Learning from Failures

by Holly Hayes

Healthcare Executive, a publication of the AmericanCollege of HealthcareExecutives (ACHE), May/June 2012 issue published an article titled “The Importance of Failing Forward” by Paul B. Hofmann. The title refers to the book Failing Forward (2000) by John Maxwell which asks, what will you do when problems occur, will you fail forward or backward?

To explain the fail forward concept, Dr. Hofmann refers to a study of physicians who participated in a simulated medical emergency where they had to choose from uncertain treatment options requiring trial and error. The doctors who paid more attention to their mistakes fared better in the simulation than those who focused on their successes. The study take away? Doctors who learned from their mistakes were better performers over time.

Dr. Hofmann lists possible reasons for familiar mistakes in the healthcare environment, including: insufficient or inaccurate information, lack of expert input, time constraints, ignorance of legitimate alternatives, carelessness, political pressure, a conflict of interest, undue haste or a failure to follow established policy and/or external requirements. Many people will simply practice avoidance of these problems or situations rather than recognize them and learn from them. One model organizations might consider when building a culture who learns to ‘fail forward’ has been taught in a one-week immersion course by Leonard Marcus, who directs the program for Health Care Negotiation and Conflict Resolution at Harvard (see more here and here):

A Four-step Approach to Problem-solving

Step one: self interests. each participant in the course articulates his or her view of key problems, issues, and options. They are encouraged to actively listen, question, and interact with one another.

Step two: enlarged interests. The participants reframe their understanding of current problems and possible options with a wider perspective, based on the integrative listening and confidence-building that occurred in step one.

Step three: enlightened interests. The group is ready to engage in innovative thinking and problem-solving, generating ideas and perspectives that had not previously been considered.

Step four: aligned interests. Participants build common ground perspectives, priorities, action items, agreement, or plans for moving forward. Depending on the scope of the intended objectives, at this point they recognize the tangible contributions and opportunities accomplished through the meeting.

Healthcare professionals at all levels will make mistakes. As Dr. Hofmann points out, Maxwell suggests “people who fail backward blame others, repeat the same mistakes and expect never to fail again. In contrast, he describes people who fail forward as those who take responsibility, learn from each mistake and know failure is part of progress.”

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Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.