organisational learning

Line of fire

Another tragic event where a family operated business has suffered the loss of one of it’s team in a workplace incident.

Without knowing the details, and based only on the media reports, we are reluctant to draw conclusions from this event. In saying that, there is no point waiting for a formal report to use the event as a learning opportunity and reminder about line of fire. This does not mean that it was a large factor in this particular incident, but there are few injuries in workplaces that the worker is not in some way exposed and would be safer in a different position.

Having worked in the same industry in the same job in the same suburb seeing the same types of situations, it hits harder than most.

thewest.com.au article – Workplace death

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Don’t eliminate your ability to learn before you start

This meme captures the very much the premise of any good incident investigation.

No matter how much one think they’ve got the answer or likely cause of an incident, by going into it in that mindset, they’ve failed before they’ve started.

It is the single most common barrier I see with an organisations own investigations. They may sometimes be in the ballpark, but it’s very rare they’ll be seeing much more than the basics or immediate causes. They’re missing valuable learnings and almost definitely destined to repeat incidents caused by many similar factors if they don’t approach it with an open, yet curious mind.

It’s costly and just bad business to jump to a conclusion too promptly or before gathering the spectrum of data.

So our advice is to make a conscious effort to don’t close your mind with an existing likely cause of an incident investigation. Do the data collection and then rule out what’s not a factor and you’ll often be surprised that there are many more significant factors than one where an individual has screwed up or a single factor has failed. Once you’ve gotten these elements of data together, then put them on a single page and rank them in a hierarchy of most to least significant or systemic. You may actually be surprised that you weren’t as accurate with your initial reasoning as you thought.

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If it hurts, you’re still in the fight

When things go bad, it’s important to understand that’s just a perspective. But perception means you’re still alive and that’s gotta be a good thing right?

So there is no point getting bummed out with how it’s painful or things went wrong when you’ve been handed an opportunity to learn. Even if you feel you were unlucky, understand that nothing fails like success, and you’ve been shown how to do t better next time. You’re going to be able to remember the lesson for longer and be more motivated to maintain the lesson for far longer than those who never learnt it like you did.

Learning opportunities like your failure or issue that’s going on are critical to success. Because you’re now one lesson ahead of everyone else, and we all know that is the difference between being good and being great. It’s those that get up from a defeat just one more time than their competition…..

Good – Jocko podcast link

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Conflict can promote learning

Seek out the painful facts, debate them in a way that gets everything, whether moose, elephant or boogey monster into the table so the final outcomes is the best one you can come up with.

Pretending it’s not an issue or avoiding the hazard because of a fear of conflict is a sure way to have it simmer, grow and rot away at things until the level of harm it shows is more than you’re prepared for. Hiding it is not the way to learn.

A learning culture needs debate but in a healthy way, and it will likely have elements of conflict. Ray Dalio goes deep on the topic in his book Principles, and worth a read for anyone interested in how to get painful topics debates openly. It’s critical to achieving greatness, yet to often avoided. The outcome? Incidents that people say – Wow, where did that come from? Well it was inside all along.

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Information of mis-information?

Are you focussed on addressing the right risks?

Too often misinformation can redirect valuable finite resources from the right risks to other less critical places due to fear or distraction.

Use a professional to help you determine where your risk management efforts should be spent.

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