Re: YOU are responsible, even when YOU are not to blame

[SteveFJong -at- aol -dot- com]

John Posada <JPosada -at- book -dot- com> wrote:

"[N]ot to belabor the point, but what does any of this matter? To know error 
is to fix error. No blame, just fix."

Finally, a chance to salvage something from this thread! Don't you get bored 
of forever fixing error? Wouldn't it be better to *prevent* error? It's much 
easier to do things right the first time--faster, more efficient, less 
stressful, and (a bonus!) more error-free. But how do you do that?

If all you want is to fix errors, you don't care where they come from; you 
assign blame--er, responsibility, the writer fixes them, and you repeat the 
cycle endlessly. It's slow, inefficient (think of the scrap and rework), 
stressful, and error-prone. It never gets better.

If, however, you want to *prevent* errors, you first have to determine where 
they come from--their root cause. Root cause analysis considers four possible 
sources of error: people, processes, tool, and materials. Errors can come 
from all four sources--not just in manufacturing, where the method origi
nated, but in software and documentation too.

To take a simple and universal example, where do typos come from? Brainstorm 
root causes and you'll come up with much more than "the writer can't spell." 
Here's my list. Can you add more? None of it is made up; I have personally 
witnessed (or committed!) everything here:

PEOPLE
Writer can't spell
Writer can't see monitor clearly

PROCESSES
No time to check spelling
Spellchecking not routinely performed
Spellchecking not done as last step
Spellchecker includes user-added typos
Engineer allowed to add edits directly
Artist misspelled captions

TOOLS
No spellchecker software
Monitor too small to see text clearly
System so slow writer dozed during spellchecking
Writer accepted all spelling suggestions
Keyboard malfunctioning

MATERIALS
Typo in spec; writer copied spec
Typo in previous revision; writer didn't spot

Don't underestimate the problem of an inadequate monitor (or poor ambient 
lighting). Right now I work with an editor whose struggle to read the screen 
is painful to watch: she takes off her glasses and puts her face RIGHT UP to 
the screen. It doesn't help that we all have 15-inch monitors. (I got rid of 
the 15-inchers at my last job five years ago.) One could admonish us to spell 
better, but that's not the root cause.

This is a trivial example. There are more important real-world examples. I 
would suggest "inaccurate procedures" would be an important problem, worthy 
of detailed analysis. 

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