“I have failed? What can I learn from it?” There, I just admitted failure (imagined at this point, but really I have). If I am in the wrong organization, I have opened myself up to immediate and long lasting criticism. When promotion opportunities come up, someone inevitably says, “Remember when….” And I am quickly removed from consideration. It does not matter that I have learned and improved the reason I failed. It doesn’t matter that I made a breakthrough that led to increased profitability.
Professor Amy Edmondson wrote an excellent article in the Harvard Business Review (April, 2011) discussing how we can learn from failure. And her first point is about eliminating blame (and, I might add, it’s first cousin shame.) Dr. Edmondson has a number of excellent comments, and my suggestion is to read the article.
One obvious point she makes is that not all failures are created equal. And in my experience, when you make a mistake, the consequences can vary for the same mistake occurring in differing circumstances. If you run a red light in your car when there is no traffic, you just made a mistake. Make the same mistake when a cement truck is coming through the intersection, and maybe you made a fatal mistake. The same behavior can lead to different consequences. Most of the time when you run a red light, there isn’t a cop in view and you don’t even get a ticket. I imagine you see, as I do, many drivers running red lights. The same is true for speeding. Without consequences, we gain a feeling of comfort.
Professor Edmondson suggests ways to build a learning organization and provides a few Lean Thinking stories. She mentions Alan Mulally’s request for his managers after he took over Ford Motor. He wanted their reports to highlight problems with green, yellow and red colors. Of course all of the reports came back green. We have all learned our lessons well. In school, a red mark was a really bad thing that controlled our future. We have been exposed to a harsh, blaming culture from the cradle.
And Toyota is mentioned in the article, of course. They have the best system ever developed for calling attention to errors—a culture of science.
“Another is the vaunted Toyota Production System, which builds continual learning from tiny failures (small process deviations) into its approach to improvement. As most students of operations know well, a team member on a Toyota assembly line who spots a problem or even a potential problem is encouraged to pull a rope called the andon (sic) cord, which immediately initiates a diagnostic and problem-solving process. Production continues unimpeded if the problem can be remedied in less than a minute. Otherwise, production is halted—despite the loss of revenue entailed—until the failure is understood and resolved.”
About midway in the article, we are introduced to root cause analysis. Lean Practitioners are very knowledgeable about Root Cause Analysis. It is my mantra. Ask the 5 Why’s? Dig deep. Use the tools of Lean to find the facts that we can analyze and identify possible countermeasures. Find 7 different solutions to every problem and rank them. Try the first one and check to see if it produces the results you hope for. If not, try the second and third if necessary.
Dr. Edmondson advocates building a learning organization and offers some good tools. My only criticism is that she didn’t put it all together and recognize that Lean Thinking already does what she is offering. For example, she segregates TQM out as a good practice, but doesn’t mention (or realize) that TQM was build on Toyota practices.
Her final advice in the article is this piece in response to her conclusion that “an understanding response to failures will simply create a lax work environment in which mistakes multiply.”
“This common worry should be replaced by a new paradigm—one that recognizes the inevitability of failure in today’s complex work organizations. Those that catch, correct, and learn from failure before others do will succeed. Those that wallow in the blame game will not.”
Lean Thinking done properly does not have this problem. A culture that accepts mistakes, defects and errors with an improvement response will not allow a lax work environment to exist. If it’s a true culture, any recognized mistake activates the improvement response—and the problem is resolved.