When corporate failures occur (costly errors, accidents and mistakes), it is common for people to indulge in a frenzy of blame.

Those closest to the problem may be formally reprimanded and may even lose their job.  Much is made of this in the media as if it is “the answer to the problem.” Given that many corporate failures actually do involve operator error, it’s easy to see why some people just blame the operators. But is it good enough to stop there?

Corporate failures can be costly in terms of loss of revenue, loss of reputation and tragically, loss of life.  Many could have been avoided had the right strategies been in place.

Looking beyond human error

The big question is whether senior leaders look beyond the human face of failures, mistakes and errors and examine the culture of the organisation and how it is impacting on operations.  Why did the operator make the error? What is it about the internal workings of the organisation that led to the problem? Is there anything about the organisational structure and the way it does business that contributed to the outcome?

Using Root Cause Analysis to identify real causes

Root Cause Analysis (RCA) is a structured process whereby a group of people who know about the issue or problem come together to discuss it’s root causes.  RCA assists to identify the real reasons behind problems, errors and non-compliance issues.  Whilst the group might start by discussing the human involvement in the problem, the analysis goes deeper to ask “why” the operator acted as they did. The answer to this question usually triggers analysis of systems issues, procedural issues and the culture of the organisation. Conversations at this level are about the organisation itself, rather than individual operators and it is engaging in the RCA process that helps people to move away from just blaming operators as their only response.

Reports that focus on fixing the issue are not enough.  Organisations need to clearly identify the reasons for problems so that comprehensive remedial and preventative action can be put in place. The RCA process helps to shine a light on the real causes of the problem so that they can be rectified for good.

In addition to helping organisations to get to the bottom of problems, RCA has a wonderful side benefit, in that it provides an opportunity for the team to collaborate in the context of problem solving.

10 warning signs of preventable problems

“So, what are the warning signs that preventable problems are on the corporate horizon?”

They include:-

1.    Pre-occupation with growth at the expense of systems and procedures
2.    Remuneration structures that compromise health or safety
3.    Demonstrated failure to learn from previous mistakes
4.    A culture that prioritises production (or sales) over safety
5.    Poor internal communications (as evidenced by misunderstandings, poor morale, workplace conflict)
6.    A lack of attention to training (including insufficient or non existent training budget)
7.    A focus on the symptoms of the problem (and quick fixes) rather than the underlying root causes
8.    Non existence of a fatigue prevention policy (particularly relevant for hospitals, mining, manufacturing to name a few)
9.    Inadequate staffing (often driven by cost cutting)
10.    Budget priorities that work against risk reduction

Organisations that ignore these warning signs may find themselves dealing with the consequences of preventable problems.

Simple changes can reduce risk

Organisations can make simple changes to reduce risks and bring about improvements. The cost of implementing them is generally far less than the cost of the consequences if ignored.

Some suggestions include:-

1.    Be sensitive to the workloads of frontline staff
2.    Devote sufficient resources to ensuring risks are properly managed
3.    Ask “why “ the operators acted as they did
4.    Treat compliance as more than a “tick the box” exercise
5.    Establish a culture which encourages learning from mistakes and errors
6.    Use root cause analysis to understand the root causes of organisational failure and to prevent them from occurring


Analysing previous errors and mistakes is one of the most effective ways of preventing things from going wrong in the future. RCA is a proven and effective process for identifying the underlying causes of issues and stopping them reoccurring.