Vanguards must not be afraid of the F word – as former Obama adviser Don Berwick tells us, ‘failure’ is an essential process if we are to improve. By Samantha Jones
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Last month we were joined by Professor Don Berwick (@donberwick) for an event with the new care model vanguards focused on learning from failure.
Professor Berwick is president emeritus of the Institute for Healthcare Improvement and a former adviser to President Obama.
By the very nature of developing new models of care, we expect things to not work as well as they need to and we expect people to not get it as right as they could have done.
We spend a lot of time as a programme encouraging people to share, but it can sometimes be hard to get people to talk about the things that they have done well, let alone the things that they haven’t done so well.
However, what was evident from the event was how everyone really embraced the conversation about failure and didn’t find it difficult to talk about it in a “safe environment” when it is deemed OK to do so.
It is uncomfortable to say, but “failure” shouldn’t be seen as a bad thing – it’s something we need to learn from so that we can make improvements.
We also need to share what went wrong with others, so they can learn too.
Professor Berwick reminded us that the only way we can improve is by failing, and that we need to take risks in our work. However, they need to be measured, managed risks.
For the vanguards, this included recognising the scale of the challenge and the time it takes for relationships to be solid enough to totally challenge the way things are done.
Professor Berwick reminded us that the only way we can improve is by failing, and that we need to take risks in our work. However, they need to be measured, managed risks.
Early in my career I learned of two simple rules. One is to make it safe and make it legal, and the second is that we are right behind you, irrespective of what happens.
Professor Berwick made clear five “conditions” that need to be in place to best allow people to test new ways of working and, as such, learn from failure:
- Safety – don’t punish people if they fail
- Slack – give people the headroom they need to try new things
- Skills – make sure they know how to do it
- Systems – suspend rules so people can test
- Social support – show them some love.
What was evident from the event is our dislike of the word “failure”. However much we talk about it being something that is an opportunity, the word is negative.
In reality it should be seen in a positive way – succeeding through learning.
For all the latest news about the new care models programme and vanguards, visit: www.england.nhs.uk/vanguards
Samantha Jones is director – New Care Models Programme (@SamanthaJNHS)
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