How do you improve? What should you improve? Where should you focus? The answer to these three questions depends very much on which lens you view the world through.
1. 
Some people and most organisations look at the world through what I call a Molehill Magnifying Lens.
The molehill magnifying lens has the peculiar characteristic that it makes molehills look just like mountains and (just to be tricky) it makes some mountain look like molehills and other mountains look just like mountains. It's very tricky when looking through the molehill magnifying lens to know where to focus your improvement efforts because every problem looks the same.
So what do you do? You try to manage all the details because - according to your lens - all of the details are important. A very large company I recently worked with had equipped all of their project staff with molehill magnifying spectacles by declaring in their project "governance" procedures that if any task on their project was RED then their entire project should be considered RED. The molehills and the mountains all looked alike. The staff working on the project teams spent hours and hours in meetings and teleconferences discussing the details to death because all of the details were equally important. The managers spent hours and hours each day ensuring that they knew all of the details of their projects so that they could share them confidently with their bosses. And needless to say everyone bloated their estimates because they didn't want to be the ones to make the project go red. (Their projects were, btw, red most of the time).
2. Some people, but few organisations, look a the world through what I call a Leverage Locating Lens.
When you look through the Leverage Locating Lens you only see the important stuff. You look at a molehill you see a molehill. You look at a mountain and you see a mountain. You look at a chain and you see the weakest link. #
Looking at the world through this lens, you not only know how to make big improvements with small changes, but - just as important - you also know what to ignore.
Here's a true story I heard from the CEO of an English Hospital who by looking at life with LLL's achieved a 23% increase in the number of ophthalmic surgeries for the price of two chairs .
When he first started working at the hospital his ophthalmic surgeons had a big waiting list and had, accordingly, requested budget for an extra surgery and more doctors. He went to talk to them. He told them that he was very impressed that they were 106% efficient but he said he was concerned that they had enough time for breaks during the day - he didn't want them wearing themselves out. They said they were fine and managed a half dozen breaks each day. Oh really, he asked. Yes - there is always a little time to spare between patients. Oh really? Yes - sometimes they have to wait 20, maybe 30, minutes. Oh really? Yes - we call down to the nurses as we wrap up one patient; they then get the patient; a wheelchair, a porter to push the wheel chair and a nurse together and then transport the patient to the surgery. Gosh, says the CEO. Yes, say the surgeons, do you know how hard it can be to get them all together and all we want to do is move the patient 200 yards. But them's the rules.
Can you guess where he put the 2 chairs, who sat in them and when they sat in them?
