Corrective Action: Deduction can never substitute for Gemba

A friend of mine posted this picture on social media with the caption, "Hooray! A Keurig machine in our hotel room! Anyone else see the problem here?"

One person responded: Aw, no pods! That's just a tease 😉

Always the clever quality management expert I responded:
They need me to help them with their quality management system (QMS). No pods is just the symptom. The root cause problem is that the bright sparks who decided to change the coffee machines did not ensure that the Work Instructions (WI) for room service were changed and then followed up with appropriate training to ensure Keurig pods were provided instead of Gourmet Roast filters.

Well, if they had taken my 'helpful' advice, even at no charge, they would have made an expensive mistake. The problem looked obvious and the root causes looked obvious but, Boy, was I wrong! I deduced the root causes without going to gemba.

Wikipedia defines 'gemba' as 
a Japanese term meaning "the real place." Japanese detectives call the crime scene gemba, and Japanese TV reporters may refer to themselves as reporting from gemba. In business, gemba refers to the place where value is created; in manufacturing the gemba is the factory floor.


Being a practical schoolteacher, my friend went to gemba with her problem, to the hotel front desk:
Long story somewhat short... when I inquired at the front desk in the morning, I was told that the owner said that they were having issues with the "pods" so he was gradually replacing the machines with the other "normal" type. I pointed out the obvious and the front desk employee completely agreed that it was "silly" to have these in the room. I asked if anyone pointed out that fact to the owner, her response... "No. May I tell him you said it was ridiculous?" My response... "of course. Tell him it makes him look "silly", for such a non-thought out decision."

My assumption, without going to gemba, was that the hotel was replacing the old, 'normal' coffee machines with Keurig. Feasible, reasonable, even probably correct in a generalised scenario but, nevertheless, WRONG. The direction of my deductive root cause analysis was out by 180 degrees. Embarrassing, to say the least.

The moral of the story: ALWAYS GO TO GEMBA when doing a root cause analysis, especially when the deductions seem obvious.