Part two of the RaDonda Vaught story examines what emerged after the event: investigation details, system design flaws, communication breakdowns, and the tiny timing error that mattered. RaDonda Vaught recounts how normalized overrides, software defaults, and organizational assumptions created conditions for failure. The episode explores the chilling effects of criminalizing mistakes, the human cost across patients and providers, and the case for shifting from blame to system-focused learning and improvement.

In this episode, nurse RaDonda Vaught tells the detailed, context-rich story of a medication error at Vanderbilt that led to criminal charges. She walks through the events, system issues (including a recent EHR rollout and medication-dispensing delays), distractions, and decision points that contributed to the mistake. RaDonda describes how workarounds, unclear documentation in radiology, drug supply changes, and interruptions combined to produce a tragic outcome, and she explains the immediate clinical response. The episode sets up a follow-up discussion about what was learned and how systems can be improved.

Episode: an extended open Q&A from the Pre-Accident Investigation Conference in Santa Fe covering big-picture safety topics.Speakers discuss the limits of traditional metrics, the power of real-time monitoring, shifting focus from managing risk to maintaining control, validating controls in the field, learning teams, contractor relationships, and prioritizing high-information events. Anecdotes and practical guidance illustrate how organizations can learn without blame.

Todd Conklin explores how blame shuts down learning and prevents organizational improvement, arguing that blaming individuals creates a chilling effect that blocks thousands of future learning opportunities.He connects blame to misunderstandings about human error, emphasizes psychological safety, and urges leaders to ask "what failed" before asking "who failed," while sharing personal anecdotes and reflections.

Todd Conklin and Brent Sutton discuss the short-term future of safety thinking—covering the rise and fall of lean/TQM, how commodification can slow innovation, and why fear, FOMO and complacency shape which ideas stick. They explore leaders' responsibility, weak signals, and the need for small 'safe-to-fail' experiments to keep systems resilient.Set in Santa Fe with lighthearted moments (including breakfast burritos and a cheese debate), the episode blends history, practical insight and a call to stay curious about evolving workplace complexity.

Recorded live at Meow Wolf in Santa Fe, this episode features a wide-ranging conversation between Todd and Andy Baker about learning, safety culture, and leadership influence.They dig into HOP and related safety approaches, debate top-down versus middle-out change, discuss the importance of language and unlearning, and explore how to turn belief into practical skill and behavior.The episode offers real-world insights on piloting change, engaging leaders and middle managers, and learning from others who have adapted these ideas in novel ways.

Tiny Todd Conklin joins the No Way Out podcast to explore Human and Organizational Performance (HOP), high-reliability organizing, and how safety emerges from complex systems rather than individual mistakes.They critique traditional investigations, surveys, and risk matrices, and discuss practical ideas for building capacity, worker agency, psychological safety, and resilient operations.

This episode examines the growing problem of children accidentally left in hot cars, explains why memory failures can happen to anyone, and argues that punishment is not the solution.It summarizes practical approaches—accepting the risk, assuming "when, not if," using technology and visual reminders, and responding with understanding rather than judgment—to create system-level changes that improve recoverability and prevent future tragedies.

Todd talks with Lauren Mooney about her book High Reliability in Action and how to translate HRO concepts into practical behaviors. They cover the rise of HRO, the 'Speaking In' approach, nine guiding questions, and the animal avatars that represent attitudes like humility, courage, and curiosity.The episode emphasizes leadership’s role, DIY team practices for recognizing risk, responding early, and adapting effectively across industries—from frontline staff to executives.

This episode of the Pre-Accident Investigation Podcast features patient safety leader Lisa Zegan, host of Tales from the Sharp End, in a candid conversation with Todd about the 2017 Vanderbilt medication error and what it reveals about healthcare systems. They explore why criminalizing mistakes harms learning, how design and billing pressures shape medication cabinets and workflows, the limits of “zero harm,” and the case for recoverability/rescuability, cross-industry learning, and leadership-driven transparency across hospitals.

