Having recently returned from a frustrating day's skiing, I was regaling a friend with my experiences over dinner. He asked me how my day had been.

I replied with a sense of hurt pride that I had fallen over a few times and found the runs really difficult.

As a novice skier, I was expecting some sympathy, but it was not to be. "That's good," he replied. "It shows you were pushing yourself." And it's true: you cannot improve unless you are prepared to challenge yourself and to step outside your comfort zone.

Few of us get things right first time. The fact is that success does not breed success. It is failure that breeds success. We experiment, try new ways of doing things and eventually get it more or less right. Abraham Lincoln failed twice as a businessman and was defeated in six state and general elections before being elected president of the United States.

Taking risks

As leaders and managers, we need to learn to love experimentation and to embrace failure as a key enabler for innovation and improvement. Real transformational change can only take place if leaders at all levels are prepared to challenge and remove some of the constraints and conventions that block innovation and creativity.

Leadership is by nature risky because it involves taking difficult decisions, often based on inadequate information.

For many managers working in hierarchical and traditional organisations, this can prove challenging. The Japanese have a saying: "The upstanding nail gets hammered down." In other words, it is safer to go with the status quo, rather than risking the disapproval of senior management. And here lies the problem. On the one hand, we want transformational change to improve services for patients, but this requires challenge, debate and even disagreement.

Safe environment

The implications are significant. Transformational leaders need to give clear direction but broad boundaries. They must make it safe for people to experiment and to challenge authority by encouraging constructive debate and not apportioning blame for mistakes. They must encourage learning from failure and reward good attempts, not just outright success.

Freedom to challenge is needed even in the most safety-conscious industries. In the aviation industry, for example, there is something called the Muser principle, named after a former head of safety for Swissair. Muser argued that aircraft and flying had become "dangerously safe". Everything is highly regulated and specified to the extent that things are rarely questioned, and yet no amount of technology or safety measures can prevent pilot error. The cockpit crew must feel free to challenge each other and so must we as we continue on the transformation journey.