

PreAccident Investigation Podcast
Todd Conklin
The Pre Accident Podcast is an ongoing safety podcast conversation of Human Performance, Systems Safety, & Safety Culture.
Episodes
Mentioned books

Oct 18, 2025 • 45min
PAPod 568 - PART ONE: Charged for a Mistake: The Nurse, the Error, and a System That Failed
RaDonda Vaught, a registered nurse at Vanderbilt, shares her harrowing experience of a medication error that led to criminal charges. She delves into systemic issues surrounding a new EHR rollout and urgent workarounds that contributed to the tragedy. RaDonda recounts the pressure of a time-sensitive request and how distractions at the dispensing cabinet led to a misadministration of a paralytic instead of the intended medication. This candid reflection highlights the complexity of healthcare systems and sparks critical conversations about patient safety.

Oct 11, 2025 • 51min
PAPod 567 - Open Questions 2025: From Metrics to Monitors — Rethinking Safety
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.

Oct 4, 2025 • 23min
PAPod 566 - Blame Stops Improvement: How Blame Silences Learning
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.

Sep 27, 2025 • 29min
PAPod 565 - Fear, FOMO & Fixing Safety: A Conversation with Brent Sutton
Brent Sutton, a safety and organizational resilience expert, joins Todd Conklin to explore the future of safety thinking. They discuss the decline of lean and TQM, how commodification stifles innovation, and the vital role of weak signals in fostering resilience. The conversation takes a lighthearted turn with breakfast burritos and debates over cheese, but the core message emphasizes the need for small, 'safe-to-fail' experiments and leaders' responsibility to navigate workplace complexities. Staying curious about evolving safety practices is key to preventing stagnation.

Sep 20, 2025 • 24min
PAPod 564 - Inside Meow Wolf: A Radical Conversation on Safety & Leadership
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.

6 snips
Sep 13, 2025 • 47min
PAPood 563 - Human Performance, Not Human Error — Todd Conklin on Reframing Safety
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.

15 snips
Sep 6, 2025 • 25min
PAPod 562 - When 'I Forgot' Becomes Fatal: Preventing Children Left in Hot Cars
The discussion tackles the alarming issue of children left in hot cars, emphasizing that such failures are often unintentional. It encourages a cultural shift towards understanding and implementing preventative measures, like technology and visual reminders. Strategies to foster safety awareness replace blame, prioritizing system-level changes. Additionally, there's a look at generational differences in workplace ghosting and the evolving challenges employers face in hiring, spotlighting the need for mutual understanding in the workplace dynamics.

Aug 30, 2025 • 29min
PAPod 561 - High Reliability in Action — Turning Surprises into Safer Outcomes
Lauren Mooney, author of 'High Reliability in Action,' joins the discussion to unveil how High Reliability Organizing (HRO) concepts can be practically applied. She shares her unique 'Speaking In' approach and introduces nine guiding questions for fostering safety. The conversation humorously dives into animal avatars, highlighting traits like humility and curiosity that can transform teamwork across industries. Mooney emphasizes leadership's pivotal role in creating a safety culture and adapting to challenges, especially in high-stakes environments like healthcare.

6 snips
Aug 23, 2025 • 1h
PAPOd 560 - When Hospitals Criminalize Error: A Patient Safety Reckoning
Lisa Zegan, a seasoned patient safety leader and former emergency room nurse, dives deep into the tragic 2017 Vanderbilt medication error. She emphasizes the dangers of criminalizing mistakes, arguing it stifles learning in healthcare. Zegan critiques how design flaws and billing pressures contribute to medical errors, advocating for a cultural shift towards transparency and systemic reforms. The conversation also touches on the fallacy of 'zero harm' and the crucial need for collaboration across hospitals to enhance patient safety. Zegan's insights shine a light on how we can transform healthcare for the better.

Aug 16, 2025 • 31min
PAPod 559 - Exploring the Evolution of Safety Leadership with Tom Krause
In a dynamic discussion, Tom Krause, founder of Behavioral Science Technology and a pioneer in behavioral-based safety, shares insights on the evolution of safety leadership. He emphasizes how leadership decisions directly shape workplace safety culture and outcomes. The conversation touches on the relevance of W. Edwards Deming's principles and critiques traditional safety models. They explore the crucial link between leadership and organizational culture, alongside the exciting yet risky intersection of AI and safety practices. Krause's transformative ideas illuminate the future of safety leadership.