Knee Surgery with Ockam's Razor

Okam's Razor states that any solution/explaination should not be any more complicated than necessary to solve the problem. As I drifted off into unconsciousness under the effects of the anaesthetic, I was confident that this principle had been applied and that I would wake up and find the dressings on the correct leg - a real boost when you are just about to undergo invasive knee surgery.

Yes, I had surgery on my left knee a couple of days ago - not too serious in the grand scheme of things, but serious enough for me. I have run since I was 11 years old, but infortunately I have not been able to get out for a few months now. The Doctor recommended surgery to repair the damage and promised that I would be out running again in pretty short order. However, the thing that was troubling me when I went into the hospital was "would they cut into the correct knee ?" You hear about people having the wrong kidney removed, and I was anxious that all concerned knew which one was the correct one because I would not be able to remind them if they went after the right (wrong !) one when I was out cold under a general anastheitic.

Initially things went well and I was pleased when the Receptionist, the Ward Clerk, the Charge Nurse and the Anaesthetist all checked their notes and confirmed that the operation was to take place on my left knee. My wife, who had some medical training many years ago, surprised me by asking each of them to ensure that they meant MY left knee, rather than the left knee as they looked at the patient from the end of the bed. This disturbed me because this potential problem of perspective had not even occurred to me ! I became more nervous than I had been before. However, they all took it in their stride and understood the point she was making - apparently left and right in hospitals do get referred to in this way (my Wife claims this is why to this day she is awful at giving directions when we are out driving) - and they each confirmed that it was my left knee that they would be dealing with. At each point, the staff wrote notes in their files, and I even had to confirm it in writing myself on the consent form. Good for "Traceability" I thought.

Finally, not long before the operation, the Surgeon himself came in to see me. He once again specifically confirmed that it was my left knee that was the problem, but then he asked me to roll up my trouser leg, and promptly got out a Permanent Marker Pen from his pocket and drew a big arrow on my left shin bone pointing to the left knee. " We cannot get it wrong this way " he said - adding "I have never got it wrong yet, and I do not intend to start now". How simple - after all the talking, paperwork, sign offs and traceability documentation, a simple black arrow and a marker pen were to provide a much more effective fail safe in the heat of the operating room, and became the cause of my peace of mind as I drifted off under the effects of the anaesthetic.

How on earth does this relate to Outsourcing ? Well I got to think about how well Service Providers ensure that mission critical tasks get done correctly - and just how useful ITIL and ISO processes and related documentation really is - or do they just help to demonstrate in the eventual root cause analysis project that the problem caused by a cock up was just an isolated exception. I did not want my knee to be "an isolated exception", and I suppose Customers do not want their systems outages to be one either. I wondered how many "Black Arrows" or "simple Marker Pen solutions" could be adopted in order to bolster up the fancy processes that are in place in many outsourced IT shops ?

My conclusions for pragmatic outsourcing are:

For Service Providers: Understand where the potential "left knee / right knee" issues are for your clients - and then address them in a way makes them comfortable and confident

For Customers: Are your Service Provider's answers to your sensitive issues all based on process and paperwork ? ..... are there enough "Black Arrow and Marker Pen" fail safe solutions out there as well ?

As the somewhat simplified version of Okam's Razor has it - keep it simple stupid !