Failure To Imagine Failure

Humans love comfort and familiarity; we avoid discomfort and unfamiliarity. This behavior has served our species well in avoiding risk and ensuring survival for another day. When our ancestors felt afraid or discomfort with their environment, they avoided the environment and, by nature, survived to procreate those genes and behaviors. Fast forward to today, functioning in a complex environment consisting of tightly coupled complex systems brings different outcomes to those behaviors. Our world is filled with complex interactions of systems and subsystems that exhibit emerging properties that we cannot explain by analyzing the individual components that make up that system.?

Fear does not necessarily indicate danger and a sense of comfort does not guarantee safety.

Our natural inclination is to rely on our internal risk barometer to navigate the perceived risks within the systems we operate in. However, in safety-critical systems, the level of complexity can be overwhelming, surpassing what any individual can fully comprehend. This complexity challenges the effectiveness of our instincts, which were honed in simpler times. In these complex systems, fear does not necessarily indicate danger and a sense of comfort does not guarantee safety. This underscores the need for specialized knowledge and skills to manage these environments effectively.?

Frontline managers would benefit from training and understanding to lead in safety-critical environments effectively. Without training and knowledge of effective management in safety-critical environments, managers will engage in practices that seem rational to the untrained manager but are ineffective. Examples of these efforts are management encouraging people to “be safe” and “keep your head on a swivel” and other well-intended directives that ultimately fail to ensure safe operations. Appeals to the emotions and behaviors of frontline employees satisfy the instinctual need to feel comfort but serve as a false surrogate for safety.

Preoccupation with failure, reluctance to simplify, sensitivity to operation, commitment to resilience, and deference to expertise are not just theoretical concepts but practical tools that can empower managers to improve safety.?

Managers in safety-critical environments can significantly contribute to the safe operations of their employees by embracing evidence-based management principles tailored to their industry. Managers can make a meaningful difference in their environment by understanding and applying the principles of high-reliability organizations in medical transport operations. These principles, including preoccupation with failure, reluctance to simplify, sensitivity to operation, commitment to resilience, and deference to expertise, are not just theoretical concepts but practical tools that can empower managers to improve safety.?

Risk is not a respecter of person, agency, intention, or gut instinct. Our emotions are poor prognosticators of event outcomes, and we must begin to recognize that by continuing to promote emotion-based safety behaviors, we are doing a disservice to our caregivers and employees. The gambler's fallacy causes us to believe that past outcomes will influence future outcomes, leading us to fail to imagine the failure we could be facing. The house will always win if we think our operation is immune to failure.