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What Leaders Can Learn From The Failure Of Healthcare.gov

Tue, 12/10/2013 - 9:51am
Amy Emondson

It’s lonely at the top. The buck stops here. I take full responsibility.

Noble sentiments. But the idea that one person, at the top, or elsewhere in an organization, is solely to blame for a complex failure in novel territory is as unhelpful as it is limited. In fact, the blame game is less useful today than ever before. Consider Healthcare.gov.

The idea that a project as complex, new, and large as the Healthcare.gov website would work smoothly right off the bat, or that one or two people are to blame now that it hasn’t, or that once we identify the bad guys we can all have easy access to affordable health care is simple, elegant, and wrong.

Post-failure damage control: The credibility gap

No matter how you slice it, it’s clear the White House won’t meet the projected enrollment of 464,920 in the first month. In a recent New York Times article, Sheryl Gay Stolberg and Susanne Craig cited numbers released by the Centers for Medicare and Medicaid Services on the botched Healthcare.gov rollout: 26,794 have chosen their health plans using Healthcare.gov, while 76,319 signed up through 14 state-run marketplaces.

In the same article, Dan Mendelson, policy advisor to President Clinton, referred to the cultural fallout from the failure as a “negative communications climate.” It’s not just about technology, Mendelson stressed, broken trust and lapsed credibility are now part of the mix preventing effective implementation of the Affordable Health Care Act.

Recently, James Furbush reflected on the Healthcare.gov fiasco and provided excellent take-away, post-failure lessons for leaders of health care organizations: Admit failure, course correct, insist on transparency, create a solution with speed and agility, manage and meet expectations, and stay ahead of the curve.

But, fixing a culture that relies on the blame game in lieu of real solutions is a much thornier problem than fixing a broken website. As one member of the Healthcare.gov program put it earlier this week, “literally everyone involved was at fault.”

Managers in most of the enterprises I’ve studied over the past 20 years — in pharmaceutical, financial, telecommunications and construction companies, to name a few — genuinely wanted to help their organizations learn from failures to improve future performance. In some cases they, and their teams, had devoted many hours to “after action reviews,” “postmortems,” and the like.

However, merely conducting after-action reviews doesn’t preclude falling into the same old patterns: fail, reflect, blame, take responsibility, eat crow, run the bad guys out of town, promise to avoid similar mistakes in the future, review, report, distribute.

Worse, too often, the lessons learned are superficial (“procedures weren’t followed”) or self-serving (“The market wasn’t ready for our brilliant product.”) And, the fundamental belief that failure is avoidable doesn’t change. The role of failure in innovation isn’t acknowledged and celebrated.

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