As people retire within your organization, they also take with them valuable knowledge, experience and know-how. Organizations will mistakenly assume that there won’t be a loss of that important institutional knowledge because there are procedures in place, but all too often that information isn’t captured within documents and procedures. What they don’t realize is that procedure accounts for the steps of a task when everything is going according to plans, but what happens when the procedures don’t account for variability within the task, environment, people, materials or the tools? This is where the process expertise and experience kicks in. But if your expert has retired, there is the potential for that knowledge to be lost--unless there is a plan to gather and document that information.
I’ll use an example to which we can all relate to will illustrate my points: grocery shopping. The simple task of picking up items at the grocery store, something that we all perform, shows the process opportunities. Imagine if you were officially retiring from going to the grocery store for your family and instead, were planning to hand off the task to your teenager. If you had to describe the process to them, it would likely be pretty straight forward:
Simple, right?
Now, think about all of the decisions you make within the process of buying groceries. For example, if avocados are on the list, how do you know where to find them? What level of ripeness do you need? How do you determine a good one from a bad one? If there aren’t any avocados that meet your criteria, do you go look at the organic ones instead? Does the cost affect your decision? What if they are on sale, should you buy extra? If it’s a key ingredient to recipe, do you consider going to another store? If you ultimately decide to scratch the avocados, will that affect whether you need other items on the grocery list?
These decisions are part of your work process but are not something you would consider when describing the process. Likely, you’re unaware they exist because it has become second nature to you over the years of going to the grocery store. Many of the decisions you make are based on your experience—learning from mistakes and making adjustments to your own work process. We are all constantly learning from our mistakes, so how do we share those lessons learned with others?
This highlights the core objective of root cause analysis: to be able to thoroughly understand and explain why a problem occurred and what can be done within your work process to prevent the problem going forward—not just for one person, but for the entire organization. This is why documentation is important for the evolution and improvement of a task.
Process maps and Cumulative Cause Map™ diagrams help capture this knowledge. Both of these tools leverage visual communication to document and capture organizational know how. The process map captures the steps of a task as well as the decisions people must make within a task. Best practices can be captured, documented and shared easily across the organization using an evergreen process map.
When problems occur, they reveal gaps in those processes, and subsequently, reveal opportunities to improve the work process. This is where the Cumulative Cause Map diagram comes into play. For those unfamiliar with our Cause Mapping approach, a Cause Map diagram is a method for visually capturing cause-and-effect relationships validated with evidence. The Map thoroughly explains why a problem occurred and reveals obstacles or other variables we may not have accounted for within the design of the task. By revealing these causes, you have the opportunity to incorporate solutions that address those causes. These solutions, if implemented, become changes in how the task is performed. A Cumulative Cause Map diagram, as the name implies, is a visual representation of the many different ways things can go poorly. In other words, it is used to represent multiple failure modes that affect a process or equipment. By understanding the many different causes, we better recognize the solutions and actions that are important for achieving high reliability. To summarize, the process map represents the specific steps we would like people to execute within a task, whereas the Cumulative Cause Map diagram illustrates why those steps are important.
So before you plan the retirement party, you may want to plan a meeting to capture as much know-how as possible. By slowly working through the experienced person’s processes, and asking questions, you can capture their knowledge in a visual format and maintain high reliability in your organization. In the 2014 Harvard Business Review article, “What’s Lost When Experts Retire,” we see that there are four primary categories of knowledge loss: relationships, reputation, re-work and regeneration. Be sure to consider those areas of expertise when walking through your detailed work processes. Most likely, the retiree has checks and balances they’ve incorporated into their process that haven’t been documented in a procedure. Incorporate their lessons learned, so the lesson doesn’t need to be learned again (and again). Education on the purpose or value of those checks can be just as important as the training on the step itself.
For more information on our Cause Mapping approach, process mapping and Cumulative Cause Map diagrams, check out one of our upcoming training opportunities.