Practicev1

Error post-mortem protocol: run a five-why analysis

Error post-mortem protocol: run a five-why analysis documenting what happened, expected, deviation point, enabling condition, and structural prevention

Why This Is a Practice

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Source Lessons

L-0481

All systems produce errors

No process works perfectly every time — error correction must be built in from the start.

Connections

Specializes (1)

AxiomMost organizational outcomes are products of system design,

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