What Don’tcha Want?

Process thinking starts with the basic idea of cause and effect. Every outcome has a cause, and process thinking breaks the cause down into manageable bite-sized pieces fit for consumption. Every process falls into one of three categories:

Processes with outcomes we want
Processes with outcomes we don’t want
Processes with outcomes that we currently don’t know or don’t really care about.

We won’t spend any time with category 3 in this post, because (as defined), it’s about things we don’t know or don’t care about so why waste time on them.

Category 1 (processes with outcomes we want)

These are commonly used for process improvements. They help us get what we want, and people are generally more engaged when the topic is improving how to get something they want. Common improvement actions include changing the process, removing barriers, and eliminating waste. A generic visualization is provided below:

We start by identifying the outcome we want (yellow happy face) and how it currently happens (process Steps A to D). We then take improvement actions and end up with a future process that’s better than what we started with. It could be a little better or a lot better, but we’ll definitely have an improved understanding of what we do (process) and why we’re doing it (outcome) which will help us continue to improve.

Category 2 (processes with outcomes we don’t want)

Now, based on the title, the focus of this post is about what we don’t want (Category 2 processes) so let’s get to it. Mapping processes that lead to what we don’t want is very similar to mapping process for what we want. The biggest differences are the actions taken to prevent the outcome or failure. For Category 1 processes we want to make the process flow as easy as possible to get the outcome we want. For Category 2 processes, we want to throw up barriers and wreck the process as much as possible to prevent the critical conditions required to produce the unwanted outcome. See the visualization below:

The Failure Conditions map shows the processes that results in generic failure conditions (yellow shapes) which allow what we don’t want to happen (red sad face). The actions to prevent failure are:

Decrease severity – Take actions that will make the failure less of a concern
Decrease probability – Take actions to reduce the likelihood of any of the failure steps occurring.
Increase detectability – Take actions improve the chances that any failure or failure step will be recognized if they happen.
Increase avoidability – Take actions to improve our ability to avoid the negative consequences of failures step if unable to prevent.

The Mitigated Conditions map shows successful mitigation actions with reduced probability of Condition 1 and 2, and 100% detectability and 100% containment at Step 3B. This will prevent Condition 3 from occurring and subsequently eliminates the possibility of failure. In practice, if the failure severity is still significant, it would still be important to continue taking actions to reduce failure condition risks because eliminating Condition 3 depends on the new detection and containment processes not failing. All of these dependencies makes practical risk management a tricky business. Also, the risk elimination is theoretical, based only on what we know, and reality is great at showing us new things we didn’t know, sometimes in very unpleasant ways.

For a specific failure map example, we can look at the fire triangle. It’s commonly used when work is required in a potentially explosive environment, where preventing a fire is absolutely critical. The fire triangle defines the three conditions required to have a fire and eliminating any one of them will prevent a fire. The conditions are:

Fuel (something to burn)
1. Mitigate by removing all potential fuel from the work area, e.g., chemical / gas containers, paper, wood, dust. Some fuel may not be feasible to remove due to the environment or urgency, e.g., forest work, emergency containment or repair work in chemical plant. In those cases, we get rid of what we can and try to keep what we can’t away from heat and oxygen.
Heat (something to ignite the fuel)
1. Mitigate by removing all sources of heat or sparks. Some common actions include using air-powered tools instead of electrical, grounding all metal to prevent static, using non-sparking-brass tools, wetting any cutting or drilling surfaces to reduce heat, avoiding the use of halogen lamps.
Oxygen (allows a fire to burn)
1. Oxygen is usually the most difficult fire condition to fully remove from a work space, and trying to do so can understandably upset the people trying to work. Having oxygen around is difficult to control, but not impossible, e.g., working underwater with SCUBA gear or use of robots in oxygen-free environments.

