The highly successful revival of the Sherlock Holmes phenomena is a testament to the popularity of Sir Arthur Conan Doyle’s stories. PBS’ updated version of “Sherlock” was a shining star at the 2014 Emmy Awards, winning the most awards (seven Emmys) by the end of the night.
Doyle made Sherlock Holmes a household literary name beginning in 1887 with his novels and short stories. Holmes became famous for his astute logical reasoning and his use of forensic science to solve difficult cases. He was noted for drawing valid conclusions from his observations.
In the short story, “A Scandal in Bohemia,” Holmes demonstrates and discusses his powers of observation in the following exchange with Dr. Watson:
“Then, how do you know?”
“I see it, I deduce it. How do I know that you have been getting yourself very wet lately, and that you have a most clumsy and careless servant girl?”
“My dear Holmes,” said I, “this is too much. It is true that I had a country walk on Thursday and came home in a dreadful mess, but as I have changed my clothes I can’t imagine how you deduce it. As to Mary Jane, she is incorrigible, and my wife has given her notice, but there, again, I fail to see how you work it out.”
He chuckled to himself and rubbed his long, nervous hands together.
“It is simplicity itself,” said he; “my eyes tell me that on the inside of your left shoe, just where the firelight strikes it, the leather is scored by six almost parallel cuts. Obviously they have been caused by someone who has very carelessly scraped round the edges of the sole in order to remove crusted mud from it. Hence, you see, my double deduction that you had been out in vile weather, and that you had a particularly malignant boot-slitting specimen of the London slavery.
I laughed at the ease with which he explained his process of deduction. “When I hear you give your reason,” I remarked, “the thing always appears to me to be so ridiculously simple that I could easily do it myself, though at each successive instance of your reasoning, I am baffled until you explain your process. And yet I believe that my eyes are as good as yours.”
“Quite so,” he answered. “You see, but you do not observe. The distinction is clear. For example, you have frequently seen the steps which lead up from the hall to this room.”
“Well, some hundreds of times.”
“Then how many are there?”
“How many? I don’t know.”
“Quite so! You have not observed. And yet you have seen. That is just my point. Now, I know that there are seventeen steps, because I have both seen and observed. “
How often have you seen and yet not observed? If you are like me, many times. One of the key concepts of Lean Healthcare is the importance of learning to observe and not just see. Even though I teach the concept and the value of observation and how important it is to observe before drawing conclusions, I learn more every day about how to be an effective observer. While going to the Gemba, or where the action occurs, is an important step, it does not guarantee useful and accurate observations and information. Even if we go and see, it is still critically important to observe carefully and thoroughly what is actually occurring.
I have accompanied many project teams to observe and ensure that that they were making valid observations and gathering accurate data. I learn more every time I observe. As is true in all of Lean Healthcare, we can continue to improve our skills while we are actually practicing them.
I recently asked a friend who is the CEO of a local Nashville hospital if I could come and observe his employees in both the ED and on a nursing floor. He and the CNO graciously invited me into their workplace and I subsequently spent a number of hours in the ED and on the nursing floor.
This observation exercise reminded me of how much “action” occurs in both places on the part of multiple caregivers and just how much effort goes into taking care of patients and even patient families. It enhanced my ability to observe what the caregivers actually had to do to ensure that patients were cared for.
No matter where you are in your Lean Healthcare journey and no matter what you are doing to eliminate waste and enhance the patient experience, insightful observation is critical. While we may never be as astute an observer as Sherlock Holmes, never let it be said that, “You see, but you do not observe.”
After all, “It’s elementary, my dear students of Lean Healthcare!
Today’s blog was written by Jay Conner, Ph.D., a Senior Manager at HPP.
Jay has more than 30 years of experience in communications, human resources, and human resources development. He has worked in both higher education and in the private sector. In healthcare, he has consulted in training and development, executive and managerial coaching, recruiting and hiring, employee relations, performance management, compensation, employment law compliance and employee manuals and handbooks.
Jay holds a B.A. from Georgetown College and an M.A. and Ph.D. in Communications from LSU.