Stupidity, error and learning

Quebec’s health and social services system has been undergoing one reform after another for 50 years, without any real improvement in the care experience for users. For their part, the employees and managers of this system are constantly under intense pressure and often express a certain degree of distress in carrying out their work. Is Quebec doomed to implement, undo, and then reimplement reforms, without any obvious positive results? Of course not. However, this legitimate hope comes with a requirement: to create a true culture of learning within the health and social services system, where everyone—whether an employee, manager, or decision-maker—learns from the challenges they face on a daily basis. For such a culture of learning to emerge, it is essential to address two deeply rooted issues in health and social services: the presence of organizational processes that consistently breed stupidity, and the negative effects of this organizational stupidity, which, once entrenched, leads to a large number of errors.

Drawing on numerous examples from the two authors’ extensive experience, the first part of the book conceptualizes organizational stupidity and analyzes its effects on Quebec’s health and social services system. While stupidity must unquestionably be eradicated due to its harmful effects on the quality of care and services, the second part of the book addresses the topic of error, demonstrating how it can serve as a useful stepping stone toward a positive culture of learning. Finally, once freed from these two unquestioned assumptions, the most useful learning strategies are presented in the book’s final part.