Lessons Learned

Root Cause Analysis

Integrated Safety Management TSP

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Any organization that is committed to continuous improvement in its performance must have a lessons learned program as a principal component in its management programs.  Since lessons learned can be applied to every type of organization with a large variety of missions, the methods used to instill lessons learned as part of the culture must vary as do the mechanisms for identifying, sharing, and using the information.  The complexity of the organization and the nature of the work are the main factors that establish the cultural and infrastructure support characteristics of a program.

Cultural methods can include setting expectations, providing support and incentives, monitoring and feedback, and continuous improvement.

Infrastructure methods include definition of resources, identification of processes, procedures by which personnel are supported to identify, share, and use lessons learned.  These methods represent the activity based aspects of a lessons learned program.

Effective lessons learned programs usually consist of two identifiable components.  These are:

  1. A developmental process that includes identification, documentation, validation, and dissemination of a lesson learned.
  2. A process to utilize and distribute lessons learned to appropriate staff, the identification of action that will be taken as a result of a review of the lesson learned, and a mechanism for follow-up to ensure that appropriate action was taken that successfully addresses the issue.

As part of an overall effectiveness improvement cycle, a lessons learned program should mesh with other programs to measure operational performance such as a strong system of performance indicators.  

What is OAC's Role?

OAC provides support in all phases of a lessons learned program starting with initial development and continuing through assessments and enhancements of existing programs.

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