If you, the reader, ever started a small business, I'll give you the credit that you'd start off with a passion for your customers, whether this means delivering a product, a service, or an app that solves a problem for them and delights them in some way. Without customers, we have no business. In the early days of the auto industry, Henry Ford realized this in 1914 when he wrote:
...for of course it is not the employer who pays wages. He only handles the money. It is the product that pays the wages." And, of course, the money ultimately comes from the customer... a satisfied customer, something Ford paid attention to for the entire life of a car: A manufacturer is not through with his customer when a sale is completed. He has then only started with his customer. In the case of an automobile the sale of the machine is only something in the nature of an introduction." But, 100 years later, far too many large companies somehow manage to lose sight of the customer and get more focused on internal matters and their finances.
The same thing happens, unfortunately, at many hospitals and healthcare institutions. GM, Quality, and the Customer I grew up near Detroit, I worked for GM in the mid 90s, and I still root for the company. I have also been rooting for their new CEO, Mary Barra, not because she's a woman (an important first for the industry), but because she's an engineer and a "car guy" (as the legendary Bob Lutz dubbed her). For better or for worse, she has worked there her entire career, since 1980. In the midst of the current controversy and GM's recalls over faulty ignition switches (and the 12 to 303 deaths that are alleged to be a result), Barra put out a video statement to employees that was also released to the public. In the video, Barra says, in part: We need to continue on the path of putting the customer first in everything we do. It's not something that only gets decided by senior leadership.
We all have to own it." It's a shame when leaders feel they have to remind their employees that the customer comes first. Do the world's best companies really have to do this? Do leaders in the world's best companies (or even a local small business) think their employees have forgotten this? Hospital leaders have been doing the same thing in recent years, talking about and promoting a seemingly new-found discovery that "patient-centered care" is important. Now that I work in healthcare, friends of mine from other industries often ask, quizzingly, "What else would healthcare be, if not patient centered? Why are they bragging about that?" Of course, the nurses and other front-line staff never forgot that healthcare is about the patients... but many executives have. To their credit, hospitals are using Lean and other methodologies to truly put the patient first, instead of designing things around the needs and preferences of physicians or the hospital. To her credit, Barra is talking about putting the customer first. But why wasn't that happening? Are they really "continuing to" put the customer first or merely "starting to?" Barra says "we all have to own" putting the customer first, meaning all employees.
Tell that to the GM engineer who warned about these "flimsy" ignition switches back in 2001 before anybody got hurt. Was the customer put first? If not, whose responsibility is that? Where Does Quality Start? The late great Dr. W. Edwards Deming famously said, "Quality starts in the board room," with the policies and decisions of the company's most senior leaders. Can we hold employees accountable for quality when the culture doesn't allow for quality and the customer to be a priority? Dr. Deming would say, "Hold everybody accountable? Ridiculous!" Barra can remind employees all she wants, but chances are the engineers and front-line employees of GM never forgot that quality and the customer come first.
When I worked at GM, I continually saw my factory's top management make decisions that directly undermined quality. Pick on the UAW all you want, but most of the UAW workers wanted to put quality first and management wouldn't let them. It was as simple as that. In just one very specific example, the operators in the engine block machining line were supposed to, per the engineered and agreed upon "process control plan," stop the line to check the critical dimensions of an engine block every hour or so. When production was behind schedule, and it often was, managers told the workers to let the machine keep cranking out parts without workers doing the proper checks.
Management decided to put production numbers (quantity) over quality. And, when there were many quality problems (such bad engines being discovered at the end of the car assembly line or, even worse, reaching a customer), management had the nerve to blame the workers in written memos that were distributed throughout the plant. Part of that memo from 1996 reads (yes, I kept a copy):
"All of us."
"We must all do our part."
These are empty words.
Management said in the memo, "adherence to the process control plan is critical," when the guy who wrote the memo was often the one refusing to let workers stop the line. Management wasn't allowing workers to follow the process control plan, yet they blamed the workers... repeatedly. Ridiculous!
The author of the memo wasn't stupid, so he must have seen the irony in this... but he couldn't admit responsibility in the "Old GM." He had to blame the workers.
Marry Barra and other manufacturing CEOs say, "We all have to put the customer first." The employees likely say, "Yeah, we know. Please let us."
The hospital CEO says, "We all have to put the patient at the center of everything we do." The nurses roll their eyes and say, "We know. Please let us."
GM can talk all they want about the customer coming first. But, old habits die hard. Is the "New GM" really different than the "Old GM?" I certainly hope so.
Are they putting the customer first? Are you and your organization? Who needs reminding about quality and the customer - the workers or your senior leaders?
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