All tagged mistakes

Systems thinking guides us to step back and look at the system. What created the environment in which the error occurred? Even beyond “errors”, what makes the system operate in some way that we find objectionable? What is the system that we are describing? What do we WANT from the system? Then we can dive in and look for understanding behind what is creating the undesirable results. It is incredibly rare that the root cause can be placed at the foot of an individual. It’s the system.