The Cost of "Human Error": Why Blame Hinders Progress

The instinct to point fingers and assign blame when things go wrong is deeply ingrained in human nature. In the workplace, this often manifests as attributing accidents and incidents to "human error." However, as Sam Goodman aptly puts it, "Citing human error as the cause of an event is like reading the first sentence on the first page of a book and pretending that you know the rest of the story. There is so much more interesting and useful information beyond the opening sentence."

The tendency to stop at "human error" is not only intellectually lazy but also incredibly costly for organizations. It wastes valuable time and resources, and, most importantly, it severely limits our ability to learn and improve.

The Illusion of Simplicity

When we attribute an incident to human error, we create an illusion of simplicity. We identify a culprit or villain – the person who "messed up" – we punish them severely and believe we've solved the problem. The reality, however, is far more complex. As Sam points out in his bestselling "10 Ideas" book, "The thing about error – and the events occurring after an error – is that they are unexpected outcomes. Everything makes perfect sense, everything seems to be going according to plan, work seems to be going well, until suddenly it’s not."

The focus on human error often leads to a superficial understanding of the incident. We fail to explore the underlying factors that contributed to the event beyond the obvious and surface-level finding of "someone messed up."

The Trap of Outcome Obsession

The traditional safety paradigm, with its relentless focus on preventing negative outcomes, often traps organizations in a reactive cycle. The obsession with lagging indicators, such as injury rates, can lead to a very narrow view of safety, where success is measured solely by the absence of accidents. However, this approach neglects the vast majority of work that goes right every day.

Sam advocates for a shift towards actively seeking to learn from everyday work, both successful and unsuccessful. By understanding how work normally happens, we can identify potential vulnerabilities and proactively implement measures to strengthen the system.

In essence, outgrowing our obsession with outcomes requires a shift in mindset. It's about recognizing that safety is not just about preventing accidents but also about fostering a culture of continuous learning and improvement. By embracing the lessons hidden within everyday work, we can create a safer, more resilient, and ultimately more successful organization.

The Blame Game

The blame game is a toxic cycle that breeds fear and discourages open communication. When employees are afraid of being blamed for errors, they are less likely to report near misses or share valuable insights about potential hazards. This creates a culture of silence, where problems fester and grow.

Furthermore, the pursuit of blame consumes valuable time and resources that could be better spent on learning and improving. Investigations become witch hunts, focused on finding a scapegoat rather than understanding the complex interplay of factors that led to the incident.

The Path to Learning and Improvement

To break free from the blame game and create a culture of learning and improvement, we must shift our focus from individuals to systems. As Sam emphasizes, "Instead of viewing ‘human error’ as causal of unwanted outcomes, we should seek to understand why the same behavior – behavior only viewed as an ‘error’ after an unwanted outcome – typically makes things go right and occasionally makes things go wrong."

This requires a commitment to understanding the context in which errors occur. By exploring the factors that influence human behavior we can identify opportunities to improve systems and processes, making it easier for people to do their jobs safely and effectively.

Embracing Humanity

Ultimately, embracing a human-centered approach to safety means recognizing that errors are an inevitable part of the human experience. By shifting our focus from blame to understanding, we can create a workplace where people feel safe to report errors, share their experiences, and contribute to a culture of continuous improvement.

As Sam reminds us, "The only choice in human error is the choosing of how we view it." Let's choose to view errors as opportunities for learning and growth, rather than as reasons for blame and punishment. By doing so, we can create a safer, more resilient, and more humane workplace for everyone.