Friday, 5 April 2013

Avoiding mistakes in procurement

Horizon had an excellent programme on 27 March, 'How to Avoid Mistakes in Surgery', which I think had some useful lessons for procurement. Dr Kevin Fong explored how 'no room for error' firefighters, aircraft pilots and F1 motor racing pit-stop teams have developed tools which minimise the risk of getting it wrong.

The primary problem appeared be that those in operating theatres could lose 'situational awareness'. This is an acknowledgement that our brains lack the capacity to focus on more than one issue at a time and having such a singular focus blinds us to other key factors. Like me, I am sure you are aware of situations when you have been so focussed on the problem in hand that when you reflected later. you said to yourself, "if only I'd spotted that". However, recognising that risk enables us to develop strategies to cope. 

The adoption of one tool has reduced deaths and complications in surgery by >35%. That tool is now used in every operating theatre throughout the UK and has been found to provide benefits beyond avoiding mistakes, for example, the tool has acted as an 'equaliser of rank' avoiding 'errors of dictatorship' and overcoming the fear of speaking out by those perceived as more junior. The tool has also helped develop a more collaborative approach. I think we can all recognise procurement situations when such a tool would have been beneficial, if for no other than quality assurance. Well that tool is available - it is the use of checklists.

The programme also acknowledged that, the more people involved in an operation the more likely it was for mistakes to happen. As procurement becomes more involved in cross-fucntional teams, inter-organsational collaborations and outsourcing there are many involved in decision-making and many 'hand-overs' of information. Ensuring one person is in charge and jobs are broken down so that everyone has a simple but effective role is reducing mistakes in surgery, as it should in procurement.

But crises happen and in a crisis there isn't necessarily time to think. I can recall recently being asked to step into a procurement of £600k and within minutes make a strategic decision as to the way forward - I am sure you have similar horror stories. The programme identified that in aircraft emergencies catastrophes have been avoided in minutes as a result of standardising protocols as much as possible and making them 'second nature' so that improvisation is only required when it is absolutely necessary.

But mistakes do happen and things go wrong beyond the big procurement fiascos we tend to focus on. The programme stressed the need to avoid 'witch-hunts' and instead be positive about errors, analysing them, learning what went wrong and then taking corrective action for the avoidance of future failures.

You will have a few days to watch the programme on iPlayer but here's my summary for avoiding procurement mistakes:
  1. Retain situational awareness; 
  2. Use checklists;
  3. Be clear who is in charge;
  4. Ensure every one has a simple but effective role;
  5. Standardise until you absolutely have to improvise;
  6. Be positive about errors so that you can correct for the future.

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