Applying Lessons from Columbia and Challenger

January 28th, 1986 – Space Shuttle Challenger broke apart a little over a minute into flight.i 

 

February 1st, 2003 – Space Shuttle Columbia disintegrated during re-entry into the atmosphere.ii 

 

A total of 14 astronauts died as a result of these tragedies.
Many of you are asking yourselves, “What could possibly be the connection between these two national tragedies and my office’s performance?”  We will get to that a little later in this blog post.

 

Here is a quick synopsis of the mechanical causes of these failures:
During liftoff, an O-ring seal in one of Challenger’s solid rocket boosters failed and hot gasses burned a structural support and caused the booster to veer into the large external tank.  This led to a chain of events culminating with extreme aerodynamic forces breaking apart the shuttle.

 

During liftoff, a briefcase-sized chunk of insulation broke free from the external tank and hit the fragile leading edge of Columbia’s left wing.  This went unnoticed for the entire length of the mission.  When the extremely hot plasma of re-entry melted the internal structure of the wing, the shuttle experienced aerodynamic instability and the orbiter broke apart.  All 7 astronauts perished.

 

The root cause of these failures was an Organizational Breakdown within NASA.  A sociologist, Diane Vaughan, describes this breakdown as a “normalization of deviance”.iii  She defines this as an unsafe practice comes to be considered normal if it doesn’t immediately cause a catastrophic event.
Again, you’re asking yourselves, “Why is this relevant?”  Normalization of deviance is present in every phase of every one of our lives; family, social clubs, government – usually to a much less catastrophic level.  However; without exception all office cultures experience this on a regular basis.
My goal in writing this is to help us all notice when anomalies occur within our office cultures and speak up about them.  We often refer to these anomalies as “exceptions”.  Some basic exceptions may be; “He always does it his way, so we just let him do it”, “She seems to work on her own schedule”, “He never seems to come to important internal meetings – he must be busy”, “We don’t need the complete 800 series of drawings, we will let the contractor figure it out”.   When we see any sign that a deviation is causing a negative effect on our projects or office culture, we need to be confident enough to bring it to the attention of those it affects.

 

A robust office culture will always benefit from a keen understanding that we, as humans, have a natural tendency to allow a “normalization of deviance”.  And with this understanding we can choose to reduce the anomalies and improve the quality of our service as well as our deliverables.
We have just scratched the surface on this topic.  We’re looking forward to the interchanges during our  “Culture” discussions at the 2019 BUiLT Design Technology Summit in Seattle.

 

ihttps://en.wikipedia.org/wiki/Space_Shuttle_Challenger_disaster
ii https://en.wikipedia.org/wiki/Space_Shuttle_Columbia_disaster
iii https://en.wikipedia.org/wiki/Diane_Vaughan

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