📅 2025-10-31 23:00
🕒 Reading time: 10 min
🏷️ SBI
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The week following the resolution of Memoria's MECE organization case, a consultation arrived from Kanto regarding an electronics retail chain's groupware problem. Episode 289 of Volume 23 "The Pursuit of Reproducibility - Sequel" tells the story of unraveling complexly intertwined problem causality to discern the essence.
"Detective, our workflow system isn't being used in the field. Five years ago, we introduced open-source groupware for operational efficiency. But now that system is hindering operations. Approvals are delayed, the field is confused, and everyone's reverting to paper and email."
ElectroMart's business reform office manager, Kenichi Sato from Tokyo, visited 221B Baker Street unable to hide his confusion. In his hands were complex approval flow design diagrams and, in stark contrast, a usage report showing "12% system utilization rate."
"We operate 42 electronics retail stores in Kanto and Tokai regions. Store proposals, expense applications, leave requests—everything was supposed to be managed through the workflow system. But no one uses it."
ElectroMart's Workflow Collapse: - Founded: 1995 (electronics retail chain) - Annual revenue: $567 million - Locations: 42 stores - Employees: 1,850 - Groupware implementation: 2020 (open source) - Implementation cost: Initial $100,000 + annual maintenance $40,000 - System utilization rate: 12% (target 80%) - Paper-based applications: Average 1,200/month (not decreasing) - Approval delays: Average 8.5 days (target 2 days)
Deep anxiety showed on Sato's face.
"The problem is the field says 'hard to use.' The systems department says 'built as designed,' and the field says 'too complex to understand.' Who's at fault, what's the problem—completely invisible."
Field Voices (Store Staff): - "Too many application types, don't know which to choose" (68%) - "Must select approver myself, don't know who to send to" (72%) - "Too many input fields, takes too long" (58%) - "System is slow, frustrating" (45%) - "In the end, asking the store manager directly is faster" (82%)
Management Department Voices: - "Field won't use it. Training repeatedly is useless" - "We built it at great cost, the investment is wasted" - "Paper and email remain, creating double management effort"
Systems Department Voices: - "Built per requirements. Not using it is the field's problem" - "Can't simplify further. Approval processes are complex by nature" - "Customization requires additional budget"
"We can't identify the cause. Is the system bad, is the field bad, are operations bad? All possibilities are pointed out, and ultimately nothing improves."
"Mr. Sato, how is current problem analysis being conducted?"
To my question, Sato answered.
"Basically, 'looking for who's at fault.' The systems department blames the field, the field blames the system, management blames both. In meetings, it's fault-finding and blame-shifting."
Current Problem Analysis (Fault-Finding Type): - Systems department: "Field won't learn how to use it" - Field: "System is too complex" - Management department: "No one takes responsibility" - Result: Conflict deepens, improvement doesn't progress
I explained the importance of structuring causal relationships.
"The problem isn't 'who' but 'why.' SBI—Situation, Behavior, Impact. Unraveling these three causal relationships reveals the true problem."
"Don't seek culprits. Seek causality. Situations create behaviors, behaviors create impact."
"Problems lie not in people but in structures. SBI is the key to visualizing structure."
"SBI analysis is a map of causality. Follow the chain: situation → behavior → impact."
The three members began analysis. Gemini deployed a "Workflow-Specific SBI Analysis" framework on the whiteboard.
SBI Framework Three Elements: 1. Situation - What situation or environment exists 2. Behavior - What actions occur in that situation 3. Impact - What that behavior causes
"Mr. Sato, let's factor ElectroMart's workflow problem with SBI."
Phase 1: Field Observation (1 week)
Rather than conference room discussions, we observed actual operational sites.
Observation Target: 3 store staff (1-day shadowing each)
Observation Case 1: Store Staff A (28, 3 years tenure)
Situation: - Suddenly feeling unwell during shift - Wants to take leave - Only has smartphone at hand (PC not booted)
Behavior: 1. Attempts to access workflow system 2. Screen difficult to see/input on smartphone 3. Confused: "Don't know which application form" 4. Gives up, calls store manager directly 5. Later submits paper leave form
Impact: - System not used - Double management via paper and email - System utilization rate doesn't improve
Observation Case 2: Store Manager B (45, 8 years as manager)
Situation: - 20 pending approval notifications accumulated - Busy with store operations—customer service, inventory management - Opens PC only 1-2 times daily
Behavior: 1. Opens approval screen 2. Checks each application content (3-5 min each) 3. Wonders "Who should I forward this to next?" 4. Tries to check approval rules but too complex to understand 5. Ends up directly confirming with subordinate 6. Approval processing takes 1 hour 7. Exhausted, postpones remainder "for later"
Impact: - Approval delays (average 8.5 days) - Subordinates frustrated "waiting for approval" - Manager frustrated with "approval work"
Phase 2: Visualizing SBI Structure (3 days)
From observations, we diagrammed the problem's causal chain.
SBI Chain Diagram:
【Situation 1】Field Staff Situation
└→ Smartphone-centered work style
└→ PC use limited (1-2 times/day)
└→ Many situations requiring urgent applications
【Behavior 1】Field Staff Behavior
└→ Attempts system access
└→ Unusable on smartphone (screen/operability)
└→ Gives up, responds via phone/paper
【Impact 1】System Avoidance
└→ 12% utilization rate
└→ Paper/email remains
└→ Double management hassle
【Situation 2】Approver (Store Manager) Situation
└→ Always has 20 pending approvals
└→ No time due to store operations
└→ Complex approval rules
【Behavior 2】Approver Behavior
└→ Postpones approval
└→ When uncertain, directly confirms with subordinates
└→ Direct communication over system
【Impact 2】Approval Delays
└→ Average 8.5 days waiting
└→ Field frustration accumulates
└→ "System is unusable" perception solidifies
【Negative Cycle】
Impact 1 + Impact 2 → Worsening Situations 1, 2
Sato was stunned.
