Failing to learn

Matthew Evans

I’ve just finished reading Matthew Syed’s ‘Black Box Thinking’, which references Tim Harford’s book ‘Adapt’, both great reads on the same theme; failure. If you haven’t read either then Tim Harford’s Ted talk on the subject (https://www.ted.com/talks/tim_harford#t-1067823) gives you a sense of the territory.

Syed’s approach is to examine the culture which has developed in aviation whereby failure (in the form of accidents and near misses) are systematically and openly picked apart and the lessons learnt used to inform improvements to safety. Over time this has resulted in an incredible safety record for the commercial airline industry. Syed calls this approach an ‘open loop system’, meaning that failure leads to progress as feedback is rationally acted upon. This, he argues, is radically different to the ‘closed loop system’ found in healthcare whereby mistakes are hidden, go unrecorded and subsequently do not lead to improvement.

I was so taken with the…

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