thanksgiving process
The High Reliability Thanksgiving
Every year, Cindy Spangler hosts ‘Friendsgiving’ for over forty friends, family, and work colleagues. Cindy is also a senior value engineer and associate editor for Accelerate. So we asked: what is the process behind a successful Thanksgiving?

What does “high reliability” mean?


hile our Thanksgiving process map is for fun, “high reliability” accurately describes the goal of healthcare systems. Highly reliable organizations have processes that are exceptionally consistent and avoid potential harm.

What is a process map?

Process maps are a useful tool for focusing your efforts and saving valuable time. They harness the power of visual thinking to help clarify complex processes.

Process mapping is used to highlight issues and where the process is breaking down in the workflow. Process maps make it easier to communicate the current or future state of the process you are hoping to improve.

How to map your process

1. Have a plan 

Before you begin, start by asking these two questions: What process problem are we trying to solve? What are we trying to see? At Thanksgiving, a table full of warm food and happy people is the goal that guides our map. In the workplace, we often begin by looking for delays or errors in an existing process. The Seven Wastes are a useful tool to help clarify what you might be looking for.

2. Go and see the process

Make sure that what you’re mapping is the actual process. In Lean, this is called going to the Gemba—"the real place" in Japanese. By observing and documenting the process in action, you increase the accuracy of your map. If you’ve never cooked for a large group, consider the dinners you’ve attended. What went well? What didn’t? Call your resident family friend or parent to learn from their experience—or even better, go and observe their process before you begin yours.

3. Include the team 

Process mapping is a team sport. By including the people who actually use the process, you increase accuracy—and improve buy-in down the road when you have a process change to implement. For group dining, call on your friends—potluck dessert options can help keep your focus on the main event.

4. Keep it simple

Workflows can be extremely complex, but your map needs to be easy to understand. At the beginning, it helps to capture enough of the action that people can easily follow the process. You can always add greater detail later as needed.

Let the process map be your guide

We're having fun with this post, but process mapping is serious business. For a deep dive into they why, how and what of process mapping, checkout this post by my colleague Luca Boi.

Bon appétit!


This article was updated November 18, 2019 to include expanded information on process mapping. It originally appeared November 16, 2016.


Cindy Spangler

Quality Manager, Global Surgery, University of Utah Health

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