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This chapter is from the book

Mental Preparation, Patterns, and Warning Signs

Many of the accidents or disasters described in this book and the mistake chains that caused them ended badly and were unusual because they had not been previously experienced in exactly the same form. Similar mistake chains may have occurred, but organizations and individuals failed to see the lesson if the learning was not internal and personal. Regardless of the history, though, some organizations and individuals clearly handle unexpected challenges better than others.

In successful cases, we will see that there was some combination of luck and skill, but the most important element in handling the unexpected in business is prior mental preparation. This preparation takes the form of training, orientation, expert consultation, and communication or cultural values for guidance, but it exists in some form. The converse is true with the multiple mistake scenarios that lead to severe damage or disaster. The success factors for others simply do not exist in the unsuccessful organizations, and thus the mistake chains are not broken.

Louis Pasteur reportedly said, "Half of scientific discovery is by chance, but chance favors the prepared mind." The power of multiple mistakes is strong, but it can be managed with preparation.

  • Insight #1: Mental preparation is critical because organizations and individuals are rarely good at learning by drawing parallels. They need to be taught to recognize types and patterns of mistakes and learn to extrapolate implications from other situations into their own.

In subsequent chapters, we will examine what constitutes a mistake and how in some circumstances, particularly around company strategy, it may take a long time to understand that a mistake chain is underway. We will see that managers and employees at all levels can have an impact on monitoring and understanding mistakes. Additionally, the initiative and bias for action of individuals who may not even have formal responsibility in an area is often the difference between success and failure in avoiding or minimizing damage. We will also contrast some of the most visible mistakes that companies and organizations have made with the often less visible efforts of excellent companies that never seem to find themselves in much difficulty.

Our exploration of mistakes, both in business and nonbusiness settings across industries, reveals patterns that are so repetitive that every manager should recognize them as potential red flags. All of these are behaviors or actions that each of us has encountered or observed at some point in our careers, but they continue to be catalysts for events that inflict serious damage in the form of reputation, money, management time, and other resources. Look for the following things as you read the examples we will describe, and begin to ask yourself if these catalysts are already at work in your organization:

  • Failure to believe information that you do not like

  • Failure to evaluate assumptions

  • Success that breeds arrogance and adversely affects decision-making

  • Frequent communications absence, failure, or misunderstanding (internal and external, including customers)

  • Failure to have and/or follow standard procedures

  • Cultures that suppress initiative, information, or action

  • Lack of understanding and respect for the laws of economics and cycles

  • Failure to evaluate past mistakes and learn from them

These patterns are more common that we might believe, but an instance or two of one or two items from this list is rarely fatal. The interesting thing is how these same things come together in ways that create damaging disasters for those who do not pay enough attention to "break the chain of mistakes."

There are warning signs that presage many of these typical mistake patterns. The following list of "red flags" will reveal themselves in the incidents we discuss throughout the book. In most cases, if the warnings had been observed and acted upon, there would have been significant economic value added in breaking or avoiding a mistake chain or sequence that led to significant economic and/or physical damage. As you read the stories in subsequent chapters, look for these warning signs as indicators and ask yourself if the same ones apply in your business:

  • Situations you have not seen before

  • Operating experience different than your competitors

  • Unusual or rapidly changing data (about operations or customers)

  • Results off plan

  • Results on plan through luck

  • Constant revision of plan/budget

  • Failures of control systems

  • Need to retrain significant numbers of personnel because they are not performing

  • Frequent operational problems that are not addressed by standard procedures

  • Problems caused by communications issues

  • Problems where help was available but not utilized

The occurrence of an item from this list does not in itself mean that you are about to have a disaster. But these are warning signs that further investigation may be required to ensure that you are not already in the process of starting a series of mistakes that will create a disaster for your business.

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