Join Todd as he delves into a captivating discussion with Tom Krause, founder of Behavioral Science Technology, on the Pre-Accident Investigation Podcast. This episode unravels the evolution of safety protocols from traditional behavioral-based approaches to modern leadership-driven strategies.Krause shares his journey from pioneering behavioral-based safety techniques to exploring the pivotal role leaders play in mitigating catastrophic events. The conversation highlights the significance of leadership decision-making in shaping organizational culture and safety outcomes.Discover how historical safety models have informed current practices and gain insights into the challenges and advancements in the safety domain, all set against the vibrant backdrop of their meeting in Santa Fe. Tune in to uncover these transformative ideas and the evolving landscape of workplace safety.

Welcome to an engaging episode of the Pre-Accident Investigation Podcast with your host Todd Conklin. In this episode, Todd delves into a thought-provoking discussion about the evolving role of AI in our workplaces and lives with guest expert Dox Brown, also known as Drew. Together, they explore the intricacies of artificial intelligence beyond surveillance products, focusing on its positive potential as a strategic partner in understanding and enhancing human tasks. Throughout this conversation, Dox Brown, an enthusiast in AI's educational implications, shares insights into how AI can augment human roles rather than replace them. Discover AI's capability to handle large data analysis, predict patterns, and assist in creative processes, transforming how we interact with technology in our day-to-day routines. This episode challenges common fears by offering a refreshing perspective on AI's role as a tool of kindness and empathy, encouraging a broader dialogue about its place in future workplaces. Tune in for a fascinating journey into how AI may redefine human-oriented work and what it truly means to collaborate with intelligent systems.

Welcome to the latest episode of the Pre-Accident Investigation Podcast, hosted by Todd Conklin. In this engaging discussion, Todd chats with Jennifer Long about their unexpected journey in writing "Workers Are the Solution, Not the Problem: A Guidebook for Leading Differently." The conversation delves into the transformative insights they discovered about leadership, accountability, and how the evolving workforce requires fresh approaches.Throughout the episode, Todd and Jennifer explore how traditional views on leadership and workforce development are outdated, urging leaders to see workers as solutions rather than problems. They share their experiences and learning moments that shifted their paradigms and offer guidance for navigating the chaotic and unpredictable modern business environment.Join Todd and Jennifer as they reflect on their collaborative process and the critical lessons from their book, offering valuable perspectives for leaders aiming to adapt and thrive in today's dynamic world.

Join Todd Conklin in the final episode of the Pre-Extended Investigation Podcast as he hosts an insightful conversation with Shane Bush and Professor David Woods. This concluding episode offers a compelling discussion on the evolution of safety practices across industries, the impact of leadership on organizational sustainability, and the challenges faced by modern safety paradigms.Dive into the nuances of human and organizational learning as Shane and Todd reflect on their decades-long journey, touching upon personal anecdotes and professional insights. Professor Woods contributes his expertise on the complexities of maintaining safety in aviation and beyond, highlighting the essential interplay of technology, human factors, and leadership in high-stakes environments. This episode is a thought-provoking exploration of the past, present, and future of safety and learning—an invaluable listen for anyone interested in organizational excellence.

Join Todd Conklin and Rob Fisher on the Pre-Accident Investigation Podcast as they delve into their experiences and reflections from past podcast episodes, discussing the art of leadership and the significance of effective communication with senior leaders. With anecdotes from previous recordings, they explore the value of predictions made unknowingly and how iteration and experience shape success. Rob shares insights into transitioning from operational roles to a leadership position, focusing on listening and adapting to the needs of the company, while providing a compelling narrative on using past experiences to build future strategies. In a dynamic conversation, Todd and Rob discuss the ever-changing landscape of work and the complexities organizations face due to technological advancements, as well as the human elements that impact safety and resilience. They emphasize the importance of keeping dialogues open, inviting new ideas, and making space for the next generation to lead the way. Listen in for practical takeaways and thought-provoking insights into building organizational resilience and the human factors that drive success. A conversation not to be missed for anyone looking to enhance their leadership capabilities and embrace the inevitable evolution of work.

