Friction Creates Traction
5 questions to ask after a failure occurs
Everyone loves a good success story. But it’s equally important — maybe even more so – to give failures their fair share of respect. Certainly, mistakes aren’t fun for anyone, but they do offer valuable opportunities to learn something new. And that’s how labs (not to mention their leaders) get better.
So the next time something goes wrong, take a deep breath, count to 10 and ask yourself these five questions:
Failure isn’t fun for anyone, but it does present valuable opportunities for learning, improvement and growth..
After a failure occurs, examine the process without laying blame to see where the breakdown happened, then think about ways to do it differently next time.
Being upfront about your failures, and providing solutions for change, may help prevent others from making similar mistakes in the future.
Contributing Lab Leaders
Quality Management Coordinator
Laboratory Quality Manager
Bryan Health, Lincoln NE
Madonna Rehabilitation Hospital, Lincoln NE
Vice President, Quality and Regulatory Affairs
Sonic Reference Laboratory, Austin TX
QUESTION 1: What was it that didn’t work?
The first thing you’ll want to do when a failure occurs to is clearly define the problem by comparing what you expected to happen with what actually did. Then, zero in on exactly what results fell short of your expectations and why
Try not to get sidetracked by tangential information or blow the issue out of proportion. If multiple failures have occurred, take a “WIN” approach to prioritize “What’s Important Now,” and focus on one problem at a time. Staying calm is key; do your best to remove emotion from the situation and examine things as objectively as possible.
“Overreacting doesn’t solve the problem”
QUESTION 2: Where did the breakdown occur?
Creating a viable solution means figuring out at precisely what point things went wrong in the grand scheme of things. Keep in mind, there’s a fine line between laying blame and figuring out where a breakdown occurred. Think process, not person.
Choose your words wisely to elicit the info you need from the employees who were involved. Asking “How did you break this?” or “What did you do?” immediately puts staff on the defensive, making your chances of having a productive conversation next to impossible. Instead, rephrase the question to something less accusatory, such as “Can you show me what happened here?” or “How did this break?”
As a lab leader, it’s your job to empower your staff to take the initiative to speak up so that they can feel comfortable reporting errors without fear of recrimination. We all know that zero-error reporting is probably not entirely accurate. And after all, you can’t fix it if you don’t even know it’s broken..
“I've seen labs where we have this policy, this electronic capture tool and they do nothing with it,” said Jason Majorowicz, Quality Management Coordinator at Mayo Clinic. “It's not an event management system, it's an event reporting system. There's no management done. On the backend, it's how you take those opportunities, what you do with them and how you can effect change so it doesn't happen again.”
“Blame the process, not the person”
QUESTION 3: What can you do differently next time?
Once you’ve determined was the problem is and how it happened, round up all of your team players and brainstorm ideas for solutions you might be able to put in place next time around. Encourage everyone to participate in the idea generation process, and acknowledge all input received as valuable if you want employees to feel good about contributing.
“What we need to do is change the culture to where the people in our labs aren’t throwing problems over the wall; they’re throwing solutions,” Majorowicz said. “We need people to say, I’ve thought about this. Here’s a problem, and here’s my proposed solution.’ Let’s empower them to go find that solution.”
QUESTION 4: What have you learned in the process?
If you look for it, there’s a lesson to be learned in every failure. Christina Nickel, Laboratory Quality Manager for Bryan Health in Lincoln, Neb., shares an example of how making a mistake led her team to a valuable lesson.
“We decided that we were no longer going to do urine qualitative pregnancy testing in our ER and talked to the chair of OB/GYN because we wanted to wipe it from the whole hospital,” she explains. “And boy, if that didn’t flip our ER docs on their backs; they were so upset. We had to work really hard to gain their trust back.”
When a similar situation arose later with a different test, Nickel included the ER docs right away in the decision-making process instead of just making the call without their input. Not only did the doctors appreciate the opportunity to express their opinions, the OB/GYN chair even wrote a letter to the vice president of the hospital praising Nickel for being so willing to collaborate.
QUESTION 5: How can you share the experience to keep it from happening again?
Being honest and transparent about failures not only helps you gain credibility, it can prevent others from making the same mistakes in the future. Don’t be afraid to share your experiences with other staff members and across other teams in the hospital, too, even if it requires getting out of the lab and physically going to other departments to do so. In today’s digital age, face-to-face communication goes a long way.
“When I worked in a hospital, I was a little intimidated at first, so I would just manage things through email and problems weren't getting solved,” said Jennifer Dawson, Vice President of Quality and Regulatory Affairs for Sonic Reference Laboratory in Austin, Tex. “We would get the wrong specimen type, or things would get lost. Then I started actually going and talking to the nurses, and we were able to work through some of those problems. I could actually see some of the barriers they were having, and we could fix them together.”
Once you’ve dealt with the failure and learned from it, it’s time to let it go and move forward, knowing you’ll do better next time..
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