?

Let me know what questions you have for my hosts at Toyota Memorial Hospital in the comments below.

My intention is to write about the day on my Shikansen trip back to Tokyo tonight, and to post the reflections and answers to your questions in the next few days.

I will be jumping off the Shinkansen in a few minutes and I want to post this before I get off, so I’m posting quickly without many photos and not a lot of quality control time to proofread.

I look forward to your questions and comments! I will write more posts about today’s visit to Toyota Memorial Hospital, and catch up on reflections from visits to two Japanese manufacturing companies, as soon as possible. You can sign up to be the first to know of the newest posts below.




Katie Anderson
About Katie Anderson 106 Articles
Lean thinker and coach. Passionate about developing people. Healthcare change agent. Living in California again after 18 months in Tokyo. Writing about lean and leadership.
  • Trevor Stuart

    Hi Katie, What does the leadership team at Toyota Memorial Hospital see as the cultural and change management barriers to adoption of lean thinking in Healthcare?

  • Charles Intrieri

    How does the hospital use technology to improve processes and eliminate waste as embraced by the TPS? Technology can reduce the manual labor involved in many processes that take place within a hospital and improve overall efficiency

  • Hi Trevor – great question! Thank you for posing it. We had a chance to talk briefly about this topic and I will be writing about it in upcoming posts.

    The quote that sums up the answer to your question came from the leader in charge of imbedding TPS into the hospital culture (he came from the HR division inside the manufacturing side of Toyota Motor Corporation). I asked how he was bringing the principles of continuous improvement and respect for people into the hospital. His answer: “this is is my challenge”.

    Much of what he brought up resonated with my experiences in bringing lean thinking to healthcare in the U.S. – how to engage physicians, teaching managers a new way of leading, and adapting manufacturing kaizen process to a healthcare environment. More details in an upcoming post!

  • Chuck – thanks for the comments and questions. We didn’t get into many specific examples – at least at the depth that I wanted to ask the question – but I learned about some ways that information technology is helping support the spread of kaizen, and got to see a new high tech Cyber Knife (the first in Japan!). But this doesn’t get at the root of your question. I hope to be able to follow up more in future conversations.

  • I’m really interested to see your posts. I’m curious when they started with Lean / TPS and if Toyota directly helped in some way.

  • A “challenge.” It’s fascinating to me how Lean doesn’t seem to be “easy” in Japan, as many Westerners might think.

  • Trevor Stuart

    The same can be seen within the healthcare system in Australia. There are some distinct culture differences between Australia and Japan which I think give the Japanese an advantage in adoption of systematic thinking (as opposed to ‘Lean’ thinking – Lean being a brand applied to systematic thinking – it’s what happens when you get a marketing team involved in anything!). There are enough similarities in advanced aconomies though to appreciate the learnings from each other, which leads me to the next question of ‘How does Toyota Memorial Hospital approach this change project?’

  • I asked a few versions of your question yesterday, as the topic of *how* organizations develop a system of problem solvers / respect / continuous improvement is of of my top interests. The answers were somewhat vague – such as the comment that “it is a challenge”, but they did discuss some of their renewed efforts in the past 15 months since the Director was brought in from TMC HR headquarters. More on this soon.

  • Totally agree, Mark. It’s been fascinating for me to talk with so many Japanese people – inside and outside of Toyota – over the past 16 months in Japan and discover that Toyota’s way of doing business is not the norm in Japan. It’s not easy no matter where you are – and even Toyota would say that they are not where they would like to be (and that the practice of TPS is much more advanced in manufacturing than in the sales side).

  • Thanks Mark! I just need to get some desk time, which is proving to be my personal challenge these days. But I’m sacrificing writing time for having the experiences. I’m going to miss living in Tokyo!

    The short answer is that Toyota has been helping both directly and indirectly. Most of the community in Toyota City is connected with Toyota Motor Corporation. The President of the hospital was the primary physician for one of the Toyoda family members – who influenced his thinking. I don’t think there is a date that they “started” TPS – rather, it’s been coming in through different pockets of influence. I did learn that they have been practicing hoshin kanri for about 10 years. And they had the best looking stock room (with kanban system) of any of the other three Japanese hospitals that I’ve visited.

    The most direct help that TMC has made has been through the deployment of the Director I met with. He was sent from Toyota HQ’s HR department about 15 months ago with the goal of accelerating the practice of TPS.

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