Zero Zeros

“Zero Mistakes” is not a realistic target.

Let’s imagine that you’re a heart surgeon. You have a literal life-or-death job. While obviously you should endeavor to never lose a patient, it’s not only unrealistic to expect that outcome, it’s bad practice to make it an institutional goal.

Sounds crazy, irresponsible, or even offensive? Let’s look closer. The hospital director tells you, the heart surgeon, that even one lost patient is unacceptable. They think that if they say “it’s okay to lose 5-8 patients per year,” then they might as well be signing a death warrant, like they’re giving you permission to screw up – and you’ll definitely do it! So they say that if you lose even one, you’re fired. That way, you’ll absolutely be motivated to make zero mistakes!

What happens in practice? In practice, you only ever agree to perform the safest, lowest-risk surgeries. The more routine ones with no comorbidities. You lose zero patients, but dozens die because they never get surgery at all. Of those dozens, some might have died even if you operated on them, but many of them could have been saved. Since your goal was zero deaths, however, you didn’t take the risk. More people died, but none of them were on you.

The reality is that some risk is necessary in order to do good. Yes, you should be careful with how you assess risk, especially if you’re a heart surgeon. But the answer isn’t to minimize your risk, it’s to seek the optimal level of risk versus progress. And you simply can’t do that with a personal or institutional goal of zero mistakes.

Another problem: If the heart surgeon gets fired after one mistake, imagine a totally random fluke early in the year. A patient having a safe, routine surgery has a random event unrelated to that surgery and dies. Now the heart surgeon gets fired, and even the routine surgeries don’t get performed! As soon as one mistake gets made, in other words, the whole project is scrapped.

On an institutional level, “zero mistake” policies leave no room to correct course. They never have a plan for what to do about mistakes, because mistakes are “illegal” in the first place. So instead of training their surgeon on what to do if a minor mistake happens, they just say “don’t make any.”

Especially in an environment that’s not life-or-death (like 99% of all situations), you should actively be targeting a few mistakes. That lets you know that you’re taking appropriate risks, growing out of your comfort zone, and stretching your effort to its furthest reaches.

The only thing you should have zero of is zero mistake policies.