Sidney Dekker talks about a couple different mental frameworks for thinking about failure. You can try to: 1) Try to fix people because they are obviously a problem as they often cut corners, workaround deficiencies, don’t follow guidelines, etc, (Did the sarcasm come through?) or 2) create contexts where things are likely to go right more often.

Another idea here is that we tend to restrict our thinking about remediation to examing our failures and completely ignoring our successes. These can be missed opportunities to learn from a larger body of evidence that often leads to very good outcomes. (Hopefully we’re successful more than not, but this isn’t strictly necessary I guess. :))

The idea that people behave differently during success and failure is false. With good outcomes, it is absolutely true that people have still cut corners somewhere, or used workarounds, and ignored unhelpful guidelines, etc.

Safety II environments are all about trust and psychological safety:

  • diversity of opinion and possibility of voicing dissent
  • keeping a discussion on risk alive - sometimes success shuts down a conversation around potential cracks when thinking about this stuff might make the system better
  • deference to expertise - whoever is the foremost expert about a topic should take point. top down always doesn’t lead to good outcomes always. context is often lacking about what the world is like on the ground
  • ability to say stop - people should be able to safely speak up and voice concerns !
  • broken down barriers between hierarchies and departments - knowledge, skills, ideas exist across an organization. the more people talk, the better things will be
  • continuous growth / improvement - people are constantly adding small things that create safety
  • pride of workmanship - people are proud of what they create and are constantly trying to improve