The process of mapping failure conditions and then trying to wreck the process can be applied to anything we don’t want to happen. The fire triangle is a relatively simple example, but it can be used on much more complicated failures as well. I told myself to map the first problem I saw on the news while writing this to provide a more complicated example, and the news of the day is… mass shootings, so here it goes:

Mass Shootings Failure Conditions Mapping Example

Disclaimer: This failure map example is a high-level breakdown of a generic mass shooting event and not officially vetted as part of any formal long-term-heavily-funded study. We will not be reviewing severity, probability, detectability, and avoidability because those are case specific evaluations. The map is intended to demonstrate how a simple picture of a complicated problem can be used to help align understanding, discussion, and ideas around what leads to mass shootings and how to prevent them.

The first step in developing the above map was to clarify the four (4) conditions (highlighted in yellow) which all need to be met to produce a mass shooting event (highlighted in red):

Shooter with intent to harm
Mass shooting weapon accessible to the shooter
Ammo for weapon accessible to the shooter
Victim(s) accessible to the shooter

Now, let’s walk through each failure condition process.

Shooter Path

This is the primary failure condition, and it’s a challenge to manage because every individual has different wants, different situations, and they constantly change. It’s unlikely that a mass shooting will give the shooter what they really wanted, so it’s a horrific lose-lose situation unless the potential shooter can follow a different path. It’s important to have a system that gives people options, and those options need to be easier to pursue than the shooter path.

(1A) [Want not satisfied / threatened]

It starts with something that a person wants. It could be something they don’t currently have or something they have but feel they may lose. This is the trigger step, and it’s happening all the time, but it usually doesn’t reach the failure condition. Some of the more common triggers include food, freedom, fairness, relationships, and respect, but it really could be anything.

(1B) [Identify options to achieve / protect want?]

If the person can see options to get what they want, then the process can break here, which it should do most of the time. If the person can’t see their options or the options they know feel out of reach, then the process continues.

(1C) [Seek help?]

If the person isn’t sure what they can do on their own, knowing how to seek help and being comfortable doing it will also help prevent the failure. It’s important to have individual and organized support systems easily accessible. Friends, family, charities, government services, and religious affiliation are all potential support systems.

(1D) [Express feelings peacefully?]

At this point in the process, a person’s feelings of frustration, anger, and despair are escalated and having non-violent methods of letting the world know about them can help break the process and attract help. Some examples include protesting, ranting, writing angry song lyrics.

(1E) [Prioritize want]

This is a critical step where the person decides just how important what they want really is. Is it more important than things like friends, family, respect, freedom, life? How much are they willing to give up pursuing it. This prioritization step will normally lead to the conclusion that one want isn’t worth losing everything else for, but unfortunately, this step can be bypassed if the person is not rationalizing normally. Some potential causes for this step to be bypassed include mental illness, addiction, obsession, being under the influence, or being caught up in the heat of the moment. If what they want is prioritized over freedom, people, and life, then harming oneself or others now becomes a real risk.

(1F) [Justify violence]

Prioritizing a want over all others makes it possible for a person to do harm. Justifying violence requires a decision that causing harm is the right thing to do. This decision can come from a place of anger, frustration, or no longer recognizing the value of life. The target of a person’s harm could be themselves, specific individuals, groups, or the universe itself. If the person is exposed to others who reinforce their existing anger, frustrations, or reasoning, and do not discourage violence then the chance of meeting this failure condition goes way up. The “heat of the moment” is a special situation worth mentioning when something triggers a person to immediately justify violence when they probably would not have if given a chance to take a step back.

(1G) [Acquire weapon]

At this step, a person has turned thoughts into tangible actions by physically getting the tools they need become a potential shooter.

(1H) [Acquire ammo]

This is the last step before the Shooter with intent to harm condition is met, and the last chance for a person to revisit previous steps and still potentially break the process. Weapons and ammo acquisition processes that require more time and effort provide more opportunities for a person to reconsider their chosen path.

** 1. Shooter with intent to harm **

Once a person has justified violence, acquired a weapon with ammunition, then the failure condition has been met and a potential shooter with intent to harm has been produced.

