Living in Your Customers’ Shoes – Airport Car Rentals & Lessons for Healthcare?


This might seem like a random topic, but what the heck, it's a Friday. I arrived in Orlando yesterday for the  Society for Health Systems and  HIMSS conferences and I picked up a rental gar from the garage. It's a nice Buick Lucerne – these rental Buicks surprise me with a nice impression, while rental Chryslers always leaving me wondering how that company is still in business.

Anyhoo, as I was pulling out of the garage, I had a thought – a customer suggestion if you will that might represent a latent undiscovered need for airport customers….

Toyota famously “goes to the gemba,” if you will, not just leaders in their factories, but they also send chief engineers and product people out into the field to understand their customer needs, as written about in the book The Toyota Product Development System: Integrating People, Process And Technology by Liker and Morgan.

See page 30 (via google books) for the story of how they discovered, from first hand observation of North American customers, that the back of the minivan needed to be large enough to hold a sheet of plywood from, say, a Lowes or Home Depot. That level of customer intimacy is pretty powerful.

That's one thing that struck me about the “Customer Development” methodology as described in Steve Blank's The Four Steps to the Epiphany and The Entrepreneur's Guide to Customer Development: A cheat sheet to The Four Steps to the Epiphany by Cooper and Vlaskovits was the focus on customer intimacy and making sure you truly understand a day in the life of your customer before you go shipping product. Early discussions with customers should be all about the problems they face, not the solutions you are trying to develop.

So my rental car customer need is this:

  1. I bring my portable GPS with me when I'm in an unfamiliar city.
  2. When you have a rental car lot that is a parking garage, turning your GPS on in the garage does no good, as it can't get a GPS signal.
  3. When you pull out of the garage, you might have 30 or 60 seconds of delay (or longer sometimes) before you get a GPS signal.
  4. If the exit to the airport is close, you don't yet have guidance about which way to go, which means making a wrong turn (requiring a U-turn once the GPS kicks in) or you have to pull over to sit and wait.
  5. There's often NOT a safe place to pull over and wait.

So one suggestion would be to have a small turnoff outside of the garage, a sub parking lot (uncovered) where you could pull off and wait for your GPS to kick in. A “GPS waiting lane” instead of a “cell phone waiting lot” – another example of a relatively new customer need?

All I want is a place to safely sit and wait for my GPS to get a signal.

Now, granted, this is a capital intensive idea and something that's not practical. But if you were building a new airport, could you take this into account? Or is this a temporary problem that solves itself when newer GPS units are more instantaneous about getting a signal?

The thing that fascinates me about web development and Lean Startups is the ability to QUICKLY if not instantly implement new features and “kaizen” ideas from your customers. If you discover a new customer need, you can adapt more quickly than you can in a physical capital-intensive enrivonment.

So this begs the question – if you are building new hospital space or doing renovations, do you REALLY understand the day in the life of your patients? The day in the day of your staff members? What latent needs are sitting there waiting to be discovered?

I have been doing some work with a children's hospital that is building out a new patient tower. The very first “lean design” steps we took was to teach staff members and managers how to observe their process – drawing spaghetti diagrams, observing the work to see the “seven flows” of healthcare. It's so eye opening for people to watch their own work and to see how their colleagues work (since typically people have heads down, just doing their own job).

It's fun to discover those latent staff needs – for example, seeing that nurses don't have a place to set items down, so they set them on the patient's bed, on the blanket… not the most  hygienic  situation so you design in a countermeasure through the physical space or the equipment they have…

What applications do you see in your workplace?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Some parts of our world experience are so well thought out, so well designed and so well implemented that we wonder how they did it. For me, opening the packaging on any Apple product is exciting in that way.

    Others are so unplanned, so under-designed and mis-applied that we how they could not have got it right.

    Hospitals have come a long way from their Dickensian roots as dormitories where the infirmed waited out the will of their maker.

  2. I’ve done some work for an online retailer which pulls of a mind boggling dance of logistics between user interface and ups deliveries, with warehouse staff, customer support, IT, marketing and all the rest in between. They pull it off by soliciting constant input from everyone, with multiple avenues for being heard and regular group presentations from one department to another. It’s a lot of work to make that happen but it pays off, when people understand each other you get both good design and good will.


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