Tag: Mistake-Proofing

Mistake-Proofing, Learning from Errors, and Safer Systems

Mistake-proofing is not about blaming people or demanding perfection. It’s about designing systems that make errors less likely and make problems visible when they occur. This archive explores mistake-proofing as a leadership and system responsibility—across healthcare, aviation, manufacturing, and everyday work.

Through real-world examples, these posts show why signs, reminders, and “be careful” messages fail—and how better process design, learning, and respect for people lead to safer, more reliable outcomes.

Warning: Signs! Mistake-Proofing Is More Effective Than Warnings

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At the 2024 KaiNexicon (the KaiNexus user conference), I gave a talk called "Warning: Signs! From Cautionary Commands to Proactive Prevention" -- a tour...

Delta’s $70,000 Slide Mistake Shows Why “Human Error” Is Really a...

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TL;DR: Emergency slide deployments happen far too often to be dismissed as "human error." When a mistake repeats at scale, it's a system design...

My Upcoming Webinar on Mistake-Proofing Across Industries

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I'm excited to be presenting this webinar on February 12th at 1 pm ET as part of the KaiNexus Continuous Improvement webinar series: Mistake-Proofing in...

Karen Martin on the Power of Mistake Proofing in Lean Management

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Karen Martin and Mark Graban discuss mistake proofing in lean management, why "zero harm" is a meaningful aspiration, and how building quality at the...

Mistake vs Error: Is There Really a Difference? (And Why Leaders...

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What's the difference between a mistake and an error? When people search "mistake vs error," they're usually asking whether the two words mean different things...

Mistake-Proofing That Builds Learning: A New Course on Preventing Errors Without...

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Over the years, I've seen how often organizations respond to mistakes with blame, punishment, or superficial fixes--rather than learning and prevention. That's why I...

What Kura Sushi Teaches About Mistake-Proofing (Poka-Yoke)

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TL;DR: A simple lunch at Kura Revolving Sushi reveals how good design quietly prevents mistakes without blaming customers or staff. It's a reminder that...

Apple and I Made a Similar Mistake: 24 or 2024?

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The other day, I was presenting at a company about "Psychological Safety as a Pre-Condition for Continuous Improvement." It was a hybrid event and...

Why a Sign Works Better Than an Email: A Condo Trash...

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TL;DR: Emails and warning signs rely on memory and attention. Point-of-use reminders--and better yet, mistake-proofed systems--are far more effective at preventing errors, as a...

Ryan McCormack’s Operational Excellence Mixtape: March 8, 2024

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Thanks as always to Ryan McCormack for this... there's always so much good reading, listening, and viewing shared here by him! Subscribe to get...

Signs Are Not Mistake-Proofing: Hospital Hallways Edition

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As I posted recently on LinkedIn, here are some photos and a story from years ago. Signs are not mistake-proofing. Signs are not adequate process...

The Boeing 737 MAX Problem Isn’t “Idiots”–It’s Systems, Culture, and Preventable...

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tl;dr: The Boeing 737 MAX incident wasn't caused by careless workers. It was the predictable result of weak systems, rushed production, poor mistake-proofing, and...
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