Writing
Nobody is doing your exercises
Every clinician knows most patients skip the home programme. The same thing happens to the software you buy for your crews, for the same reasons, and it is not a discipline problem.
The shrug
Ask any clinician what proportion of patients actually do the home exercises they were given. You will get a number well under half, followed by a shrug. Everybody knows. Nobody has fixed it.
I prescribed those programmes for years. Three exercises, twice a day, written on a sheet. The patient nods, and means it. Two weeks later they are no better, and when you ask whether they did the exercises they say yes, mostly.
Then I started building systems for field crews, and met the same shrug in a different building.
The same problem in a hard hat
There is a case in the fleet safety literature I keep coming back to. A carrier moved its daily vehicle inspections from paper to a mobile app. Completion went to ninety-nine per cent. Management was delighted.
Defect reports nearly stopped.
Drivers were tapping through the checklist in under ninety seconds without leaving the cab. A trailer ran six days with a slow air leak and failed a roadside inspection. On paper the compliance record was immaculate. The number that mattered — problems found before they became failures — had gone to almost nothing.
Roughly two in five paper inspections show every box ticked in under ninety seconds, which is another way of saying the same thing. And most estimates put the majority of failed technology rollouts down to change management rather than the technology.
That is not a different problem from the exercises. It is the same problem, and the same four things move it.
What moves adherence
Fewer items.
A twelve-exercise programme gets done by nobody. Three gets done by some people. In rehab you learn to give away the exercises you would like to prescribe in order to keep the ones that matter. A forty-point inspection form fails for the identical reason, and adding points to be thorough makes the record worse, not better.
The person has to know why.
A patient who understands that the glute exercise is what stops the knee pain coming back will do it in a hotel room. A patient who was handed a sheet will not. Same with an operator and a slack adjuster. The training that works is not training on how to open the app. It is explaining what happens to the report after they hit submit, and what the check is actually for.
Progress has to be visible to them, not just to you.
Adherence climbs when the person can see the thing improving. If your inspection data flows exclusively upward into a dashboard the operator never sees, you have built a reporting system, not a safety system.
Reporting a problem must not create trouble for the reporter.
This is the one people get wrong, and it is the expensive one.
The expensive mistake
A patient who gets a lecture for admitting they skipped a week learns to say they did it. A driver who reports a defect, and then gets questioned about the delay it caused, learns that silence is easier. Both of them stop giving you information, and neither of them is being difficult. You taught them.
The version of this I see most often in operations is a productivity report built on top of field data. The intention is reasonable — somebody wants to know where the hours are going. The effect is that hours get padded and defects go unmentioned, because the crew now understands that the data is used to judge them. The report gets cleaner. The underlying record rots.
There is a hard-nosed argument here for anyone who finds the ethical one unpersuasive: a system people trust produces more accurate data than one they do not. If you want honest numbers, you cannot punish the people who supply them. Those are not two separate goals.
What this means if you are buying software
Ask fewer questions about features and more about what happens on a cold Monday when three machines need to move dirt in ten minutes. Ask how long the form takes. Ask what the operator gets back. Ask what happens to the person who reports something inconvenient.
And if your crew is not using the system you already paid for, resist the explanation that they need reminding. They are telling you something about the system. It is usually cheaper to listen than to send another email.