KaiNexus Education Video #7 – No Countermeasure? That’s OK


Here is the seventh in our series of short, simple Kaizen education videos from KaiNexus, a software startup where I am on the management team.  We are embedding these videos into our web-based (and iOS) software, to provide short tips and hints for our users (see the whole series here). We're also making the videos available on our YouTube Channel and our education videos playlist. Subscribe to our channel to be notified of each new one that's released.

Click here to see all of the videos through my blog or here to view them on the KaiNexus website. We also have an RSS feed and a podcast on the iTunes Store.

This video talks about what to do when you identify a problem (or an “opportunity for improvement”) and you don't have a solution (or what we tend to all a “countermeasure” in Lean). Long story short — it's OK if you don't know the answer. It's still great (and a necessary first step) to just identify the opportunity. Your co-workers might have an idea…

Video updated September, 2014 – View on YouTube.

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Approximate transcript of the video:

  • Video #7 – I don't know what the solution is, but submit an OI anyway

Hi, I'm Mark Graban, from KaiNexus, where we make improvement happen…

If you find yourself being frustrated at work, there's likely a process problem of some sorts behind it. If you can, try to think about what the cause of the frustration is – that's an opportunity for improvement.

Even if you have just identified a problem, and don't know how to solve it, that's a great thing to capture in KaiNexus.

Before KaiNexus you might have just said something about the problem to your manager while passing in the hallway… but keep in mind what one of our early KaiNexus users, a manager, once said that they don't claim to remember everything that's ever told to them verbally in the hallway, so they always remind people to enter it into the KaiNexus system.”

If you take a few seconds to log an OI in KaiNexus (in a computer's web browser or through our iPhone app), the system then automatically notifies your manager so they, or your colleagues, can work with you later on that OI. Using KaiNexus ensures that nothing falls through the cracks.

When you log in and click “Submit a new OI,” there are fields for a title and a brief description. That's all you have to enter. Notice that the “proposed solution” field says “optional.” You can be brief in your description of the OI, but add enough detail so it can be followed up on. As a famous engineer once said, “a problem well defined is half solved.”

Identifying an opportunity for improvement is a great first step. If you can identify and log problems, you are contributing to improvement. Keep in mind, though, that KaiNexus isn't a system for merely venting or complaining about other people.. it's about identifying legitimate opportunities for improvement that would benefit our patients, our colleagues, and our organization.

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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.


    • Yes, that’s exactly the idea. Every employee, including front-line staff, has a login to KaiNexus and they all participate in identifying opportunities and helping to fix things.

  1. One example that comes to mind that I saw in KaiNexus recently where collaboration/brainstorming on an Opportunity for Improvement (OI) led to a better outcome than the initial proposed solution was one about abdominal pain patients in the ER.

    The OI was that abdominal pain patients need to be told, in triage, not to eat any food or drink anything until they are evaluated by the ER doctor. The proposed solution was to simply remind all the nurses of this policy.

    Ultimately, after this OI was discussed further with the triage nurses, an additional idea came up to add signs in both English and Spanish next to the vending machines that explain that all patients need to ask the triage nurse before consuming any beverages or food. This is because there are many types of patients, not just abdominal pain patients, that should not eat or drink anything before seeing a doctor. Interestingly, once the triage nurses were included in the OI, it was learned that a big source of the violations of this policy were the ER’s own vending machines.

    I think this is a great example of where the final outcome was better than the initial submission. I don’t have any specific percentages on how often this occurs, I would venture to say though that it is the norm rather than the exemption. It is also how you get such a high percentage of OI that result in a change. Currently, it KaiNexus it is 72% across all KaiNexus users. We have some departments that approach 90%.

    • It happens both ways, Kevin. There’s online discussion in KaiNexus but people also talk face to face, have meetings, etc. and they might put notes into KaiNexus so people on other shifts can be in the loop, etc.

      The most effective thing is to find a balance between online and offline communication. Healthcare organizations often have people separated by space and/or time, which can make offline collaboration difficult.

  2. Most manufacturing jobs are routine and monotonous. I do not know how people can do these jobs. What would you think about all day long? Most manufacturing employees do not have access to a computer. Phones are banned in most factories.

    Even if you provide a computer for employees to use, when would they use this computer? Once you clock in, you must report to your work area. Even if your employer allowed you 5 to 10 minutes to check the new OIs and comments/suggestions, you would have to compete with possibly hundreds of employees for access to the computer.

    Bulletin boards must be used to inform employees of new posts. When employees report to their routine jobs, they will have something to think about that will help the company. The employee terminal is provided only for employee input. If an employee has something good to share, he will find the time even if it is his own time.

  3. I think you bring up some great points. I think Kaizen is not for an organization that wants their employees to leave their brain at the door. I think the routine and monotonous aspect of manufacturing jobs is not necessarily a killer for Kaizen. Recall, the philosophy was born out of the manufacturing industry and most success stories are from manufacturing companies. In our experience, there is no type of work done that could not be improved on.

    At a minimum, if you define value as meeting the needs of the customer and if you theoretically had a perfect system that had zero waste that was meeting the needs of a customer today, the needs of the customer are consistently changing. So that company to remain successful will need to evolve and thus processes will need to change and evolve along side it. Most failures of successful companies lies in the fact that the company did not change with the times. So, in short, I do not believe there is an industry or a company that would not benefit from doing kaizen. I think it has more to do with what you think the workers work is. Is it just doing the work or doing the work and improving the work?

    With regard to the technology side of things. KaiNexus has features that allow leaders to put Opportunities for Improvement (OI) in on behalf of other people. So, if for some reason the facility does not have a lot of computers or rules of the company prevent people from accessing computers or using their smartphones, OI submissions can be done with paper at the bulletin board and the supervisor/manager could enter it into KaiNexus on behalf of the employee. Naturally, some of the benefit would be lost but, I think, the feature of being able to Enter an OI on Behalf of someone else and the feature of printing an OI to put on a bulletin board allows a company with limited computer access to still find a lot of value in KaiNexus.

    Now if the company does not use computers in any way shape or form – that is a company that I think would have a harder time finding value in KaiNexus.

  4. My background is mostly in the food industry. Most food companies have multiple locations. An online kaizen program will greatly expand the team and the value for the customer.

    I agree the lack of personal computers is a minor problem to solve. I was taught a project is never done. An online kaizen project can be improved by employees years into the future. An online kaizen program is the ultimate tool of continuous improvement.


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