Toyota Kata: A missing link in quality improvement in healthcare?

There is great attention in the literature to how to achieve the culture change necessary for adopting and sustaining quality improvement, particularly ‘lean’, in anything more than a superficial way. This is a particularly prominent issue in the English NHS. Toyota Kata is a set of organisational routines designed to embed the foundational behaviours underlying Toyota’s management system. They are currently being tried for the first time in the NHS. We find evidence that, even in this very challenging environment, kata can develop lean management behaviours. Though it is necessarily slow and demanding, these behavioural habits can be embedded.