13 Apr Failure to Rescue
Emma is very interested in TV shows that feature baking competitions. Last Saturday, we watched a new show that combines the talents of engineers and bakers. In pairs, the competitors had several hours to make a boat out of cake that could motor 20 feet in the water while still looking beautiful (and tasting good). As the teams discussed their plans and designs, many noted the ways they were attempting to prevent things from going wrong –adding extra layers of chocolate to waterproof the cake or melting gummy bears to create a sticky substance to seal cracks.
With less than an hour to go, tensions were high as each team took their near-final creations to the testing area to see how their designs were working. With information from their test run and running into minor issues, some pairs decided to stay the course and hope for the best. Fewer contestants saw the beginnings of problems, admitted it wasn’t going as well as they hoped and reworked their designs by adding extra buoyancy or making the mast less heavy.
The buzzer sounded, and it was time for the contestants to put their creations in the water. Of the nine teams, only two boats successfully traveled the 20 feet. What separated the winners from the losers was that the winning teams were the ones who, at the sign of something amiss during the test run, had taken steps to prevent an issue from becoming a disaster.
It reminded me of Atul Gawande’s research on what separates hospitals with excellent patient outcomes from mediocre hospitals. Scientists call deaths that occur in surgery after something goes wrong “failure to rescue.” What the top performing hospitals do differently is that they are excellent at rescuing people when there are complications. They don’t fail less. They rescue more.
It’s great to do as much as possible to control and minimize risks – having medical teams go through a checklist, for example, to make sure they are clear on whether it’s the right or left leg to amputate – but the very best surgeons are the ones who can, in the moment complications arise, prevent a complication from becoming a catastrophe. The sooner they can see that something is not going well, admit that things have gone awry and acknowledge they need a new plan, the better.
Risk is necessary in trying new things and initiating changes of any kind. Things won’t always go right in everything we try. A dragon head crafted out of fondant-covered cake may nose-dive into the water despite all of the advance calculations. The person making a change in their life may get off track, perhaps returning to substance use after a period of change. We have better chances of success when we are prepared for the likelihood of bumps, when we can admit things aren’t going according to plan, and when we respond in a helpful way to get back on track.
Because it’s not just about falling down less – that part is inevitable. It’s about getting back up – what we do next.