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Writer's pictureStephen Harden

How to Remove 6000 Defects from Your Processes

Updated: Oct 22




A study of the effectiveness of debriefing revealed that in 44 months of use, the debriefing process identified 6202 defects in processes of care (e.g., issues with instrumentation, radiology, laboratory, supply, communication/safety, etc.).


Wouldn't it be awesome if you had a system in your hospital or clinic to identify and fix this number of defects? Think how much better you'd be with 6000 fewer process defects!


This study, among several others, showed that debriefings are a practical and successful means of identifying and fixing clinical and operational errors in healthcare. The value of a debriefing after any procedure, episode of care, case, event, or work day cannot be underestimated. Debriefing has been linked to improved performance in various medical and surgical fields, including improvements in specific procedures, teamwork, error identification, improved communication, and professionalism.


Based on my experiences as a fighter pilot, competitive shooter, commercial airline Captain, FAA-certified flight examiner and instructor, firearms instructor, healthcare simulation scenario developer, TeamSTEPPS facilitator, private pilot of high-performance airplanes, and coach for healthcare leaders, I'd say that effective debriefing is the turbocharger for performance improvement in all high-stress, high-skill professions.


This may be why all elite organizations like the Navy SEALS, TOPGUN, the Blue Angels, the Thunderbirds, the Army's Delta Force & Green Berets, and Marine Force Recon have embedded debriefing into every aspect of their operations. They've found debriefing essential for continuous improvement and mission success.


Debriefing allows teams to analyze every action, decision, and outcome in a structured way, identifying strengths and areas for improvement. By openly discussing what went well and what didn’t, these units can adjust tactics, improve communication, and refine their skills to enhance future performance. The debrief process ensures accountability, fosters a culture of learning, and ultimately sharpens the operational effectiveness of these high-performance teams.


However, to achieve this level of effectiveness, debriefing MUST follow these three rules and be accomplished...


  1. Consistently - after every procedure, even when things go well. Otherwise, debriefings will become associated with poor outcomes or bad behavior. If you don't debrief when things go well, you won't debrief when things go poorly.

  2. As soon after a procedure as possible and with all team members involved - including the surgeon. If not, memories fade quickly and you'll make changes based on inaccurate lessons learned.

  3. For the express purpose of identifying and fixing systemic issues. Staff must be updated on the progress of remedying the problems. If you won't fix issues identified in debriefings, don't waste time implementing a debriefing system.


Debriefing can be a powerful tool in creating team unity and awareness, as well as reducing errors, which in turn lead to a more enjoyable working environment for medical personnel and a safer operative experience for the patient.


In my 24 years of experience helping hospitals improve patient safety, and 42 years as a professional pilot, I've come to believe that a debriefing system is THE MOST POWERFUL TOOL available to create a culture of safety - but it is also the most difficult tool to implement well. Making the effort to implement it is worth the difficulty, but only if you are willing to adhere to the three rules above.

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