Throwback Thursday: Paying Attention to Small Details

throwback thursday lean blog

Back in 2011, I wrote this homage to In-N-Out Burger.  Their food is awesome, they treat managers and employees with respect, and they pay attention to details.

One such example is the simple error proofing of their trashcans, as I wrote about here: “Simple Brilliant Error Proofing at the Amazing In-N-Out Burger.”

Recently, I've seen many examples where businesses don't pay attention to little details. When you see little things going wrong, it makes you wonder about the more important stuff. One example from healthcare might be this story from the Cleveland Clinic, where patients told the CEO that there were dust balls under the beds in patient rooms. Why don't staff notice these things? Why don't they have better standardized work for cleaning the patient rooms?

What are some of the other problems that I've seen just in the past two weeks?

Reminiscent of the In-N-Out error proofing, a reader reported a problem where she could NOT throw away a bowl at the chain Which Wich… because it didn't fit (when it should have). That's the opposite of mistake proofing.

How does a sandwich chain not think of that little detail when designing a new product, like a “BowlWich” (otherwise known as a “salad”)? Will this problem now get fixed in some way, or will they just keep apologizing to customers?

LeanBlog contributor Chad Walters shared a picture with me from his gym location:

It's a pretty consistent workplace rule that containers and bottles must be labeled with their contents, for a number of reasons. I doubt anybody is going to think that bottle is water or a sports drink, but it seems like this should still be labeled.

There are OSHA laws about this, regarding secondary containers. There are exemptions for containers that will ?”remain in the direct control of an employee” for a short period of time, but that's not the case here, it seems.

In healthcare organizations, little details get missed all the time. I wrote Tuesday about my primary care physician posting a sign about their new “always bring your insurance card each time” policy in the exam room, which was too late… they had already informed me of the new policy at the registration desk (instead of telling me about it on the phone, which required an additional trip to my car).

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Before I realized my primary care MD had a cancellation, I first tried to use a local urgent care facility. When my wife had the flu a few weeks back on the weekend, she was impressed with how she could “get in line” via the web and wait at home. She got a text message that gave her 15 minutes' notice and off we went.

When I tried that last Monday, I saw a message that said the wait was 77 minutes and then a conflicting webpage (with their name and contact info blacked out):

urgent care screen

It says both “We are accepting On-Line check in. You can reserve your spot now…” AND then “We cannot allow scheduled appointments at this time.”

There was no button to click to reserve, so I guess I couldn't. This seems badly designed.

I called the urgent care center and the woman who answered said that I couldn't make a reservation because the wait was too long (which seems to defeat the purpose of the system). I guess it was because they were going to be closing in two hours, which probably makes more sense.

When I suggested to her that the website had really confusing and non-sensical language on it, she sighed and said, “Yeah, we know.”

That's the type of frustrated sound that you hear when an employee hears about the same problem all the time and can't do anything about it. And, they're not getting a response from their leaders. It reminds me of this airport bartender who was crabby at me because the broken bar stools never got fixed.

How does 1) somebody in the Urgent Care leadership not get this fixed or 2) how does ClockwiseMD not provide a better system to their customers?

It often begs the question: “Do they not notice or do they not care?”

I heard Jon Taffer of Bar Rescue coincidentally just ask this exact question of a bar owner in an episode (after I had written this post).

Many teams, people just don't notice.

I need to get some new prescription sunglasses and booked an appointment with the optometrist who is attached to my local eyeglasses store. While I was waiting, there was an overhead music system.

But, the music system was repeatedly playing a promotional announcement about how to subscribe to the digital music service. It repeated about every 60 seconds and started to quickly get VERY annoying.

Do they not notice or do they not care?

I finally went and mentioned it to somebody who seemed like a store manager. She said, “Oh you're right… we just tune that out, I guess.”

How do we create organizations where people DO notice little problems? How do we create an environment where things get fixed?

There's a local museum near us in San Antonio called The Witte Museum. For at least a year, if you try to visit their website without a “www” — — you get an error message.

Please come back later.

But, if you go to, the webpage works fine.

I figure this glitch is costing them some web traffic and they might also be losing some visitors, memberships, or donations, as a result. As a member of the museum, I felt obligated to email a staff member to tell them about the web glitch. It's an easily fixable website configuration issue — to forward or not forward “non-WWW” traffic to the main www website.

The response, “Yeah, we know that's a problem, but it's going to get fixed when our site gets redesigned.”

That's a false choice. They could fix the www issue and THEN do a website redesign.

I guess sometimes the answer is “they don't care.”

I *do* think the little things matter. If you can't take care of the small stuff, I don't trust you with the bigger issues that I'll face as a customer or patient.

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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.



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