"No one's at fault. Situations create behaviors, behaviors create impact, and that impact worsens situations. A negative loop."
Phase 3: Identifying Root Causes
From SBI analysis, true problems became visible.
Root Cause 1: Situation Design Mismatch - System designed for "PC use" - But field reality is "smartphone-centered" - Mismatch between situation and design
Root Cause 2: Approval Flow Complexity - 10+ approval rule patterns - Specification where approver "selects next approver themselves" - Field cognitive load too high
Root Cause 3: Impact Feedback Loop - Hard to use → Don't use → Paper remains → System not used - Negative spiral solidified
Phase 4: SBI-Based Improvement Design (2 weeks)
Understanding causality, we designed to reverse the chain.
Improvement Strategy: Change situation, behavior changes
Improvement 1: Situation Redesign (Smartphone-First)
New Situation: - All applications complete on smartphone app - Voice input support (no typing needed) - Easy photo attachment for supporting documents
Expected Behavior Change: - Apply immediately on smartphone (no PC needed) - Can apply while out - Reduced input hassle
Expected Impact: - Improved utilization rate - Reduced paper/email
Improvement 2: Approval Flow Automation
New Situation: - Approval route automatically determined by application type - Approver only needs "approve" or "reject" (no next approver selection needed) - Auto-escalation if approval deadline (48 hours) passes
Expected Behavior Change: - Managers can approve without confusion - Approval work under 1 minute per item - Timely approval
Expected Impact: - Shortened approval period - Reduced manager burden
Improvement 3: Application Form Simplification
New Situation: - Consolidate application types to 3 (leave, expenses, proposals) - Reduce input fields 50% (required only) - Templatize past applications (one-click reuse)
Expected Behavior Change: - Applications complete in 30 seconds - Reduced input errors
Expected Impact: - Lower application hurdle - Improved utilization rate
Phase 5: Phased Implementation (3 months)
Step 1: Smartphone App Development (6 weeks) - Native app development (iOS/Android) - Voice input, photo attachment, push notifications - Budget: $40,000
Step 2: Approval Flow Redesign (4 weeks) - Approval route automation - Deadline management and escalation - Budget: $15,000
Step 3: Pilot Operation (4 weeks) - Advance implementation at 5 stores - Feedback collection and improvement - Full deployment preparation
Results After 3 Months:
Situation Changes: - Everything completable on smartphone - System matches field reality
Behavior Changes: - System utilization rate: 12% → 68% - Application time: Average 8 min → Average 45 seconds - Approval time: Average 8.5 days → Average 18 hours
Impact Changes: - Paper-based applications: 1,200/month → 120/month (90% reduction) - Approval delay complaints: 45/month → 2/month - Management processing time: 240 hours/month → 30 hours/month
Phase 6: Creating Positive Spiral (6 months)
The negative loop transformed into a positive loop.
Positive Spiral:
【New Situation】Easy to use on smartphone
↓
【New Behavior】Everyone uses it
↓
【New Impact】Operations become efficient
↓
【Feedback】Want to use more
↓
【New Situation】"This is convenient" perception solidifies
Comprehensive Results After 12 Months:
System Usage Establishment: - Utilization rate: 12% → 92% - New employees: Master system training in 30 min (previously half day) - Staff satisfaction: 2.3 → 4.6
Operational Efficiency Leap: - Application ~ approval completion: Average 8.5 days → Average 12 hours - Management workload: 2,880 hours/year → 360 hours/year (87% reduction) - Paper/printing costs: $23,300/year → $1,667/year
Decision-Making Acceleration: - Proposals requiring management decisions: Average 2 weeks → Average 2 days - Reduced business opportunity loss - Field proposals more likely to pass
Organizational Change: - "System is enemy" → "System is ally" - Deepened understanding of IT investment - Other departments requesting "improve similarly"
Field Testimonials:
Store Staff A (28): "Previously, applications were troublesome, so I endured until the last minute. Now 30 seconds on smartphone. Can apply casually, making work more comfortable."
Store Manager B (45): "Approval work was painful. Now I can quickly approve during my commute. No more 'Is it done yet?' pressure from subordinates."
Holmes compiled the comprehensive analysis.
"Mr. Sato, SBI's essence is 'structural understanding.' Problems lie not in people but in situations. Situations create behaviors, behaviors create impact. Understanding this causality, changing situations changes everything."
Final Report 24 Months Later:
ElectroMart was recognized as "the most operationally efficient company" in the electronics retail industry.
Final Results: - Annual revenue: $567M → $623M (+10%) - Labor cost reduction from efficiency: $10 million/year - Decision-making speed: Industry top - Employee satisfaction: Industry #1
Sato's letter expressed deep gratitude:
"Through SBI analysis, we transformed from 'a fault-finding organization' to 'a structure-improving organization.' Most important was asking not 'who's at fault' but 'what's the problem.' If situations create behaviors, changing situations changes behaviors. Now when facing new problems, we always analyze with SBI. We understand that problems lie not in people but in structures."
That night, I reflected on the essence of problem-solving.
SBI's true value lies in liberation from blame. When problems occur, people blame someone. But in many cases, no one's at fault. Situations simply create behaviors, behaviors create impact.
Understanding causality eliminates blame. And enables focus on changing situations. Change situations, behaviors change. Change behaviors, impact changes.
"Those seeking problem culprits eternally fight problems. Only those who solve causality can eliminate problems."
The next case will also depict a moment when SBI thinking carves out a company's future.
"Don't blame people. Change situations. Situations create behaviors, behaviors create the future."—From the detective's notes
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