Massive Failure What Disasters Can Teach Us About Experience Design 7 th Society and Information Technologies Encounter November 13, 2006 Santiago, Chile

Rounding error

Rounding error

Rounding error or Programmer error?

Rounding error

or

Programmer error?

Rounding error or Programmer error or System failure?

Rounding error

or

Programmer error

or

System failure?

Why disasters? Reveal real-world complexity Defy our expectations about accountability and corrective action Cascade of ordinary failures Attract small-problem solutions Blame and shame

Reveal real-world complexity

Defy our expectations about accountability and corrective action

Cascade of ordinary failures

Attract small-problem solutions

Blame and shame

Management 101

What is a system? Collection of “stuff” Dynamic, complex, interdependent relationships Can't be decomposed into linear processes Can't be separated from the environment or context in which they occur Small changes  big effects

Collection of “stuff”

Dynamic, complex, interdependent relationships

Can't be decomposed into linear processes

Can't be separated from the environment or context in which they occur

Small changes  big effects

What are systems? Economies Ecosystems Organizations Markets Projects Social Networks

Economies

Ecosystems

Organizations

Markets

Projects

Social Networks

Do Systems Matter? GM closes plant in Fremont, California (1982) Worst quality record Worst labour relations Highest employee absenteeism and drug use Toyota opens Fremont plant in 1984 Hires 80% of GM’s workforce Outstanding quality record

GM closes plant in Fremont, California (1982)

Worst quality record

Worst labour relations

Highest employee absenteeism and drug use

Toyota opens Fremont plant in 1984

Hires 80% of GM’s workforce

Outstanding quality record

Relevance to Experience Design Web is an ecosystem Systems within the web eBay Blogosphere Digg, Flickr, MySpace Cross-channel experiences

Web is an ecosystem

Systems within the web

eBay

Blogosphere

Digg, Flickr, MySpace

Cross-channel experiences

Value-Centered Design

Lessons Learned Cascade of ordinary failures Complex accountability Real-world tests

Cascade of ordinary failures

Complex accountability

Real-world tests

All Dead

“ Good-to-great transformations do not happen overnight or in one big leap. Rather, the process resembles relentlessly pushing a giant, heavy flywheel in one direction.”

“ Good-to-great transformations do not happen overnight or in one big leap. Rather, the process resembles relentlessly pushing a giant, heavy flywheel in one direction.”

Lessons Learned Real-world tests Complex accountability Big problems have shared ownership Assumed safety nets can vanish easily Small changes  Big impact The Flywheel Effect

Real-world tests

Complex accountability

Big problems have shared ownership

Assumed safety nets can vanish easily

Small changes  Big impact

The Flywheel Effect

http://www.boeing.com/commercial/safety/pf/pf_accident_rate_history_cht.html

Eastern Flight 401

NASA Research (1979) Primary cause of most aviation accidents: Leadership Decision-making Interpersonal communication Led to teamwork training for flight crews Reporting of near misses

Primary cause of most aviation accidents:

Leadership

Decision-making

Interpersonal communication

Led to teamwork training for flight crews

Reporting of near misses

Successful Systems Transparency Quality over authority Shared ownership No goats (and few heroes) Team training Real-world tests

Transparency

Quality over authority

Shared ownership

No goats (and few heroes)

Team training

Real-world tests

Bringing Systems Thinking to Experience Design Context, context, context Ignore boundaries Create simple models of systems Actors, objects, policies What influences what? What/where are the incentives? Are there leverage points? Feedback loops? Experiment, experiment, experiment

Context, context, context

Ignore boundaries

Create simple models of systems

Actors, objects, policies

What influences what?

What/where are the incentives?

Are there leverage points? Feedback loops?

Experiment, experiment, experiment

“ Screw around vigorously” - Tom Peters

Questions? Email: [email_address] URL: http://atomiq.org/etc/massive_failure_chile_2006.pdf