Weapon Path

A person can’t become a shooter without a weapon, and a weapon is just a tool, which makes this a simple flow ending with the weapon being accessible to the potential shooter. In some cases, potential shooters may already have possession of a mass shooting capable weapon, which means there will be no opportunity to break the process to the second failure condition. Also, having possession of a weapon means process step 1G [Acquire weapon (+ Ammo)] is bypassed, which increases the severity of heat-of-the-moment justification of violence, which can turn what might have been a fist fight into a mass shooting.

(2A) Mass shooting weapon designed

This process starts with the idea for a weapon.

(2B) [Produce weapon]

This step brings the weapon into existence, which should happen though legal manufacturing processes, but illegal manufacturing can just as easily complete this step.

(2C) [Advertise weapon]

This step relates lets the potential shooter know about the weapon. Information about weapons is readily accessible by the public and not hard to find if searching.

(2D) [Make weapon available]

This step means the weapon has been released by the manufacturer, and ready to be sold directly or through a vendor.

** 2. Mass shooting weapon accessible **

Once the weapon is in a place to be acquired by the potential shooter, the failure condition is met. This could be a store, a gun show, an unsecured residence, black market, or already owned by the potential shooter.

Ammo Path

The ammo process is very similar to the weapon process but are separate because each process has different opportunities available and controlling either of them would prevent the mass shooting failure.

(3A) Ammo required to use weapon

The need for appropriate ammo for the weapon starts this process.

(3B) [Produce ammo]

This step brings the ammo into existence, which should happen though legal manufacturing processes, but illegal manufacturing can just as easily complete this step.

(3C) [Make ammo available]

This step means the ammo has been released by the manufacturer, and ready to be sold directly or through a vendor.

** 3. Mass shooting weapon accessible **

Once the ammo is in a place to be acquired by the potential shooter, the failure condition is met.

Victim Path

As unsettling as it is to say, everyone is a potential victim, so mitigating the victim process isn’t easy. People can’t be expected to live in constant fear and paranoia their whole lives because that would be a really big impact to quality of life and wouldn’t help that much to reduce the risk of a shooting. Potential victims would only be able to take specific precautions there were indications of a shooting risk that they were aware of. Something we can all do, as potential victims, is try and be more mindful and respectful of others which could help break-up shooter processes without us even knowing about it.

(4A) Person living life

People are generally not living their life preparing for a mass shooting, so this process starts with people doing whatever they normally do.

(4B) [Aware of imminent threat / risk?]

If aware of a mass shooting threat, the potential victim has an opportunity to avoid high risk venues and take precautions until the threat has passed. It would also be nice if they made other people aware so they too can take precautions and possibly stop the potential shooter.

Victim(s) accessible

This failure condition will be met without the victim’s knowledge because they have very little say when it comes to the shooter’s choice of location.

With a basic mass shooting failure map available, the next step would be to have key stakeholders review it, refine it, and agree on it. Then, the key stakeholders will have to agree that the process is one they want to break because without that high-level alignment, any “solutions” proposed will have limited practical effectiveness. Even if there’s no agreement on trying to break everything, only one of the four conditions needs to be removed from the equation to prevent a mass shooting: shooter, weapon, ammo, or victim(s).

I won’t be getting into the solutioning process for this example because I don’t have the right stakeholders with me right now to truly understand the process. If I did, they would see me typing in my underwear drinking a Red Bull. However, I think there’s value in recommending a simple cost-free action that everyone can do that could help, and that is to do at least one explicitly nice thing for someone each day. 6 billion little thoughtful gestures every day like holding a door, helping someone free a stuck shopping cart, lending an ear, or giving a compliment could save lives, and not just by affecting the shooter path, but by reminding people of the good in this world that they may occasionally lose sight of.

Respect and empathy for others is a recurring factor in preventing all sorts of things we don’t want to happen, not just for this example, which is why I’m putting it out there.

I hope everyone can see some value with having a process map available for people to look at and be on the same page both figuratively and literally.

Thanks.