Do you cultivate a practice of debriefing in your team?

I'm reading now "Complications - A surgeon's notes on an imperfect science" by Atul Gawande. I took this book for two reasons. One, I was thinking of overcoming my panic, almost physical disgust for medical stories told (let alone shown) in details - really, just can't stand it. And second, I think that reading about parallel worlds (professions, industries, and experiences we don't cross in our business) can be a good means for widening the horizon. I'm in the middle of the book and if the first wish doesn't seem achievable (struggling forward scary medical terminology doesn't come effortless for me) the second idea brought some outcome.

In chapter "When doctors make mistakes" Dr. Gawande talks about mistakes that inevitably happen in a doctor practice. Medicine (both, science and practice) can't become one day error-less and he brings a number of examples when the human factor plays its dramatic role in every doctor's career. What nearly every hospital has, however, is a M&M process - Morbidity and Mortality conference. That's the place where doctors openly and candidly talk about their mistakes: "[doctors] gather behind closed doors to review the mistakes, untoward events, and deaths that occurred on their watch, determine responsibility and figure out what to do differently next time".

In my group we call it a debriefing process instead of M&M but although the process exists I found a few things we can borrow from its medical incarnation. I wrote before on how to love lost deals  and this time instead of concentrating on the sales aspect want to draw some suggestions on a generic level of process improvements.

• Discuss process not people. "Go after process, not people" - is the recipe from Dr. Gawande. M&M appears as a people-less processes. A good M&M discussion has lost of passive words implicitly accentuating on the process part of the problem, not the human part. I think a fear of a personal attack and reluctance to defend oneself in such a case makes debriefing projects unwanted practices in our world. In a recently performed debriefing  by my group one of the leads of the analyzed team complained that the report wasn't balanced. He wanted the areas needed additional development were accompanied by  accomplishments of the team. He missed the point (and I doubt I succeeded to come across with all my attempts) that the mission of the debriefing is in finding what to improve in the processes and not what to reward. For the latter it should be another discussion, probably internal. Also I think that we shouldn't forget the people part of the problems and its addressing should be, apparently, done internally as well.
• Make it a permanent practice. Almost every hospital holds M&M weekly. Although we don't have the highest criticality in our projects and engagements as the hospitals do, it may be a good idea to perform debriefing sessions periodically. Making the process a known place/time for critique and improvement suggestions is an important part of the team structure. Making this practice occur periodically with results focused on the areas required improvements will diminish the reluctance I referenced before.
• Build outcomes - find problems. M&M goes to discourage both attitudes - self-doubt and denial. But if surgeons can't afford being self-doubt for our industry, I believe, it's a healthy situation. When at M&M a chairman asks what the doctor, reporting the case, would do differently "nothing" is "seldom acceptable answer". Surgeons must have a "correct" view of mistakes - recognize them and come up with a solution. For our industry I think only the denial is the foe to relentlessly attack. Neither can we always come with suggestions on how to fix a problem or make things differently next time. But problem recognition is not a less crucial part of the solution. To discuss and identify problems openly is 50% of their solutions.

I'm in the middle of the book and really enjoying it. Maybe I'll find other things we can adopt from the surgeons. Dr. Gawande tells how his profession borrowed practices from aviation and engineering to minimize mistakes. Thrilling examples in the book of how new ideas helped to reduce fatal errors in medicine excite and encourage us to look at other industries in our turn and maybe to adopt something too. If not to safe somebody's life but simply to make our code better.

Technorati tags: improvement, debriefing

Comments

[Longevity Science]

Thank you for your interesting post!
I thought perhaps you may find this related post about new article by Atul Gawande interesting to you:
Longevity Science: The Way We Age
http://longevity-science.blogspot.com/2007/04/way-we-age.html