What the history of open heart surgery can teach us about leading organizational change.

SparkNotes Version:

Make failure an option:  Being open to failure is the baseline attribute for successful organizational change. Knowing that failure along the change journey will happen is a simple mindset shift that can allow individuals to try new ways of working, take risks, and quickly learn as part of the change journey.     

Speak openly and proactively: Research suggests that the teams that learn the fastest are the teams that communicate the most transparently. During change projects, lead differently, by making sure that all people feel included that they can speak openly and share, regardless if it is “good news” or “bad news”.

Make the journey about learning: There is an old cliche, that goes “It’s not about the destination, it’s about the journey.” Work to see the learning journey as the value, not the end state. 

Institute reflective conversations: The breakneck speed of our quarter over quarter pressure doesn't allow us the time to reflect. For organizational change to be effective, you need to institute time to reflect. This simple, but hard discipline, can dramatically help you learn from the mistakes and failures along the change journey.  

Full Length Version:

Have you ever taken the time to reflect on how doctors learned to perform open heart surgery?  Today over 2 million open heart surgeries are performed a year, with less than a 2% chance of failure.  Those are pretty good odds.  But it hasn’t always been that way.

In the 1950s there was an endeavor to successfully operate on the heart of a living, breathing patient.  Pioneering surgeons across the United States took on the heavy responsibility of charting out the path of how to complete successful open heart surgery with little to no map.   The challenges that needed to be overcome were many.  The main challenges though were one, controlling the amount of blood that would be lost during a surgery- as the main function of the heart is to pump blood.  The second challenge was suturing tissue that was moving- as it is hard enough to do this on still tissue.  As you would imagine lives were lost during this experimental time.   These lives were not lost in vain however, as it was paramount that learnings from mistakes be applied to the next patient.  Experiments that have life or death consequences are extremely hard for us to consider.  But to keep advancing, they need to happen.  (To learn more about this heroic endeavor, and how to fail well, I recommend reading, Right Kind of Wrong by Amy Edmonson).

By definition organizational change is entering into uncharted territory, as change is often the result of a decision that is in the direction of progress.  The funny thing about progress is that failure is an unavoidable part of it.  The two go hand and hand, we can’t have progress without failure.  In reality, we actually learn more from our mistakes than from our successes.

When we embark on organizational change in the direction of progress, we tend to feel a sense of stress, that we can’t ‘get it wrong’.  Often it is our natural aversion to failure that restricts us from successfully changing.  The learning from the history of open heart surgery can provide a few powerful lessons that we can work to adopt and apply to how we successfully lead organizational change.  Remember when you are leading organizational change, you are not “saving lives”. 

Make failure an option.  We all have a natural aversion to failure.  This is a complex combination of our biological evolution and societal conditioning.  But if we can reframe failure for ourselves, we can use it as a catalyst for change.  Being open to failure is the baseline attribute for successful organizational change.  In the example about the discovery of open heart surgery, the doctors and staff were starkly aware that failure was an option.  The risk of failure was a matter of life or death in this example, even with such dire consequences of failure, it was still made clear that the potential for failure was an option.  Knowing that failure along the change journey will happen is a simple mindset shift that can allow individuals to try new ways of working, take risks, and quickly learn as part of the change journey.     

Speak openly and proactively.  Research suggests that the teams that learn the fastest are the teams that communicate the most transparently.  Often we fear communicating openly and proactively, as we are led to believe if we don’t have “good news” we will be punished for it.  Reward people for sharing “bad news” and work to quickly learn and adjust from the information.  With the open heart surgery example, doctors realized that they needed to lead differently, by making sure that everyone in the operating room felt compelled and responsible to speak openly and proactively.  During change projects, lead differently, by making sure that all people feel included that they can speak openly and share, regardless if it is “good news” or “bad news”.  Further, work to  keep a failure log and publish it regularly, so team members begin to see that proactive communication, regardless of the message, is normal and rewarded.

Make the journey about learning.   There is an old cliche, that goes “It’s not about the destination, it’s about the journey.”  This couldn’t be more true than in times of change and transformation.  Work to see the learning journey as the value, not the end state.  In the open heart surgery example, the surgeons made it known that the team's input was a critical component of the learning journey.  This open door request, that team members share their input as part of the learning is critical for learning to take place.  The learning that happens along the journey is where the real value exists.  It is not the ‘top of the hill’ that matters, it is the person or organization we become to get to the ‘top of the hill’ that matters.  Therefore learning is the value in the journey.

Institute reflective conversations.  In our organizations we are often moving at mach speeds.  Focused on monthly results, quarterly results, and yearly results.  The breakneck speed of our quarter over quarter pressure doesn't allow us the time to reflect. In our open heart surgery example, doctors and staff become very good at openly reflecting in the moment of what was working and what was not, adjusting accordingly.   Similarly, for organizational change to be effective, you need to institute time to reflect.  One way to do this is to dedicate time in meetings to reflect on the current status of what is working, versus what is not working.  Additionally, look to incorporate a process around After Action Reviews (AARs) or Post-Mortem Celebrations to operationalize the time and energy of reflecting on what we learned and how it can be applied going forward.  This simple, but hard discipline, can dramatically help you learn from the mistakes and failures along the change journey.