Operational Postmortem
This page explains Operational Postmortem and its relevance to business operations.
D08 - Meeting Design Quality
Definition
A structured, facilitated review of an operational failure conducted within days of the incident, using a five-whys methodology to trace the root cause to a system or process gap and producing CARE format action items with a 30-day completion check.
An operational failure that is discussed but not structured produces a story, not a prevention plan.
The postmortem format, which includes timeline-first, interpretation-second, root-cause-third, and action-fourth, ensures that the same meeting that processes the failure also produces the system change that prevents recurrence.
Indicators
- You've had the same category of operational failure occur more than once.
- When something goes wrong, the first discussion is informal and primarily about what happened, not formally structured around what caused it and what changes will prevent it.
- No 30-day check has ever verified that action items from a failure discussion were completed.
Quick Win
- Think of your last operational failure.
- Write down the timeline of facts only — no interpretation, no attribution of cause or blame in this step.
- Causes come in the next conversation.
Comments ()