'It is simply not possible to sit in a room and work out what led to something going wrong without going and seeing it for yourself'

Before joining the NHS, I worked for a large engineering firm that refurbished rolling stock for various train operating companies across the country.

Every morning, the managing director and operations director would walk through the plant to gain an overview of the progress being made in the manufacture of trains.

We had progress boards throughout the plant indicating each of the 18 stages required to complete a train. Each stage was broken down into four components.

As each component was completed, it would be shaded in, indicating the stage was 25 per cent, 50 per cent, 75 per cent or 100 per cent complete.

At any point in time we would have three trains on site. Each would take around 25 days to complete - 3,000-5,000 person hours at a cost of approximately£350,000-£500,000.

Every day our team would await the outcome of the daily visit. If we were on schedule all would be fine. If not, we were expected to explain how we would get round any problems we had encountered.

This is a perfect example of 'gemba', a Japanese word for the 'real place' or 'place the truth can be found'. It is the idea that, in order to understand what is going on in your organisation you need to 'go and see' what is happening, where it is happening and why it is happening.

It is simply not possible to sit in a room and work out what led to something going wrong without going and seeing it for yourself.

I regularly get the chance to go and see trusts. While it is possible to have discussions with members of staff about the issues they face in the workplace, there is no substitute for going and seeing it myself.

There is a classic anecdote in Jeffrey Likers' book The Toyota Way about the 'Ohno Circle'. Taichi Ohno was the father of the Toyota production system and what would become known as lean manufacturing.

He asked Teruyuki Minoura, the president of Toyota Motor Manufacturing in the US, to draw a circle on the shop floor, stand in it, watch the process and think for himself.

Ohno returned during the day and asked Minoura what he was seeing. However, he did not listen to Minoura's response. Instead, he observed the process for himself.

Eight hours after Minoura had entered the circle, Ohno returned and sent him home. Minoura later reflected on the experience, concluding that the longer he stood and watched, the more apparent problems with the system became.

There are lessons here for those that want to understand processes at work in their organisations. To gain a complete and thorough understanding of your work environment you have to see what is happening within it.

If you want to tackle a problem, Ohno's advice would be to go and see it in the environment where it arose.

Rather than discussing what people perceive to be the problems in a meeting, why not schedule time in your diary every week, or even every day, to talk to staff on the shop floor. Go and see for yourself.

Andrew Castle is service improvement consultant at the NHS-funded South West London improvement academy.