Why It Matters
“Fail forward” has never been one of my favorite sayings.
I know it’s popular in improvement circles. I understand that it means we can make progress by learning from our mistakes. But I worry about what often seems like a singular focus on failures in the world of improvement. (When was the last time you saw a root cause analysis of something that went spectacularly well, for example?) We sometimes behave as if the only learning that’s valuable is what we learn when things go wrong.
Failing to Learn from Success
When I was Chief Executive of the National Health Service in Scotland, I recall a long meeting at the start of our work on patient safety. We looked at the results of the analysis of hospital standardized mortality across the country. There were two hospitals that seemed to be underperforming, and we spent almost the entire meeting trying to deeply understand what was going wrong.
There were also two hospitals who were well ahead of the curve. They seemed to be doing much better than the majority. In retrospect, we spent very little time trying to learn from what they were doing right.
I used to spend all my time looking for “bad apples.” I realize now that I should have spent more time on the whole orchard. After working with health care improvement leaders around the world, I’ve also come to the conclusion that if we focus primarily on failure, we may risk:
- Losing opportunities to learn from success — Focusing on the 2 percent of the activities that fail, instead of the 98 percent that are going well, distorts our view and doesn’t help us understand how our whole system is performing.
- Slowing improvement — Not recognizing and celebrating success may impede momentum and progress. If we identify and spread what goes right, we can improve more quickly than if we study only what goes wrong.
- Developing a culture of blame — Leaders who focus all their attention at one end of the performance curve breed fear and secrecy. This leads to people hiding defects and working to avoid being in the bottom 2 or 3 percent instead of learning how to continuously improve.
- Overlooking those who deserve recognition — If we never look for and recognize success, we risk ignoring the many people doing fantastic work who are never adequately acknowledged for their efforts.
How Leaders Can Learn from Success
There are several ways leaders can incorporate learning from success into their work. First, look at the whole of the performance curve in your organization. Be open to every opportunity to learn. Examine what’s going well, what’s not, and the majority of activities that fall in between successes and occasional failures. Learn from mistakes and don’t just repeat them. Don’t assume a success means everything went as expected. People often say, “If it ain’t broke, don’t fix it.” I would counter with, “If it ain’t broke, figure out how to improve it.”
Second, thank the individuals responsible for your organization’s successes, personally and publicly. It’s one of the most powerful things we can do as leaders. It’s a good way to exemplify the leadership behavior highlighted in IHI's High-Impact Leadership white paper that advises leaders to be “a regular, authentic presence at the front line and a visible champion of improvement.”
Third, set the tone for how you take on challenges by drawing upon the reservoir of your organization’s successes. As Edgar Schein says, organizational culture comes from how we solve problems. Sharing lessons learned from success stories helps encourage joy in work and demonstrates forward momentum.
Of course, I’m not saying it’s wrong to learn from failure, especially if we use scientifically grounded methods, like root cause analyses or the 5 whys. We should continue to “fail forward.” Learning from failure is essential — it just shouldn’t be our only strategy for improvement. We should try “succeeding forward,” too.
Editor’s note: Look for more from IHI President and CEO Derek Feeley (@DerekFeeleyQI) on leadership, innovation, and improvement in health care in the “Line of Sight” series on the IHI blog.