Welcome to the Pre-Accident Investigation Podcast hosted by Todd Conklin, featuring an engaging conversation with Bob Edwards from the Community of Human and Organizational Learning. In this episode, Todd and Bob dive into the significance of operational learning and how it is reshaping leadership responses within organizations. Discover how learning teams are providing valuable insights and driving improvements across various sectors, going beyond the realm of safety to address broader operational challenges.Listen as they discuss the importance of fostering a culture where reporting is appreciated, not feared, and explore the role of leaders in utilizing data gathered from learning teams for continuous improvement. Bob shares his experiences and insights on encouraging leaders to look for opportunities to say 'yes' rather than just identifying problems, fostering a collaborative environment that propels organizations forward.Join the conversation on redefining success, breaking away from traditional blame-oriented responses, and focusing on systemic improvements that benefit not just safety, but quality and productivity as well. Gain valuable perspectives on how to effectively engage leaders in the learning process and inspire them to make data-driven decisions that promote growth and innovation.

Join Todd Conklin in an engaging conversation with Shane Bush at the Pre-XMet Podcast, as they dive into Shane's unexpected Hall of Fame induction and the surprising gift of his own bobblehead. Throughout the episode, they explore the dynamics of safety conferences, focusing on the interaction between academia and practitioners. Shane shares insights into how historical discussions are being refreshed with new perspectives, emphasizing the significance of both fields in improving systems.The conversation also touches on the evolution of conference content, reflecting on past and present trends, while highlighting the role of academia in shaping the themes. Shane, known for his resilience work, discusses how safety measures evolve, often leading to unexpected outcomes. The hosts further explore ideas from renowned experts, updating concepts like just culture and shifting focus towards more dynamic monitoring and assurance in organizations.With humorous anecdotes and reflective moments, this episode offers a unique perspective on the future of safety and the importance of embracing both change and continuity in professional learning environments.

Officetoddconklin@gmail.com Join Todd Conklin on this episode of the Pre-Accident Investigation Podcast as he delves into a fascinating open Q&A session recorded during a conference in Santa Fe. Our expert panel, including Bob Edwards, Andrea Baker, and Martha Acosta, shares valuable insights into transforming skepticism into a driving force for change within workplace safety culture. Explore how leaders can foster curiosity, handle resistance, and leverage skepticism to drive meaningful discussions around safety and performance improvement. Whether dealing with management skepticism or the challenges of workforce accountability, this episode offers practical advice and strategies to enhance learning and engagement in your organization. Listen in as Todd and the panel navigate complex questions, providing a wealth of knowledge and experience on how to approach learning and change from a proactive standpoint. Discover how to shift from reactive to proactive strategies by addressing weak signals and enhancing resilience, all while honing your leadership and communication skills. Don't miss this opportunity to gain insights into fostering a culture of openness, safety, and continuous improvement in your organization.

Join host Todd Conklin on the Pre-Accident Investigating Extra podcast as he delves into the complexities of everyday life and work. In this episode, explore the philosophical musings of how each day of the week shapes our lives and dive into a lively discussion on turning uncertainties into opportunities. Todd shares his recent cooking experiment with papas rellenas, highlighting how creativity can emerge from chaos. The episode also features a captivating conversation with Sam Olliges, a young safety professional from Landmark Structures, who sheds light on the challenges and rewards of attracting and retaining skilled workers in the water tower construction industry. Discover the importance of micro experimentation, the art of making safety seamless, and how leadership can embark on a journey with their teams towards a safer future. Whether you're interested in innovative safety solutions, the intricacies of human behavior, or simply want to hear insightful discussions from industry professionals, this episode offers valuable perspectives for all listeners. Don't miss out on this engaging exploration of safety, creativity, and resilience!

In this compelling episode of the Pre-Exit Investigation Podcast, host Todd Conklin delves into a deeply personal story that challenges perspectives and ignites conversation around resilience and adaptation in organizations. Through the eyes of Hector, a familiar figure from a local restaurant, Todd explores the impact of fear and leadership response in today’s rapidly changing world.With insightful anecdotes, the episode brings to light the unseen pressures faced by individuals and the significant role leaders play in shaping organizational culture. As systems are pushed to their limits, Todd invites listeners to reflect on their own leadership choices and the type of world they want to help create. It's a thought-provoking episode that encourages deep reflection and meaningful dialogue.