Tips for leaders - When things go wrong

Tips for leaders - when things go wrong, and harm occurs

Despite best intentions and careful planning – things go wrong from time to time. Mistakes, miscommunications and misinterpretations happen, systems can fail or circumstances conspire. There’s a reason why “To err is human…” is such a well-used phrase.

Your organisation will have formal processes for when patient or staff harm occurs (e.g. a patient safety or experience event, staff injury), generally focussed on addressing the harm, understanding the causes and reducing the risk of future harm.

In a team setting, when harm occurs, there can be an impact not only on the individuals directly involved, but on the team as a whole.

How can we support our team to recover from a harm event? This may require working to restore confidence and dignity, repair relationships, and restore trust or a sense of safety.

What does everyone think happened?

If there is a formal process of review, then the ‘facts’ will be captured within that, but it will often be a confidential process that is not visible to the team.

Learning what people in the team think happened can help unearth rumours, myths or exaggerations that might be in play. This can also help identify assumptions or biases.

Different people may have different pieces of the picture. Identifying different perspectives and views can help build a shared narrative, that will help the event to become part of the story and then integrated into the history of the team.

Who has been affected?

In addition to impacts on the people directly involved, there can be a range of impacts that are less direct.

How are the people involved, viewed by colleagues? Have they lost mana?

In some cases, a team may become split in views about what happened and who is “to blame”.

Identifying and addressing this dynamic will be really important for the functioning of the team.

What can be done to make things right?

Affirm dignity.

It is essential that you as the leader use language respectful to all involved and that you resist any urge to speculate or hypothesise. As always, you role model the culture of the team.

If you feel it is appropriate to have a team discussion about the event. Speak to those involved prior to the discussion as to what they might need or whether they would prefer not to be present.

Think about the professional and cultural dynamics that might be important to maintain dignity for those involved.

Hear and acknowledge how people are feeling.

Remember, feelings are not facts or evidence – but they are powerful in driving people’s perceptions.

Ask people how they feel about what has happened. The same event will affect each person differently, what may be a minor event for one person may have a major impact on another.

Invite questions and ensure all have accurate information (as much as is appropriate).

This helps build trust and quash rumours or myths. Within privacy parameters, you may well be able to clarify and provide information that helps the team develop their understanding of the event.

Highlight safety.

The event itself may have made people feel unsafe in some way. If so, what has been done to increase safety? Communicate this to the team to address any safety concerns they may have.

Has the event made people feel vulnerable to making the same mistake? Is there an impact on people’s efficiency, due to increased checking behaviours and vigilance? Are people avoiding certain tasks or activities?

Also important for future safety, is to ensure the team have confidence in the process that follows a harm event. Will the team have observed a punitive/blame response and therefore be reluctant to speak up or admit mistakes in future? Or will they have seen a process that is supportive and fair?

Create opportunities to put right/restore and rebalance.

The team as a whole may need a little extra TLC in the wake of this event. It can be useful to start by asking them what would be helpful – for them individually and for the team. Recognising that harm events can be distressing and draining and acknowledging that they may experience impacts, helps to de-stigmatise and to support all involved.

What can be learned for the future?

Again, the formal process for your organisation may well have this as a key focus, but if appropriate this can also be a useful debriefing conversation to have with the team once the situation is resolved.

Focus this conversation around how we as a team might help and support each other to reduce the likelihood of future events. It can also be valuable to identify what has been helpful to individuals in the team, following the event.